代谢因素对康柏西普治疗糖尿病黄斑水肿的影响

Impact of metabolic parameters on clinical response to conbercept treatment for diabetic macular edema

目的评估全身代谢因素对康柏西普治疗糖尿病黄斑水肿疗效的影响。方法回顾性分析25例(25只眼)玻璃体腔注射康柏西普治疗糖尿病黄斑水肿患者的临床资料,其中女性12例,男性13例,平均年龄(61.36±8.98)岁,观察最佳矫正视力(BCVA)(ETDRS视力表)、黄斑中心凹厚度(CST)、黄斑总容积(TMV)的变化及与同期相关的糖化血红蛋白、血脂、血肌酐、血尿素等全身代谢因素之间的关系。结果术前BCVA 22.70±3.30(字母数),CST(506.52±33.45)μm,TMV(13.95±0.53)mm^3。至术后1个月时,BCVA平均增加10.70±1.82(P<0.001),CST平均降低(137.48±33.61)μm(P<0.001),TMV平均减少(1.34±0.35)mm^3(P=0.001)。BCVA的提高与术前各代谢指标未显示有明显的相关性;术后1周及1个月CST的变化仅与三酰甘油呈负相关(r_(1周)=-0.601,P=0.002;r_(1个月)=-0.522,P=0.015),三酰甘油高,CST较基线下降更大;术后1周TMV的变化与三酰甘油呈负相关(r=-0.424,P=0.044),术后1个月TMV与三酰甘油水平无明显相关(r=-0.323,P=0.153),TMV变化与其他代谢指标未见明显相关性。结论玻璃体腔注射康柏西普能明显降低黄斑中心凹厚度,提高最佳矫正视力,血脂可能是影响康柏西普注射后黄斑中心凹厚度变化的代谢性因素。

OBJECTIVE To evaluate the role of systemic factors on outcomes of diabetic macular edema treated by conbercept injection. METHODS It was a retrospective study including 25 diabetic macular edema（DME） patients（25 eyes） treated with conbercept therapy. The study included 12 female and 13 male patients with a mean age of 61.36±8.98. The main outcome was indicated by change in best corrected visual acuity（BCVA）, central subfield macular thickness（CST）, and total macular volume（TMV）; and their correlation with clinical findings（the serum hemoglobin A1 c values, serum lipid, creatinine, urea nitrogen） were analyzed. RESULTS Before treatment,result of BCVA, CST and TMV were 22.70 ±3.30 letters, 506.52 ±33.45 μm and 13.95 ±0.53 mm^3 respectively. One month after conbercept treatment, there was statistically significant improvement in BCVA（10.70 ±1.82 letters, P〈0.001） and statistically significant decrease in CST（-137.48 ±33.61 μm, P〈0.001） and TMV（-1.34±0.35 mm^3, P=0.001）. The triglycerides values were found to be negatively correlated with the change in CST（r=-0.522, P=0.015）.CONCLUSIONS The results of intravitreal conbercept injection for DME demonstrated beneficial effects on BCVA and decrease in CST. Serum lipids may impact the effects of conbercept therapy on CST improvement.