改良视网膜光凝术联合玻璃体腔内注射雷珠单抗对增殖期糖尿病视网膜病变患者TGF-β1、CTGF及VEGF水平的影响

Effect of modified retinal photocoagulation combined with intravitreal injection of ranibizumab on the levels of TGF-β1,CTGF and VEGF in patients with proliferative diabetic retinopathy

目的探讨改良视网膜光凝术联合玻璃体腔内注射雷珠单抗治疗增殖期糖尿病视网膜病变的效果。方法选择2018年7月至2019年10月收治的82例(132眼)增殖期糖尿病视网膜病变患者,根据治疗方法不同将其分为对照组(41例,65眼)和观察组(41例,67眼)。对照组采用改良视网膜光凝术治疗,观察组采用改良视网膜光凝术联合玻璃体腔内注射雷珠单抗治疗。比较两组的治疗效果。结果观察组的治疗总有效率高于对照组(P<0.05)。治疗后6个月,两组的最佳矫正视力均增加,中心黄斑厚度均减小,TGF-β1、CTGF及VEGF水平均降低,且观察组优于对照组(P<0.05)。两组的并发症总发生率比较,差异无统计学意义(P>0.05)。结论改良视网膜光凝术联合玻璃体腔内注射雷珠单抗治疗增殖期糖尿病视网膜病变效果满意,可促进视力恢复,减小中心黄斑厚度,改善VEGF、CTGF、TGF-β1水平,且不增加并发症发生风险。

Objective To explore the effect of modified retinal photocoagulation combined with intravitreal injection of ranibizumab in the treatment of proliferative diabetic retinopathy.Methods Eighty-two patients(132 eyes)with proliferative diabetic retinopathy admitted from July 2018 to October 2019 were selected and divided into control group(41 cases,65 eyes)and observation group(41 cases,67 eyes)according to different treatment methods.The control group was treated with modified retinal photocoagulation,and the observation group was treated with modified retinal photocoagulation combined with intravitreal injection of ranibizumab.The therapeutic effects of the two groups were compared.Results The total effective rate of treatment in the observation group was higher than that in the control group(P<0.05).At 6 months after treatment,the best corrected visual acuity in the two groups increased,the central macular thickness reduced,and the levels of TGF-β1,CTGF and VEGF decreased,and those in the observation group were better than the control group(P<0.05).There was no significant difference in the total incidence of complications between the two groups(P>0.05).Conclusion Modified retinal photocoagulation combined with intravitreal injection of ranibizumab in the treatment of proliferative diabetic retinopathy has a satisfactory effect.It can promote the recovery of visual acuity,reduce the central macular thickness,improve the levels of VEGF,CTGF and TGF-β1,and does not increase the risk of complications.