新型全视网膜激光光凝治疗对增生型糖尿病视网膜病变患者视网膜前膜相关因子的影响  

Effect of New Panretinal Laser Photocoagulation on Related Factors of Epiretinal Membrane in Patients with Proliferative Diabetic Retinopathy

作　　者：胡苹 王世龙 谭娟 代燕 李富元 HU Ping;WANG Shilong;TAN Juan;DAI Yan;LI Fuyuan(Department of Endocrinology,Linyi Central Hospital of Shandong Province,Linyi 276400,Shandong,China)

机构地区：[1]山东省临沂市中心医院内分泌科,山东临沂276400

出　　处：《糖尿病新世界》2024年第10期5-8,12,共5页Diabetes New World

基　　金：山东省临沂市重点研发计划书(医学类)(2022YX0019)。

摘　　要：目的探讨新型全视网膜激光光凝(panretinal laser photocoagulation,PRP)治疗对增生型糖尿病视网膜病变(proliferative diabetic retinopathy,PDR)患者视网膜前膜相关因子的影响。方法选取2021年12月—2023年11月山东省临沂市中心医院行PRP治疗的120例PDR患者为研究对象,按照手术方法不同分为对照组与研究组,各60例,分别施行常规PRP术与新型PRP术。对比两组治疗前后眼压(intra-ocular pressure,IOP)、视力、黄斑中心厚度(central macular thickness,CMT)变化,术后6个月血管内皮生长因子(vascular endothelial growth factor,VEGF)、环氧化酶-2(cyclooxygenase-2,COX-2)、CD34免疫组化的阳性区域积分、吸光度(inte-gral absorbance,IA)与微血管密度(micro vessel density,MVD)、临床有效率与并发症(新生血管性青光眼、玻璃体积血、视网膜出血、眼压高)发生情况。结果研究组治疗后IOP、CMT低于对照组,视力高于对照组,差异有统计学意义(P均<0.05)。研究组并发症发生率为5.00%(3/60),低于对照组的16.67%(10/60),差异有统计学意义(χ^(2)=4.227,P<0.05)。研究组术后随访6个月的VEGF、CD34与COX-2的IA值以及MVD数量均小于对照组,差异有统计学意义(P均<0.05)。研究组治疗总有效率为96.67%(58/60),高于对照组的86.67%(52/60),差异有统计学意义(χ^(2)=3.927,P<0.05)。结论新型PRP术的治疗效果更理想,可有效抑制VEGF、COX-2、CD34高表达,提高患者视力与治疗有效率,降低眼压与术后并发症发生率。Objective To investigate the effect of new panretinal laser photocoagulation(PRP)on the related factors of epiretinal membrane in patients with proliferative diabetic retinopathy(PDR).Methods A total of 120 patients with PDR who underwent PRP in Linyi Central Hospital of Shandong Province from December 2021 to November 2023 were selected as the research objects.They were divided into control group and study group by different surgical meth-ods,60 cases in each group,conventional PRP and new PRP were performed respectively.The changes of intraocular pressure(IOP),visual acuity and central macular thickness(CMT)before and after treatment were compared between the two groups.Vascular endothelial growth factor(VEGF),cyclooxygenase-2(COX-2),CD34 immunohistochemical positive area integral,integral absorbance(IA)and micro vessel density(MVD),clinical effective rate and complica-tions(neovascular glaucoma,vitreous hemorrhage,retinal hemorrhage,high intraocular pressure)were observed at 6 months after operation.Results After treatment,the IOP and CMT in the study group were lower than those in the con-trol group,and the visual acuity was higher than that in the control group,and the differences were statistically signifi-cant(all P<0.05).The incidence of complications in the study group was 5.00%(3/60),which was lower than 16.67%(10/60)in the control group,and the difference was statistically significant(χ^(2)=4.227,P<0.05).The IA values of VEGF,CD34 and COX-2 and the number of MVD in the study group were lower than those in the control group,and the differences were statistically significant(all P<0.05).The total effective rate of treatment in the study group was 96.67%(58/60),which was higher than 86.67%(52/60)in the control group,and the difference was statistically sig-nificant(χ^(2)=3.927,P<0.05).Conclusion The therapeutic effect of new PRP is more ideal,which can effectively in-hibit the high expression of VEGF,COX-2 and CD34,improve the visual acuity and treatment efficiency of patients,and reduce the incidence o

关 键 词：新型全视网膜激光光凝 增生型糖尿病视网膜病 视网膜前膜相关因子 

分 类 号：R587.2[医药卫生—内分泌] R774.1[医药卫生—内科学]