VEGF抑制剂联合激光疗法治疗对糖尿病视网膜病变预后的影响

Prognosis of VEGF inhibitors combined with laser therapy in patients with diabetic retinopathy

目的:探讨血管内皮生长因子(VEGF)抑制剂联合激光疗法治疗对糖尿病视网膜病变患者预后的影响。方法:选取2014-09/2015-12期间我院确诊糖尿病性视网膜病变患者120例129眼,依据随机数表法随机分为抑制激光组(60例65眼)和激光组(60例64眼),激光组患者给予常规激光疗法治疗,抑制激光组患者在此基础上给予VEGF抑制剂治疗,采用国际标准视力表进行视力检查,采用酶联免疫吸附法(ELISA)检测血浆VEGF水平,随访6mo,统计分析所有患者治疗疗效、治疗前后病变中心凹厚度(CMT)、视网膜新生血管渗漏面积(RNV)、血浆VEGF水平和不良反应及治疗前、治疗后1、3、6mo的最佳矫正视力(BCVA)情况。结果:抑制激光组患者治疗有效率明显高于激光组,有统计学差异(P<0.05);抑制激光组患者治疗后CMT、RNV、血浆VEGF水平明显低于激光组,有统计学差异(P<0.05);抑制激光组患者治疗后1、3、6mo的BCVA水平明显高于激光组,有统计学差异(P<0.05);抑制激光组和激光组患者不良反应发生率基本相同,比较无统计学差异(P>0.05)。结论:VEGF抑制剂联合激光疗法治疗可有效提高糖尿病性视网膜病变患者的治疗疗效,可有效改善视网膜厚度和新生血管渗漏,并可有效提高患者的视力,且具有良好的安全性。

AIM：To discuss the prognosis effects of vascular endothelial growth factor（VEGF） inhibitors combined with laser therapy in patients with diabetic retinopathy.METHODS：Totally 120 patients（129 eyes） with diabetic retinopathy were selected from September 2014 to December 2015 in our Hospital.According to the random distribution,all patients were divided into inhibitor-laser group（60 case with 65 eyes） and laser group（60 case with64 eyes）.The laser group was treated with conventional laser treatments.Inhibitor- laser group patients were given VEGF inhibitors treatment besides laser.The international standard was used to charted the visual acuity and enzyme-linked immunosorbent（ELISA） was used to detect the plasma VEGF levels.All patients were followed up for 6mo,analyzed before and after the treatment for curative effect,the lesion center concave thickness（CMT）,retinal neovascularization leakage area（RNV）,plasma VEGF levels and adverse reactions,and the best corrected visual acuity（BCVA） before and 1,3,6mo after treatment.RESULTS：Efficient rate of inhibitor-laser group was obviously higher than that of the laser group,with statistical difference（P〈0.05）.CMT,RNV,plasma VEGF level of inhibitor-laser group after treatment were lower than those of laser group,with statistically significant（P〈0.05）.BCVA at 1,3 and 6mo after treatment in inhibitorlaser group were obviously higher than those of laser group,with statistical difference（P〈0.05）.Incidence of adverse reactions of the two groups were basically the same,there was no significant difference（P〉0.05）.CONCLUSION：VEGF inhibitors combined with laser therapy can effectively improve the curative effect of patients with diabetic retinopathy.It can effectively improve the retinal thickness and leakage of new blood vessels,and the patient＇s vision,with good security.