全视网膜激光光凝联合不同药物对PDR患者视网膜厚度、BCVA和N1波潜伏期的影响比较

Comparison of the effects of panretinal photocoagulation combined with different drugs on retinal thickness and BCVA,N1 wave latency in patients with PDR

目的 比较全视网膜激光光凝术(PRP)联合不同药物(曲安奈德、康柏西普)对增生性糖尿病视网膜病变(PDR)患者视网膜厚度、最佳矫正视力(BCVA)及N1波潜伏期的影响。方法 前瞻性选取2016年9月至2018年6月86例PDR患者,均行PRP治疗,随机分为两组,对照组术前给予曲安奈德注射液治疗,研究组术前给予康柏西普注射液治疗,两组各43例。比较两组患者治疗前和治疗后1个月、3个月视网膜厚度、BCVA、N1波潜伏期波幅及术后并发症发生情况。结果 相比治疗前,两组患者治疗后1个月、3个月视网膜厚度均明显下降,且研究组治疗后视网膜厚度较对照组明显下降( P <0.05)。与治疗前相比,两组患者治疗后1个月、3个月BCVA均明显提高,且研究组治疗后BCVA较对照组明显提高( P <0.05)。治疗后1个月、3个月,两组患者N1波潜伏期波幅较治疗前均明显下降,且研究组治疗后的水平较对照组明显下降( P <0.05)。研究组术后视网膜脱离、眼高压及出血发生率为4.65%,较对照组的25.58%明显下降( P <0.05)。结论 在PRP治疗的情况下,相比曲安奈德,康柏西普不仅可有效降低PDR患者视网膜厚度,明显改善术后BCVA,矫正患者术后视力,改善视功能,而且可有效降低术后并发症的发生率,具有较高的用药安全性,因此值得临床应用。

Objective To compare the effects of panretinal photocoagulation (PRP) combined with different drugs (triamcinolone acetonide or conbercept) on retinal thickness, best corrected visual acuity (BCVA) and N1 wave latency in patients with proliferative diabetic retinopathy (PDR). Methods 86 patients with PDR in our hospital from September 2016 to June 2018 were treated with PRP. 86 cases were divided into control group treated with triamcinolone acetonide injection and study group treated with conbercept injection, with 43 cases in each group. The differences of retinal thickness, BCVA, N1 wave latency and complications were compared between the two groups before treatment and 1, 3 months after treatment. Results Compared with before treatment, the retinal thickness of the two groups decreased significantly 1 and 3 months after treatment, and the retinal thickness of the study group decreased significantly after treatment compared with the control group ( P <0.05). Compared with before treatment, BCVA in the two groups was significantly increased 1 and 3 months after treatment, and BCVA in the study group after treatment was significantly increased compared with the control group ( P <0.05). After 1 and 3 months of treatment, the amplitude of N1 wave latency in the two groups was significantly lower than that before treatment, and the level in the study group was significantly decreased compared with the control group ( P <0.05). The incidence of retinal detachment, ocular hypertension and bleeding in the study group was 4.65%, which was significantly decreased compared with the control group of 25.58%( P <0.05). Conclusion Under the circumstance of PRP treatment, compare with triamcinolone acetonide, conbercept can not only effectively reduce retinal thickness, improve BCVA, correct visual acuity and improve visual function in patients with PDR, but also effectively reduce the incidence of complications after PRP, which has high safety of medication, so it is worthy of clinical application.