玻璃体腔康柏西普注射辅助微创玻璃体切割术对增殖型糖尿病视网膜病变患者VEGI及PEDF的影响

Effect of intravitreal Compoxip injection-assisted minimally invasive vitrectomy on VEGI and PEDF in patients with proliferative diabetic retinopathy

目的:探讨玻璃体腔康柏西普注射辅助微创玻璃体切割术对增殖型糖尿病视网膜病变(PDR)患者血管内皮生长抑制因子(VEGI)及色素上皮衍生因子(PEDF)的影响。方法:选取2016年3月至2017年3月陕西省西安医学院第二附属医院收治的100例PDR患者,按随机数字表法分为对照组(微创玻璃体切割术)和观察组(玻璃体腔康博西普注射+微创玻璃体切割术),每组50例。比较两组术中出血、医源性视网膜裂孔、眼内电凝使用和并发症发生情况、手术时间、最佳视力矫正(BCVA)、黄斑厚度及血清VEGI、PEDF水平。结果:观察组术中出血、医源性视网膜裂孔的发生率及眼内电凝使用率均低于对照组,手术时间短于对照组(均P<0.05)。术后1个、2个、3个月,两组BCVA、VEGI和PEDF升高,黄斑厚度降低,且观察组改善更为明显(P<0.05)。观察组术后并发症发生率明显低于对照组(P<0.05)。结论:康柏西普注射辅助微创玻璃体切割术能够提高PDR患者血清VEGI、PEDF水平,抑制新生血管形成,减少术中出血、医源性视网膜裂孔的发生及眼内电凝的使用,进而缩短手术时间,提高患者术后视力,减轻黄斑水肿。

Objective:To explore the effect of intravitreal Compoxip injection-assisted minimally invasive vitrectomy on vascular endothelial growth inhibitor(VEGI)and pigment epithelium-derived factor(PEDF)in proliferative diabetic retinopathy(PDR).Methods:A total of 100 PDR patients in our hospital from March 2016 to March 2017 were selected,and randomly divided into a control group(minimally invasive vitrectomy,50 cases)and an observation group(intravitreal Compoxip injection+minimally invasive vitrectomy,50 cases).The incidence of intraoperative bleeding,iatrogenic retinal holes,intraocular electrocoagulation and adverse reaction,operation time,best-corrected visual acuity(BCVA),macular thickness and serum VEGI and PEDF levels were compared.Results:The incidence of intraoperative bleeding,iatrogenic retinal holes,intraocular electrocoagulation and adverse reactions in the observation group was lower than that in the control group bleeding,and the operation time was decreased compared with the control group(P<0.05).After 1,2 and 3 months of operation,the BCVA,VEGI and PEDF increased while macular thickness decreased in both groups,and the changes were more marked in the observation group(P<0.05).Conclusion:Compoxip injection-assisted minimally invasive vitrectomy could elevate the serum VEGI and PEDF levels,neovascularization,reduce intraoperative hemorrhage and iatrogenic retinal hole risks as well as the use of intraocular electrocoagulation,thus shorten the operation time,improve postoperative visual acuity and reduce macular edema.