抗血管内皮生长因子药物联合激光光凝治疗糖尿病性黄斑水肿临床观察被引量：20

Clinical Study of Anti-VEGF Plus Photocoagulation for Treating Diabetic Macular Edema

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摘要目的:回顾分析对糖尿病性黄斑水肿(DME)患者进行激光治疗或者联合抗血管内皮生长因子药物(雷珠单抗或康柏西普)治疗的临床效果。方法:收集整理并分析2012年11月-2015年11月间我院经眼底荧光素血管造影(FFA)和光学相干断层扫描技术(OCT)检查确诊为糖尿病性视网膜病变(DR)继发DME患者72例102眼的病历及随访资料。其中重度非增殖性DR(NPDR)56眼,增殖早期46眼。按照治疗方法分:A组,单纯光凝组[49眼,全视网膜光凝术(PRP)在1月内分次完成];B组,联合治疗组[53眼,先玻璃体内注射抗血管内皮生长因子(VEGF)药,3d后进行激光治疗,1月内完成PRP]。观察两组治疗前和治疗后6个月的最佳矫正视力(BCVA)、黄斑中心凹视网膜厚度(CMT)的改变,并进行比较及统计学分析。结果:联合治疗组(B组)视力提高率为71.7%,显著高于A组(视力提高率44.9%),两组比较其差异有统计学意义(χ~2=8.05,P<0.05);黄斑中心凹厚度(CMT)改善情况B组优于A组(t=7.94,P<0.05)。结论:玻璃体腔注射抗VEGF药物能在短期内减轻血管渗漏及黄斑水肿从而提高视力,联合法治疗DME效果更好。 Objective：To retrospectively analyze clinical effect of laser therapy combined with or without anti-VEGF（Ranibizumab or Conbercept）on patients with diabetic macular edema（DME）.Methods：From November 2012 to November 2015,one hundred and two eyes of 72 patients with DME were enrolled in this study according to fundus fluorescein angiography（FFA）and optical coherence tomography（OCT）.The patients were assigned to the simple laser photocoagulation group A（49eyes）and the laser combination with anti-vascular endothelial growth factor（antiVEGF）therapy group B（53eyes）.The best corrected visual acuity（BCVA）and central macular thickness（CMT）were examined before and 6 months after photocoagulation.Results：The results indicated that visual acuity improved rate was 71.7%in group B and 44.9%in group A.Vision conditions and macular thickness in group B were better than those in group A with significant difference（χ~2=8.05,P〈0.05;t=7.94,P〈0.05）.Conclusion：Anti-VEGF reduced activeleakage and macular edema to improve the visual acuity in the short-term.Combined intravitreal anti-VEGF and PRP achieved better visual improvement than PRP alone in the treatment of DME.

作者奚翠萍范寒桂

机构地区武汉大学中南医院

出处《武汉大学学报（医学版）》 CAS 2017年第5期794-795,818,共3页 Medical Journal of Wuhan University

关键词糖尿病性黄斑水肿抗血管内皮生长因子激光光凝 Diabetic Macular Edema Anti-VEGF Photocagulation

分类号 R774.5 [医药卫生—眼科]

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参考文献2

1陈静,赖铭莹,罗恒,佘洁婷.抗VEGF药物联合激光光凝治疗糖尿病性黄斑水肿观察研究[J].中国实用眼科杂志,2014,32(6):693-697. 被引量：62
2李沭岩,刘莎莎,刘丽华,李婧.玻璃体内注射雷珠单抗联合视网膜光凝治疗糖尿病性黄斑水肿的临床疗效及安全性评价[J].吉林大学学报（医学版）,2015,41(3):643-647. 被引量：21

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