康柏西普联合玻璃体切除术对糖尿病性视网膜病变患者房水两种生长因子的影响

Effect of conbercept combined with vitrectomy on two growth factors of aqueous humor in patients with diabetic retinopathy

目的探讨康柏西普(conbercept)联合玻璃体切除术对糖尿病视网膜病变(DR)患者房水中血管内皮生长因子(VEGF)及基质细胞衍生因子-1(SDF-1)的影响。方法回顾性分析2017年6月至2018年6月本院DR 80例,依据随机数字表分为两组,每组40例。A组以玻璃体切除术治疗,B组在此基础上联合玻璃体内注射康柏西普,比较两组房水VEGF、SDF-1及黄斑中心区厚度(CMT)、最佳矫正视力(BCVA)及并发症。结果B组术后房水VEGF为(151.46±18.52)pg/ml,SDF-1为(462.72±50.97)mg/L,均明显低于A组[(186.74±20.17)pg/ml及(568.46±59.24)mg/L],差异均有统计学意义(t=8.149,8.557,P<0.05)。B组术后1周及1个月CMT分别为(306.35±31.04)μm,(263.35±27.72)μm;最佳矫正视力(BCVA,LogMAR)1.29±0.14,0.91±0.11均明显低于A组[CMT:(342.42±35.98)μm,(295.24±30.54)μm;BCVA:1.47±0.17,1.20±0.13],差异有统计学意义(t=4.801、4.890;5.169、10.770,P<0.05)。B组并发症率15.00%明显低于A组30.00%,差异有统计学意义(χ^2=5.000,P<0.05)。结论康柏西普联合玻璃体切除术可有效降低DR患者房水VEGF、SDF-1,有利于改善患者CMT、BCVA及减少并发症。

Objective To investigate the effect of conbercept combined with vitrectomy on the aqueous humor vascular endothelial growth factor (VEGF) and stromal cell derived factor-1 (SDF-1) in patients with diabetic retinopathy (DR). Methods Total of 80 patients with DR were selected from Jun.2017 to Jun.2018. According to the random number table, they were divided into two groups, 40 cases in each group. Group A was treated with vitrectomy, and group B received vitrectomy combined with intravitreal injection of conbercept. The aqueous humor VEGF, SDF-1 and central macular thickness (CMT), best corrected visual acuity (BCVA) and complications were compared between the two groups. Results The postoperatively aqueous humor VEGF[(151.46±18.52)pg/ml], SDF-1[(462.72±50.97)mg/L] in the group B were significantly lower than those in the group A [(186.74±20.17)pg/ml,(568.46±59.24)mg/L], the difference were statistically significant (t=8.149, 8.557, P<0.05). At 1 week and 1 month postoperatively the CMT of group B were [(306.35±31.04)μm,(263.35±27.72)μm] and BCVA(LogMAR) of group B were 1.29±0.14, 0.91±0.11. CMT and BCVA of group B were significantly lower than those of group A[CMT:(342.42±35.98)μm,(295.24±30.54)μm;BCVA: 1.47±0.17, 1.20±0.13], the difference were statistically significant (P<0.05). The complication rate in the group B was 15.00% and 30.00% in the group A, the difference was statistically significant (P<0.05). Conclusion Intravitreal injection of conbercept combined with vitrectomy for the treatment of patients with DR can effectively reduce the aqueous humor VEGF, SDF-1 in patients with DR, it is helpful to improve the CMT, BCVA and complications.