抗血管内皮生长因子治疗糖尿病性黄斑水肿的效果观察

Effect of anti-vascular endothelial growth factor in treating diabetic macular edema

目的观察抗血管内皮生长因子(VEGF)治疗糖尿病性黄斑水肿(DME)的效果和对血清一氧化氮合酶(NOS)、VEGF、白细胞介素-6(IL-6)水平及鼻侧睫状后动脉血流动力学参数的影响。方法选取98例DME患者(122眼)作为研究对象,均给予抗VEGF治疗,将治疗敏感者56例(72眼)纳入敏感组,将治疗不敏感者42例(50眼)纳入对照组,比较2组治疗前后黄斑中心凹视网膜厚度、鼻侧睫状后动脉血流动力学参数和血清NOS、VEGF和IL-6水平等。结果敏感组视网膜外丛状层连续性中断率为9.72%,低于对照组的72.00%,差异有统计学意义(P<0.05);治疗后,敏感组黄斑中心凹视网膜厚度为(301.12±67.28)μm,小于对照组的(410.11±52.21)μm,差异有统计学意义(P<0.05);治疗后,敏感组收缩期峰值血流速度(PSV)、舒张末期血流速度(EDV)均高于对照组,差异有统计学意义(P<0.05);治疗后,敏感组NOS水平高于对照组,VEGF、IL-6水平低于对照组,差异有统计学意义(P<0.05)。结论抗VEGF治疗DME有一定效果,治疗敏感者的黄斑中心凹视网膜厚度、鼻侧睫状后动脉血流动力学参数和血清NOS、VEGF及IL-6水平明显优于治疗不敏感者。

Objective To observe the effect of anti-vascular endothelial growth factor(VEGF)in treating diabetic macular edema(DME)and its effects on serum nitric oxide synthase(NOS),VEGF,interleukin-6(IL-6)and hemodynamic parameters of nasal posterior ciliary artery.Methods A total of 98 patients(122 eyes)with DME treated with anti-VEGF were selected as research objects,and 56 patients(72 eyes)who were sensitive to treatment were included in the sensitive group,and 42 patients(50 eyes)who were insensitive to treatment were included in the control group.The macular fovea retinal thickness and hemodynamic parameters of nasal posterior ciliary artery,levels of NOS,VEGF and IL-6 were measured before and after treatment.Results The continuous interruption rate of extraretinal plexiform layer in the treatment sensitive group was 9.72%,which was significantly lower than 72.00%in the treatment insensitive group(P<0.05).The retinal thickness of macular fovea in the sensitive group after treatment was(301.12±67.28)μm,which was significantly lower than(410.11±52.21)μm in the control group(P<0.05).The peak systolic blood flow velocity(PSV)and end diastolic blood flow velocity(EDV)in the treatment sensitive group after treatment were significantly higher than those in the treatment insensitive group(P<0.05).After treatment,the NOS level in the sensitive group was significantly higher than that in the control group(P<0.05),while the levels of VEGF and IL-6 were significantly lower than those in the control group(P<0.05).Conclusion Anti-VEGF therapy has a certain effect in treating DME.Retinal thickness of macular fovea,hemodynamic parameters of nasal posterior ciliary artery,levels of serum NOS,VEGF and IL-6 are significantly better in sensitive patients than those without sensitivity.