雷珠单抗联合眼底激光治疗糖尿病视网膜病变的疗效

Curative effect of ranibizumab combined with laser photocoagulation on diabetic retinopathy

目的观察玻璃体腔内注射雷珠单抗联合视网膜激光光凝术治疗糖尿病视网膜病变(dia-betic retinopathy,DR)的临床效果及其对患者生存质量、视网膜血流动力学的影响。方法将我院2018年2月至2019年8月间收治50例DR患者,分为两组:观察组采用玻璃体腔内注射雷珠单抗联合视网膜激光光凝术,对照组采用单纯视网膜激光光凝术;观察治疗前及治疗后最佳矫正视力、视网膜中央动脉及静脉血流动力学,依照中文版低视力者生活质量量表对患者生存质量进行问卷调查,同时记录术后并发症。结果治疗后3个月观察组平均最佳矫正视力为(0.64±0.11),对照组平均最佳矫正视力为(0.58±0.12),观察组显著高于对照组(P<0.05);治疗后观察组平均中文版低视力者生活质量量表中各量表维度评分均高于对照组(P<0.05);治疗后观察组平均视网膜中央动脉的峰值血流速度、平均血流速度、舒张末期血流速度、搏动指数及阻力指数等差异均有统计学意义(P<0.05);治疗后观察组视网膜中央静脉的最大血流速度、最低血流速度及平均血流速度等均显著低于对照组(P<0.05);两组并发症差异无统计学意义。结论玻璃体腔内注射雷珠单抗联合视网膜激光光凝术治疗DR可有效改善视网膜血流动力学及提升患者生活质量。

Objective To evaluate the effect of ranibizumab combined with laser photocoagulation in the treatment of diabetic retinopathy(DR)and analyze its influence on the quality of life and retinal microcirculation after operation.Methods Fifty DR patients treated in our hospital from February 2018 to August 2019 were divided into two group.The control group was treated with laser photocoagulation,while the observation group with ranibizumab combined with laser photocoagulation.Best corrected visual acuity was measured before and after treatment.Their quality of life was investigated with Chinese Low Vision Quality of Life Questionnaire,and the hemodynamic parameters of central retinal artery and vein were also measured before treatment and after treatment.The complications were also recorded after treatment.Results The mean score of best corrected visual acuity of the observation group was significantly higher than that of the control group after treatment(0.64±0.11 vs.0.58±0.12,P<0.05).The average score in the different dimensions of Chinese Low Vision Quality of Life Questionnaire in the observation group was significantly higher than the control group after treatment(P<0.05).The hemodynamic parameters of central retinal artery(including peak systolic velocity,mean velocity,end diastolic velocity,pulsatility index and resistance index)between the observation group and control group were statistically different(P<0.05).The hemodynamic parameters of central retinal vein(including maximal velocity,minimum velocity and mean velocity)in the observation group were significantly lower than those in the control group(P>0.05).Conclusion Ranibizumab combined with laser photocoagulation in the treatment of DR can effectively can improve the retinal microcirculation of DR patients and therefore their quality of life.