羟苯磺酸钙对PDR患者全视网膜激光光凝术后玻璃体积血的影响

Effect of calcium dobesilate on vitreous hemorrhage in patients with PDR after pan retinal photocoagulation

目的:探讨羟苯磺酸钙对增生期糖尿病视网膜病变(proliferative diabetic retinopathy,PDR)患者全视网膜激光光凝术后玻璃体积血的影响。方法:以2015-01/2017-07我院收治的PDR患者62例92眼(30例双眼,32例单眼)为研究对象,依据医师建议和患者自愿原则分为对照组(行全视网膜激光光凝术治疗,30例43眼,单眼17例,双眼13例)和研究组(全视网膜激光光凝术联合羟苯磺酸钙治疗,32例49眼,单眼15例,双眼17例)。观察治疗后两组患者视力恢复情况、血液流变学(血浆黏度、红细胞比容、红细胞变形指数)和术后玻璃体积血等并发症发生率。结果:治疗前两组患者视力优良率、血浆黏度、红细胞比容、红细胞变形指数比较,差异无统计学意义(P>0.05);治疗后研究组视力优良率明显高于对照组(P<0.05);治疗后仅研究组血浆黏度和红细胞比容明显降低,红细胞变形指数明显升高,且治疗后研究组各项指标变化较对照组明显(P<0.05);研究组术后玻璃体积血发生率和并发症总发生率明显低于对照组,差异有统计学意义(P<0.05)。结论:羟苯磺酸钙应用于PDR患者全视网膜激光光凝术后,可有效提高患者视力恢复效果、降低玻璃体积血等并发症发生率,机制可能与其有效改善患者血流动力学有关。

AIM： To investigate the effect of calcium dobesilate on vitreous hemorrhage in patients with proliferative diabetic retinopathy（PDR）after pan retinal photocoagulation（PRP）. METHODS：Totally 62 patients（30 cases with binocular lesions, 32 cases with monocular lesions, a total of 92 eyes）with PDR who were treated in our hospital from January 2015 to July 2017 were selected as the subjects. They were divided into the control group（treated with pan retinal photocoagulation, n=30, 17 cases with monocular lesions, 13 cases with binocular lesions, a total of 43 eyes）and the study group（treated with calcium dobesilate on the basis of treatment for the control group, n=32, 15 cases with monocular lesions, 17 cases with binocular lesions, a total of 49 eyes）. The recovery of visual acuity, blood rheology（plasma viscosity, hematocrit, erythrocyte deformation index）and the incidence of complications such as vitreous hemorrhage in the two groups after surgery were observed. RESULTS： There was no significant difference between the two groups in the rate of excellent and good visual acuity, plasma viscosity, hematocrit or erythrocyte deformability index before treatment（P〉0.05）. After treatment, the rate of excellent and good visual acuity in the study group was significantly higher than that in the control group（P〈0.05）. After treatment, the plasma viscosity and hematocrit decreased significantly while the erythrocyte deformability index significantly increased only in the study group, and changes of above-mentioned indexes in the study group were more obvious than those in the control group after treatment（P〈0.05）. The incidence rate of vitreous hemorrhage and total incidence rate of complications in the study group were significantly lower than those in the control group（P〈0.05）. CONCLUSION： The application of calcium dobesilate in patients with PDR after pan retinal photocoagulation can effectively improve the recovery of visual acuity and reduce the incidence of complications such as vitreous hemorrhage. The mechanism may be related to effectively improving the hemodynamics.