晚期糖基化终末产物对糖尿病黄斑水肿改良格栅样光凝效果的影响

Effect of advanced glycosylation end products on the modified-grid photocoagulation for diabetic macular edema

目的:研究晚期糖基化终末产物(advanced glycosylation end products,AGEs)对糖尿病黄斑水肿(diabetic macular edema,DME)改良格栅样光凝效果的影响。方法:收集正常眼底组30例、非增殖期糖尿病视网膜病(NPDR)并发DME组患者26例及增殖期糖尿病视网膜病(PDR)并发DME组患者27例,检测所有受试者血浆AGEs浓度、黄斑中心厚度(CMT)和最佳矫正视力(BCVA)。采用改良格栅样光凝法治疗DME,比较治疗前及治疗4周、8周后CMT及BCVA变化。结果:NPDR并发DME组及PDR并发DME组AGEs含量明显高于正常眼底组,PDR并发DME组AGEs含量明显高于NPDR并发DME组,差异均有统计学意义(P<0.05)。NPDR并发DME组经改良格栅光凝4周、8周后,CMT和BCVA均较激光治疗前明显好转(P<0.05)。PDR并发DME组经改良格栅光凝4周后,CMT和BCVA较激光前无明显变化(P>0.05);8周后CMT较治疗前明显下降(P<0.05),但BCVA无明显提高(P>0.05)。结论:AGEs含量与DME发生发展相关,AGEs大量形成影响DME激光光凝疗效。

Objective：To study the level and role of advanced glycosylation end products（AGEs）in the modified-macular grid photocoagulation for diabetic macular edema （DME ）.Methods：Normal control group （30 cases）,non-proliferative diabetic retinopathy（NPDR）with DME group （26 cases）and prolifera-tive diabetic retinopathy（PDR）with DME group （27 cases）were enrolled in this study.The level of AGEs,central macular thickness （CMT）and the best corrected visual acuity（BCVA）were examined in each group,then the changes of CMT and BCVA before and after the photocoagulation （4,8 weeks）were analyzed.Results：The level of AGEs in NPDR with DME group and PDR with DME group were significant higher than control group（P 〈0.05）,the level of AGEs in PDR with DME group was higher than NPDR with DME group（P 〈0.05）.The CMT and BCVA of NPDR with DME group were improved obviously after modified-macular grid photocoagulation（4,8 weeks）（all P 〈0.05 ）.The CME and BCVA of PDR with DME group had no change after photocoagulation 4 weeks（P 〉0.05）.After photocoagulation 8 weeks,the CMT of PDR with DME group decreased（P 〈0.05）,but the BCVA had no improvement（P 〉0.05 ）. Conclusion：The increase of AGEs level was closely related to the occurrence and development of DME, massive AGEs formation had great effects on photocoagulation of DME.