康柏西普联合577nm微脉冲激光治疗糖尿病性黄斑水肿临床观察

Clinical effect of Conbercept intravitreal injection combined with 577nm micro-pulse laser on the treatment of diabetic macular edema

目的:探讨玻璃体腔内注射康柏西普联合577nm微脉冲激光治疗糖尿病性黄斑水肿(diabetic macular edema,DME)的临床疗效。方法:回顾性研究。选取2014-06/12在宝鸡市人民医院眼科经眼底检查、眼底荧光素血管造影(fluorescein fundus angiography,FFA)及光学相干断层扫描(optical coherence tomography,OCT)检查确诊的DME患者64例64眼,按所采用治疗方法不同分为试验组和对照组各32例。试验组给予玻璃体腔内注射康柏西普联合577nm微脉冲激光治疗;对照组给予577nm微脉冲激光治疗,对比分析两组患者治疗前后最佳矫正视力(best corrected visual acuity,BCVA)和黄斑中心厚度(central macular thickness,CMT)的变化。结果:对两组患者BCVA和CMT分别采用两因素重复测量方差分析结果表明,两组BCVA和CMT在组间的处理效应与时间效应的交互作用均有明显统计学意义(F=46.92,P<0.01;F=60.231,P<0.01),处理主效应也均有明显统计学意义(F=12.16,P<0.01;F=8.983,P<0.01),两种治疗方法的疗效有明显的差异,试验组的BCVA和CMT指标优于对照组。时间主效应有明显统计学意义(F=116.14,P<0.01;F=397.376,P<0.01),BCVA均数随治疗时间延长而增加,CMT均数随治疗时间延长而减少。结论:玻璃体腔内注射康柏西普联合577nm微脉冲激光在治疗DME上,减轻黄斑水肿、提高患者视力方面效果更优于单纯微脉冲光凝治疗。

AIM：To investigate the clinical effect of Conbercept intravitreal injection combined with 577 nm micro-pulse laser on the treatment of diabetic macular edema（DME）.METHODS：From June to December in 2014,after the diagnosis was confirmed by fundus examination,fundus fluorescein angiography（FFA） and optical coherence tomography（OCT）,64 patients（64 eyes） from department of ophthalmology in Baoji Peoples Hospital with DME were randomly divided into experiment group（32 cases） and control group（32 cases）.The experiment group received 577 nm micro-pulse laser combined with intravitreal injection of Conbercept.The control group was treated with 577 nm micro-pulse laser.The best corrected visual acuity（BCVA） and central macular thickness（CMT） of two groups before and after treatments were compared.RESULTS：The ANOVA for two-way repeated measures was used to analyze the data of BCVA and CMT between two groups.The results showed that the interaction between treatment effects and time effects in BCVA and CMT was significant（F=46.92,P〈0.01;F=60.231,P〈0.01）,the main effect of the treatment were significant（F=12.16,P〈0.01;F= 8.983,P〈0.01）.There was significant difference on the effect between the two treatments,BCVA and CMT of experiment group were better than those of control group.The main time effect was statistically significant（F=116.14,P〈0.01;F=397.376,P〈0.01）.The BCVA means increased with the treatment time,but the CMT means decreased.CONCLUSION：Intravitreal injection of Conbercept combined with 577 nm micropulse laser on the treatment of DME was much better on reducing macular edema and improving visual acuity than the micro- pulse treatment.