羟苯磺酸钙联合眼底激光对糖尿病视网膜病变的治疗效果及对血清胆红素水平的影响

Effect of calcium dobesilate combined with fundus laser on diabetes retinopathy and serum bilirubin level

目的探讨羟苯磺酸钙联合眼底激光对糖尿病视网膜病变的治疗效果及对血清胆红素水平的影响。方法前瞻性选取2021年1~12月空军军医大学第二附属医院收治的120例糖尿病视网膜病变患者作为研究对象,应用随机数字表法将所有患者分为观察组与对照组,每组60例。对照组患者在常规治疗基础上应用眼底激光治疗,观察组在常规治疗基础上应用羟苯磺酸钙联合眼底激光治疗,对比两组患者的临床治疗效果,近远期治疗后视力恢复情况与平均散光度,黄斑厚度、出血斑面积以及血管瘤体积,血清胆红素水平以及并发症情况。结果观察组临床治疗总有效率为91.67%,明显高于对照组78.33%,差异有统计学意义(P<0.05)。治疗后1、3个月,两组患者视力明显提升,且观察组治疗后1、3个月视力为0.792±0.214、0.957±0.221,高于对照组(0.711±0.254、0.837±0.29),差异均统计学意义(P<0.05)。两组患者平均散光度治疗后1个月升高,到治疗后3个月降低,观察组治疗后1、3个月,平均散光度为(1.365±0.247)、(0.927±0.236)D,均低于对照组[(1.811±0.324)、(1.425±0.246)D],差异均统计学意义(P<0.05)。治疗后,两组患者黄斑厚度、出血斑面积以及血管瘤体积均降低,且观察组黄斑厚度、出血斑面积以及血管瘤体积为(308.59±49.78)μm、(1.24±0.34)mm 2、(10.41±2.35)μm^(3),均低于对照组[(336.28±36.19)μm、(1.85±0.25)mm 2、(13.66±2.24)μm^(3)],差异均统计学意义(P<0.05)。治疗后,两组患者间接胆红素、总胆红素水平均降低,且观察组间接胆红素、总胆红素水平为(7.58±2.12)、(10.41±2.35)μmol/L,均低于对照组[(9.36±2.15)、(13.06±2.24)μmol/L],差异均统计学意义(P<0.05)。观察组并发症发生率为6.67%,对照组为5.00%,两组对比无明显差异(P>0.05)。结论羟苯磺酸钙联合眼底激光能够提升糖尿病视网膜病变患者的治疗效果,提升远期视力与散光度,能够进一步降低黄斑厚度、出血斑面积以及血管瘤体积,降低血清胆红素水平,且不增加患者治疗后并发症。

Objective To investigate the therapeutic effect of calcium dobesilate combined with fundus laser on diabetes retinopathy and its effect on serum bilirubin level.Methods A total of 120 patients with diabetic retinopathy admitted to the Second Affiliated Hospital of Air Force Military Medical University from January 2021 to December 2021 were prospectively selected as the research subjects.All patients were divided into observation group and control group by random number table method,with 60 cases in each group.The control group was treated with fundus laser on the basis of routine treatment,and the observation group was treated with calcium dobesilate combined with fundus laser on the basis of routine treatment.The clinical treatment effects,short-term and long-term treatment visual acuity recovery and average astigmatism,macular thickness,hemorrhagic spot area and hemangioma volume,serum bilirubin level and complications were compared between the two groups.Results The total effective rate of clinical treatment in the observation group was 91.67%,which was significantly higher than taht in the control group(78.33%),the difference was statistically significant(P<0.05).The visual acuity of the two groups was significantly improved one month and three months after treatment,the visual acuity of the observation group was 0.792±0.214,0.957±0.221,which was higher than that of the control group(0.711±0.254 and 0.837±0.29),the difference was statistically significant(P<0.05).The average astigmatism of the two groups increased 1 month after treatment and decreased 3 months after treatment,the average astigmatism of the observation group was(1.365±0.247),(0.927±0.236)D,which was lower in the observation group than in the control group[(1.811±0.324),(1.425±0.246)D],the difference was statistically significant(P<0.05).After treatment,the macular thickness,hemorrhagic spot area and hemangioma volume of the two groups decreased,and the macular thickness,hemorrhagic spot area and hemangioma volume in the observation group were(308.59±49.78)μm,(1.24±0.34)mm 2,(10.41±2.35)μm^(3),which were lower than those of the control group[(336.28±36.19)μm,(1.85±0.25)mm 2,(13.66±2.24)μm^(3)],the differences were statistically significant(P<0.05).After treatment,the levels of IBIL and TBIL in the two groups were decreased,and the levels of IBIL and TBIL in the observation group were(7.58±2.12)and(10.41±2.35)μmol/L,which were lower than those in the control group[(9.36±2.15),(13.06±2.24)μmol/L],the differences were statistically significant(P<0.05).The incidence of complications was 6.67%in the observation group and 5.00%in the control group.There was no significant difference between the two groups(P>0.05).Conclusion Calcium dobesilate combined with fundus laser can improve the treatment effect of patients with diabetes retinopathy,improve long-term visual acuity and astigmatism,further reduce macular thickness,hemorrhagic spot area and hemangioma volume,reduce serum bilirubin level,and do not increase after treatment complications.