康柏西普与雷珠单抗联合577nm微脉冲激光在糖尿病黄斑水肿治疗中的疗效差异

Difference in clinical efficacy of conbercept or ranibizumab combined with 577nm micropulse laser on diabetic macular edema

目的:探讨康柏西普与雷珠单抗玻璃体腔注射联合577 nm微脉冲激光治疗糖尿病黄斑水肿(DME)的疗效差异。方法:选取我院确诊的DME患者164例(164眼)为研究对象,采用2×2析因设计将入选患者随机分为康柏西普联合治疗组(接受康柏西普玻璃体腔注射联合577 nm微脉冲激光治疗),雷珠单抗联合治疗组(接受雷珠单抗玻璃体腔注射联合577 nm微脉冲激光治疗),康柏西普药物治疗组(仅接受康柏西普玻璃体腔注射治疗),雷珠单抗药物治疗组(仅接受雷珠单抗玻璃体腔注射治疗),每组41例(41眼)。治疗后随访6个月,对比分析4组患眼治疗后最佳矫正视力(BCVA)、黄斑中心凹视网膜厚度(CMT)、黄斑体积(TMV)及玻璃体腔注射次数。结果:4组患眼治疗后BCVA均较治疗前升高,CMT、TMV较治疗前降低,治疗方式对BCVA、CMT、TMV及玻璃体腔注射次数的影响均具有统计学意义(P<0.05),抗VEGF药物因素对BCVA、CMT、TMV的影响无统计学意义(P>0.05),对玻璃体腔注射次数的影响有统计学意义(P<0.05),且治疗方式、抗VEGF药物对玻璃体腔注射次数存在交互作用,康柏西普联合577 nm微脉冲激光治疗的玻璃体腔注射次数最少。结论:康柏西普、雷珠单抗联合577 nm脉冲激光治疗DME的临床疗效相近,均能有效改善患眼的BCVA,减轻黄斑水肿程度,康柏西普与577 nm微脉冲激光联合能更有效地减少玻璃体腔注射次数。

Objective:To investigate difference in clinical efficacy of conbercept or ranibizumab combined with577 nm micropulse laser on diabetic macular edema(DME).Methods:A total of 164 patients(164 eyes)with DME diagnosed in our hospital were enrolled in the study.The patients were randomly divided into 4 groups according to the 2×2 factorial design,conbercept combined group(treated by conbercept intravitreal injection combined with 577 nm micropulse laser),ranibizumab combined group(treated by ranibizumab intravitreal injection combined with 577 nm micropulse laser),conbercept treatment group(treated by conbercept intravitreal injection),ranibizumab treatment group(treated by ranibizumab intravitreal injection),41 eyes in each group.The follow-up period after treatment was 6 months.The best corrected visual acuity(BCVA),central macular thickness(CMT),total macular volume(TMV)and number of intravitreal injections were compared between the 4 groups.Results:Compared with before treatment,the BCVA increased and CMT,TMV decreased in 4 groups after treatment.The effect of treatment on the BCVA,CMT,TMV and the times of intravitreal injections were statistically significant(P<0.05).There was no statistically significant difference in the effects of anti-VEGF on BCVA,TMV,CMT after treatment(P>0.05).The effect of anti-VEGF on intravitreal injections was statistically significant(P<0.05).Treatment and anti-VEGF had interacted effect on intravitreal injections,and the times of intravitreal injections in conbercept combined with 577 nm micropulse laser was the least.Conclusion:Conbercept and ranibizumab intravitreal injection combined with 577 nm micropulse laser have similar effects on improving BCVA and reducing macular edema in patients with DME.Conbercept combined with 577 nm micropulse laser can more effectively in reduce the times of intravitreal injections.