康柏西普联合玻璃体切除术治疗增殖型糖尿病视网膜病变效果及对血清血管内皮生长因子和胎盘生长因子水平的影响

The curative effect of conbercept combined with vitrectomy in the treatment of proliferative diabetic retinopathy and its influence on serum VEGF and PIGF levels

目的探讨康柏西普联合玻璃体切除术治疗增殖型糖尿病视网膜病变(PDR)效果及对血清血管内皮生长因子(VEGF)和胎盘生长因子(PIGF)水平的影响。方法我院住院治疗的242例PDR患者,按照随机数字表法分为观察组(n=120)及对照组(n=119)。对照组行常规玻璃体切除术,观察组在手术前3~6 d玻璃体腔内注射康柏西普治疗。于术前及术后3个月测定患者血清VEGF、PIGF水平、最佳矫正视力(BCVA)、黄斑中心区厚度(CMT);评价患者生活质量并记录并发症发生情况。结果治疗后两组血清VEGF、PIGF水平及CMT下降,BCVA上升,观察组下降幅度大于对照组(P<0.05);观察组在自理、活动、心理等维度评分均优于对照组(P<0.05);术后随访期间,两组并发症发生率比较差异无统计学意义(P>0.05)。结论康柏西普联合玻璃体切除术可明显降低PDR患者血清中VEGF及PIGF水平,延缓新生血管的生成,提高患者视功能及生活质量,具有较好的疗效及安全性。

Objective To investigate the curative effect of conbercept combined with vitrectomy on proliferative diabetic retinopathy(PDR)and its influence on levels of serum vascular endothelial growth factor(VEGF)and placental growth factor(PIGF).Methods Patients with PDR in our hospital were divided into observation group(n=120)and control group(n=119)according to random number table method.Patients in the control group were treated with routine vitrectomy and patients in the observation group were treated with intravitreal injection of conbercept before 3 to 6 days of surgery.Serum VEGF and PIGF levels,the best corrected visual acuity(BCVA)and central macular thickness(CMT)were measured before surgery and after 3 months of surgery.Patients quality of life was assessed and incidence of complications was recorded.Results After treatment,serum VEGF and PIGF levels and CMT were significantly decreased,and the BCVA was significantly increased(P<0.05).The decrease of serum VEGF and PIGF levels and CMT was significantly greater in the observation group than the control group(P<0.05).Scores of self-care,activity and psychological dimension in the observation group were significantly better than those in the control group(P<0.05).There was no significant difference in the incidence rates of complications between the two groups(P>0.05).Conclusion Conbercept combined with vitrectomy can significantly reduce the levels of serum VEGF and PIGF in patients with PDR,delay the formation of new blood vessels,and improve the visual function and quality of life of patients.The therapy has better efficacy and safety.