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玻璃体腔内注射康柏西普联合激光光凝对糖尿病性黄斑水肿患者疗效及预后的影响观察

作者:宋 锐 郭 飞 王 健

所属单位:河南省漯河市第三人民医院眼科 (河南 漯河 462000)

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摘要

目的 观察玻璃体腔内注射康柏西普联合激光光凝对糖尿病性黄斑水肿(DME)患者疗效及预后的影响。方法 回顾性 分析2015年1月-2017年1月我院97例(97眼)DME患者临床资料,根据其治疗方案分为康柏西普+激光光凝组(研究组, n=54)和激光光凝组(对照组,n=43)。于治疗前(T1)及治疗1、2、3个月(T2、T3、T4)时检测治疗情况[最佳矫正视 力(BCVA)、黄斑中心厚度(CMT)],观察不良反应情况。结果 T1-T4时,组间效应、时间点效应及组间与时间点交 互效应均有显著统计学意义(P均<0.05);2组组内BCVA随时间推移而增加,且研究组T2-T4时均大于对照组(P均 <0.05);2组组内CMT随时间推移而减小,且研究组T2~T4时均小于对照组(P均<0.05);2组不良反应发生率比较 差异无统计学意义(P>0.05)。结论 玻璃体腔内注射康柏西普联合激光光凝可有效改善DME患者视力和黄斑水肿症 状,安全性良好,于患者疾病恢复有利。

Objective To observe the therapeutic effect of laser photocoagulation combined with intravitreal injection of conbercept on diabetic macular edema (DME) and its influence on prognosis. Methods The clinical data of 97 DME patients (97 eyes) treated in our hospital from January 2016 to January 2017 were retrospectively analyzed. All the patients were divided into conbercept plus laser photocoagulation group (study group, n=54) and laser photocoagulation group (control group, n=43) according to their treatment plans. The treatment conditions [best corrected visual acuity (BCVA) and central macular thickness (CMT)] were detected before treatment (T1) and 1, 2, 3 months (T2, T3, T4) after treatment, and the adverse reactions in the two groups were also observed. Results From T1 to T4, the differences in the intergroup effect, time point effect and interaction effect were statistically significant(P<0.05), the BCVA levels in the two groups were increased over time, and the BCVA levels in the study group were all higher than those in the control group from T2 to T4 (P <0.05), the CMT levels in the two groups were decreased over time, and the CMT levels in the study group were all less than those in the control group from T2 to T4 (P<0.05); there was no significant difference in adverse reactions between the two groups (P>0.05). Conclusion Intravitreal injection of conbercept combined with laser photocoagulation which is safe and effective, can effectively improve the visual acuity and macular edema symptoms in DME patients, and it is also beneficial to the recovery of the patients' disease.

【关键词】玻璃体腔内注射;康柏西普;激光光凝;糖尿病性黄斑水肿;预后

【中图分类号】R587.1

【文献标识码】A

【DOI】10.3969/j.issn.1009-3257.2019.02.006

前言

糖尿病(DM)是一组因胰岛素绝对或相对分泌不足 以及靶组织细胞对胰岛素敏感性降低引起蛋白质、脂 肪和电解质等一系列代谢紊乱综合征。约95%患者为2 型糖尿病(T2DM),易并发视网膜病变,表现为DM黄斑 水肿(DME),损害患者视力[1]。激光光凝在视网膜疾 病治疗中应用广泛,疗效显著。随着研究的深入,部 分学者发现,康柏西普等抗血管内皮生长因子(VEGF)类药物可通过抑制新生血管生长治疗DME,效果良好 安全性良好[2]。对此,本研究观察康柏西普联合激光 光凝在DME中的应用情况,现报告如下。