不同疗法对糖尿病性黄斑水肿患者房水因子的影响

The effect of different treatments on aqueous humor factors in diabetic macular edema

目的探讨玻璃体切除术联合玻璃体腔注射康柏西普治疗糖尿病性黄斑水肿(DME)患者房水中血管内皮生长因子(VEGF)、白介素6(IL-6)和白介素8(IL-8)的影响。方法采取病例对照研究。选取2017年9月至2019年9月宁波市奉化区中医医院医共体眼科收治DME 50例(80眼),依据随机数字表法分为两组。A组,25例(42眼),接受玻璃体切除术。B组,25例(38眼),接受玻璃体切除及康柏西普玻璃体腔注射,比较两组房水中VEGF、IL-6、IL-8及黄斑中心区视网膜厚度(CMT)、视力及并发症。结果两组术后房水中VEGF、IL-6及IL-8均低于术前,B组术后房水中VEGF、IL-6及IL-8均低于A组,差异均有统计学意义(P<0.05);术后3天和3个月,两组CMT及视力优于术前,B组CMT及视力优于A组;B组并发症发生率低于A组,差异均有统计学意义(P<0.05)。结论玻璃体切除术联合康柏西普玻璃体腔注射可有效降低DME患者房水中VEGF、IL-6及IL-8水平,改善患者CMT及视力,且可减少并发症。

Objective To investigate the effects of vitrectomy combined with intravitreal injection of conbercept on vascular endothelial growth factor(VEGF),interleukin-6(IL-6)and interleukin-8(IL-8)in aqueous humor of patients with diabetic macular edema(DME).Methods This was a case control study.Total of 80 eyes of 50 cases with DME from Sep.2017 to Sep.2019 in Fenghua District Hospital of Traditional Chinese Medicine of Ningbo were selected.All patients were divided into two groups according to the random number table method.Group A,42 eyes of 25 cases,underwent vitrectomy.Group B,38 eyes of 25 cases,received vitrectomy and intravitreal injection of conbercept.The VEGF,IL-6 and IL-8 in aqueous humor,central macular thickness(CMT),best corrected visual acuity(BCVA)and complications were compared between the two groups.Results The levels of VEGF,IL-6 and IL-8 in aqueous humor after operation in two groups were lower than those before operation.The levels of VEGF、IL-6、IL-8 in aqueous humor after operation in group B were significantly lower than those in group A and the differences were statistically significant(P<0.05).At 3 days and 3 months after operation,the CMT and visual acuity of the two groups were better than those before operation.The CMT and visual acuity of group B were lower than that of group A.The incidence of complications in group B was better than that in group A and the difference was statistically significant(P<0.05).Conclusion Vitrectomy combined with intravitreal injection of conbercept can effectively reduce the levels of VEGF,IL-6 and IL-8 in aqueous humor of patients with DME,ameliorate CMT and BCVA and reduce the rate of complications.