玻璃体腔注射康柏西普联合PPV治疗增殖型糖尿病视网膜病变

Intravitreal injection of Conbercept combined with PPV in the treatment of proliferative diabetic retinopathy

目的:研究玻璃体切割术联合玻璃体腔注射康柏西普治疗增殖型糖尿病视网膜病变(PDR)的价值。方法:前瞻性研究。选取2016-01/2019-10我院收治的PDR患者64例75眼,按照随机数字表法分为观察组32例38眼采用玻璃体切割术联合玻璃体腔注射康柏西普治疗与对照组32例37眼采用单纯玻璃体切割术治疗。比较两组患者手术前后最佳矫正视力(BCVA)、黄斑中心凹厚度(CMT);手术前后均采集患者房水标本,酶联免疫吸附法测定血管内皮生长因子(VEGF)、胎盘生长因子(PIGF)、碱性成纤维细胞生长因子(bFGF)浓度;记录两组患者手术时间、术中出血量及各症状(视网膜水肿、眼底出血、渗出)改善时间及并发症。结果:术后1wk,1、3mo观察组患者BCVA优于对照组(P<0.05),术后3mo观察组患者CMT低于对照组(P<0.001);观察组患者房水中VEGF、PIGF、bFGF浓度低于对照组(P<0.001);观察组手术时间、视网膜水肿、眼底出血、渗出吸收时间短于对照组,术中出血量少于对照组(P<0.05),并发症发生率低于对照组(P<0.05)。结论:玻璃体切割术前采用玻璃体腔注射康柏西普可消退新生血管,缩短手术时间,有助于改善患者视力,减轻黄斑水肿,减少手术并发症,促进术后恢复。

AIM:To observe the value of intravitreal injection of Conbercept in the treatment of proliferative diabetic retinopathy(PDR).METHODS:Totally 64 patients(75 eyes)with PDR admitted to the hospital between January 2016 and October 2019 were recruited and divided into observation group(32 cases,38 eyes)and control group(32 cases,37 eyes)by random number table method.The observation group received vitrectomy and intravitreal injection of Conbercept,while the control group received simple vitrectomy.The best corrected visual acuity(BCVA)was detected before treatment,at 1wk,1mo,and 3mo after operation.Changes in central macular thickness(CMT)before treatment and at 3mo after operation were determined.Aqueous humor or vitreous humor samples were collected before and after treatment to measure concentrations of vascular endothelial growth factor(VEGF),placental growth factor(PIGF)and basic fibroblast growth factor(bFGF)by enzyme-linked immunosorbent assay.The operation time,intraoperative blood loss and improvement time of symptoms(retinal edema,fundus hemorrhage,exudation)of the 2 groups were statistically analyzed.Incidences of complications in the 2 groups were recorded.RESULTS:The observation group had better BCVA than the control group at 1wk,1mo and 3mo after operation(P<0.05),and had smaller CMT than the control group at 3mo after operation(P<0.001).The concentrations of VEGF,PIGF and bFGF in observation group during operation were lower than those in the control group(P<0.001).The operation time,absorption time of retinal edema,fundus hemorrhage and exudation,intraoperative blood loss,and the total incidence of complications in the observation group were shorter and lower than those in the control group(P<0.05).CONCLUSION:Intravitreal injection of Conbercept before vitrectomy can degrade new blood vessels,and shorten the operation time.It can not only help improve vision and relieve macular edema but also reduce surgical complications and promote postoperative recovery.