Lucentis玻璃体注射治疗糖尿病黄斑水肿的近远期疗效和稳定性研究

Long-term efficacy and stability of Lucentis vitrectomy in the treatment of diabetic macular edema

目的研究Lucentis玻璃体注射治疗糖尿病黄斑水肿(DMF)的近远期疗效和稳定性。方法随机选取2014年10月至2016年10月我院就诊的糖尿病黄斑水肿患者70例(70只眼),分为试验组和对照组,各35只眼,试验组进行Lucentis玻璃体注射治疗,对照组进行格栅样激光光凝治疗,比较两组DME情况计量表、最佳矫正视力(BCVA)、黄斑区水肿OCT图像特征、中央黄斑厚度(CMT)变化、荧光素眼底血管造影(FFA)、稳定性等,采用SPSS20.0统计学软件进行分析。结果 (1)4个月后开始,4个月至12个月期间随访,试验组中患者的BCVA-ETDRS letters分数高于对照组,有统计学差异(P<0.05);试验组提高分数≥1、≥10、≥15和≥20的病例数明显高于对照组,有统计学差异(P<0.01)。(2)1、3、6、9和12个月后随访,试验组OCT示CMT明显低于对照组,有统计学差异(P<0.05&P<0.01)。(3)6、12个月后随访,试验组的FFA检查结果与对照组比较,有统计学差异(P<0.05)。(4)试验组治疗注射3、4、5、6和8次的病例数都低于对照组,有统计学差异(P<0.05);(5)试验组治疗稳定性明显高于对照组,有统计学差异(P<0.05)。结论 Lucentis玻璃体注射治疗,对糖尿病黄斑水肿的近远期疗效和稳定性优于格栅样激光光凝治疗,值得临床推广应用。

Objective To study the short-term and long-term efficacy and stability of Lucentis vitrectomy in the treatment of diabetic macular edema. Methods Seventy patients（70 eyes） with diabetic macular edema in our hospital from October 2014 to October 2016 were randomly divided into the test group and control group,35 eyes in each group,test group was given Lucentis vitrectomy treatment,control group was given grid-like laser photocoagulation treatment,SPSS20. 0 software was used to analyze the changes of the DME status,central macular thickness（ CMT）,fundus fluorescein angiography（ FFA） and post-treatment stability,visual acuity（ BCVA）,macular edema OCT image and central macular thickness（ CMT）. Results（1） The BCVA-ETDRS letters scores of test group were higher than those of control group at 4 months and 4 months to 12 months. There was significant difference（ P〈 0. 05）.（2） At 1 month,3 months,6 months,9 months and 12 months after the follow-up,OCT in test group showed that CMT was lower than control grou（ P〈 0. 05）.（3） After 6 months and 12 months follow-up,the FFA test results of test group compared with the control group,there was significant difference（ P〈 0. 05）.（4） The number of cases treated with 3 times,4 times,5 times,6 times and 8 times was lower than that of control group,there was significant difference（ P〈 0. 05）;（5） The treatment stability of test group was significantly higher than that of control group,there was significant difference（ P〈 0. 05）. Conclusion Lucentis vitreous injection therapy is superior to grid-like laser photocoagulation in the treatment of diabetic macular edema. It is worthy of clinical application.