激光联合康柏西普治疗糖尿病视网膜病变伴黄斑水肿的临床效果及机制研究

Clinical Efficay of Laser Combined with Conbercept in the Treatment of Diabetic Retinopathy with Macular Edema and Its Possible Mechanisms

目的:探讨激光联合康柏西普治疗糖尿病视网膜病变伴黄斑水肿的临床效果及可能机制。方法:选取2017年1月至2017年12月我院收治的糖尿病视网膜病变伴黄斑水肿患者92例作为研究对象,随机分为观察组46例(46眼)及对照组46例(46眼)。对照组患者实施激光治疗,观察组在注射康柏西普1周后再进行激光治疗。比较两组患者治疗后的临床疗效,治疗前后最佳矫正视力(BCVA)、黄斑中心厚度(CMT)、血管内皮生长因子(VEGF)、胰岛素样生长因子-1(IGF-1)及红细胞生成素(EPO)水平的变化。结果:治疗后,观察组的总有效率为91.30%,显著高于对照组(69.57%,P<0.05);两组患者的BCVA均较治疗前明显提高(P<0.05),CMT均低于治疗前(P<0.05),但观察组BCVA较对照组更高(P<0.05);CMT较对照组更低(P<0.05)。治疗后,两组患者的VEGF、IGF-1、EPO均较治疗前明显降低,且观察组的VEGF、IGF-1、EPO均显著低于对照组(P<0.05)。结论:激光联合康柏西普治疗糖尿病视网膜病变伴黄斑水肿的临床疗效显著优于单用激光治疗,并可有效改善VEGF、IGF-1、EPO水平,这可能对抑制血管新生产生积极作用。

Objective: To explore the clinical effect of laser combined with conbercept on the diabetic retinopathy with macular edema and its possible mechanis. Methods: From January 2017 to December 2017, 92 cases of patients with diabetic retinopathy and macular edema were selected as the research subjects, and they were randomly divided into the observation group(46 eyes) and the control group(46 eyes). Patients in the control group were treated with laser treatment, and the observation group was treated with laser therapy after 1 week of conbercept injection. The clinical efficacy of two groups after treatment was compared, and the changes of best corrected visual acuity(BCVA), central macular thickness(CMT) and vascular endothelial growth factor(VEGF), insulin-like growth factor-1(IGF-1) and erythropoietin(EPO) level were compared between the two groups before and after treatment. Results: After treatment,the total effective rate of observation group was 91.30%, which was significantly higher than that of the control group(69.57%)(P<0.05).The BCVA of both groups were significantly higher than those before treatment(P<0.05), CMT were lower than those before treatment(P<0.05), but BCVA of observation group was higher than that of control group, CMT was lower than control group(P<0.05). After treatment, the serum VEGF, IGF-1 and EPO of both groups were significantly decreased than those before treatment, and which were lower in the observation group than those of the control group(P<0.05). Conclusion: The clinical effect of laser combined with Compassix in the treatment of diabetic retinopathy with macular edema is significantly better than that of laser alone, and it can effectively improve the levels of vascular endothelial growth factor, IGF-1 and EPO, which may contribute to the anti-angiogenic effect.