康柏西普联合全视网膜激光光凝术治疗增殖性糖尿病视网膜病变的疗效及对血清VEGF及PEDF水平的影响  

Effect of Conbercept combined with panretinal photocoagulation in the treatment of proliferative diabetic retinopathy and its influence on serum vascular endothelial growth factor and pigment endothelial growth factor levels

作　　者：刘政国 王艳婷 高静 关建宁 段玲红 LIU Zheng-guo;WANG Yan-ting;GAO Jing;GUAN Jian-ning;DUAN Ling-hong(Department of Ophthalmology,Luoyang Yanshi People's Hospital,Luoyang 471900,Henan,CHINA;Department of Ophthalmology,Henan Provincial People's Hospital,Zhengzhou 450000,Henan,CHINA)

机构地区：[1]洛阳市偃师人民医院眼科,河南洛阳471900 [2]河南省人民医院眼科,河南郑州450000

出　　处：《海南医学》2024年第20期2960-2964,共5页Hainan Medical Journal

基　　金：河南省洛阳市科技发展计划项目(编号:2022029Y)。

摘　　要：目的研究康柏西普联合全视网膜激光光凝术(PRP)治疗增殖性糖尿病视网膜病变(PDR)的疗效及对患者血清血管内皮生长因子(VEGF)、色素内皮生长因子(PEDF)水平的影响。方法选择2022年2月至2023年12月洛阳市偃师人民医院收治的78例PDR患者作为研究对象,依据随机数表法将患者分为对照组和观察组各39例。对照组患者采用PRP治疗,观察组患者基于对照组治疗基础上联合康柏西普治疗,两组患者均在治疗后随访3个月并回院复查。比较两组患者的临床疗效,以及治疗前和随访3个月后的最佳矫正视力、黄斑中心凹厚度和血清VEGF及PEDF水平;同时比较两组患者的激光治疗情况(光斑数量、激光能量、激光次数)及并发症发生情况。结果观察组患者的治疗总有效率为97.44%,明显高于对照组的82.05%,差异有统计学意义(P<0.05);随访3个月后,两组患者的最佳矫正视力均提高,黄斑中心凹厚度均缩小,且观察组患者的最佳矫正视力为0.46±0.05,明显高于对照组的0.40±0.04,黄斑中心凹厚度为(243.09±30.26)μm,明显低于对照组的(278.93±34.11)μm,差异均有统计学意义(P<0.05);治疗后,两组患者的VEGF水平均降低,PEDF水平均上升,且观察组患者的血清VEGF水平为(124.53±14.93)μg/L,明显低于对照组的(178.06±20.01)μg/L,血清PEDF水平为(83.47±10.55)μg/L,明显高于对照组的(75.64±8.93)μg/L,差异均有统计学意义(P<0.05);治疗后观察组患者的光斑数量、激光能量、激光次数均少于对照组,差异均有统计学意义(P<0.05);观察组患者的并发症发生率为7.69%,略高于对照组的5.13%,但差异无统计学意义(P>0.05)。结论康柏西普联合PRP能够显著改善患者术后视力,缩小黄斑中心凹厚度,降低血清VEGF水平,促进PEDF的表达,并减少PRP治疗所需激光次数和能量,安全性高。Objective To study the efficacy of Conbercept combined with panretinal photocoagulation(PRP)in the treatment of proliferative diabetic retinopathy(PDR)and its effect on the levels of serum vascular endothelialgrowth factor(VEGF)and pigment endothelial growth factor(PEDF).Methods A total of 78 PDR patients admitted toLuoyang Yanshi People's Hospital from February 2022 to December 2023 were selected and divided into a control groupand an observation group according to random number table method,with 39 patients in each group.Patients in the controlgroup were treated with PRP,and those in the observation group were treated with Conbercept combined with PRP.Both groups of patients were followed up for 3 months after treatment and returned to the hospital for reexamination.The clinical efficacy after 3-month follow-up,as well as the best corrected visual acuity,thickness of macular fovea,serumVEGF,and PEDF levels before treatment and after 3-month follow-up were compared between the two groups.Thelaser treatment situation(number of spots,laser energy,laser frequency)and complications were compared between thetwo groups.Results The total effective rate of the observation group was 97.44%,which was significantly higher than82.05%of the control group(P<0.05).After treatment,the best corrected visual acuity was improved and the thicknessof macular fovea was reduced in both groups;the best corrected visual acuity in the observation group was 0.46±0.05,which was significantly higher than 0.40±0.04 in the control group,and the thickness of macular fovea in the observation group was(243.09±30.26)μm,which was significantly lower than(278.93±34.11)μm of control group;the differenceswere statistically significant(P<0.05).After treatment,the levels of VEGF and PEDF in both groups decreased and increased;the serum VEGF level in the observation group was(124.53±14.93)μg/L,which was significantly lower than(178.06±20.01)μg/L in the control group;the serum PEDF level in the observation group was(83.47±10.55)μg/L,which was

关 键 词：增殖性糖尿病视网膜病变 血管内皮生长因子 色素内皮生长因子 康柏西普 全视网膜激光光凝术 疗效 

分 类 号：R587.2[医药卫生—内分泌]