雷珠单抗辅助视网膜激光光凝治疗糖尿病视网膜病变伴玻璃体积血的疗效及对患者视力和HbA1c、mAlb水平的影响

Curative effect of Leizumab-assisted retinal laser photocoagulation in treating DR with VH and the influence of that on the vision,HbA1c and mAlb of patients

目的:探讨雷珠单抗辅助视网膜激光光凝治疗糖尿病视网膜病变(DR)伴玻璃体积血(VH)的疗效,以及对患者视力和糖化血红蛋白(HbA1c)、尿微量白蛋白(mAlb)水平的影响。方法:选取医院眼科收治的80例DR伴VH患者,采用抽签随机分为观察组和对照组,每组40例,对照组采用视网膜激光光凝术治疗,观察组在视网膜激光光凝术前注射雷珠单抗治疗。比较两组临床疗效,手术前后最佳矫正视力(BCVA)、黄斑中心凹厚度(CMT)以及HbA1c和mAlb水平;比较两组术后并发症发生率及复发率。结果:观察组临床治疗总有效率为90.00%,显著高于对照组的70.00%,差异有统计学意义(x^(2)=5.001,P<0.05)。两组术后1个月、3个月及6个月时的BCVA均好于术前,且观察组好于对照组,差异有统计学意义(t=7.481,t=8.990,t=9.588;P<0.05)。两组术后1个月、3个月和6个月时的CMT均低于同组术前,术后3个月、6个月时的CMT低于术后1个月,且观察组术后1个月、3个月和6个月时的CMT均低于对照组术后同时段,差异有统计学意义(t=9.373,t=3.977,t=4.651;P<0.05)。两组术后6个月时的HbA1c、mAlb水平均低于术前,且观察组低于对照组,差异有统计学意义(t=3.374,t=2.049;P<0.05)。两组术后并发症发生率比较,差异无统计学意义。观察组术后复发率(2.50%)低于对照组(15.00%),差异有统计学意义(x^(2)=0.048,P<0.05)。结论:雷珠单抗辅助治疗DR伴VH临床疗效好,可显著提高患者术后视力,降低术后HbA1c和mAlb水平。

Objective:To investigate the curative effect of Leizumab-assisted retinal laser photocoagulation in treating DR with VH and the influence of that on the vision,HbA1c and mAlb of patients.Methods:A total of 80 patients with diabetic retinopathy(DR)complicated with vitreous hemorrhage(VH)who hospitalized in the ophthalmology department of hospital were selected,and they were randomly divided into the observation group and the control group,with 40 cases in each group.The control group was treated by retinal laser photocoagulation,and the patients of observation group were injected by Leizumab before retinal laser photocoagulation.The clinically curative effects,the levels of best corrected visual acuity(BCVA)before and after surgery,central macular thickness(CMT),the levels of HbA1c and mAlb between the two groups were compared.In addition,the incidence and recurrence rate of postoperative complications were further compared between the two groups.Results:The total effective rate of clinical treatment in the observation group was 90.00%,which was significantly higher than 70.00%in the control group,with a statistically significant difference(x^(2)=5.001,P<0.05).The BCVA of the two groups at the 1st month,the 3rd month and the 6th month after surgery were respectively better than those before surgery,and that of observation group was significantly better than that control group,with statistically significant differences(t=7.481,t=8.990,t=9.588,P<0.05).The CMT levels of the two groups at the 1st month,the 3rd month and the 6th month after surgery were respectively lower than those before surgery,and the CMT levels of the two groups at the 3rd month and the 6th month after surgery were respectively lower than those at the 1st month after surgery,and the CMT levels of the observation group at the 1st month,the 3rd month and the 6th month after surgery were respectively lower than them of the control group at the same stage after surgery,with statistically significant differences(t=9.373,t=3.977,t=4.651,P<0.05).The HbA1c and mAlb levels of two groups at the 6th month after surgery were respectively lower than them before surgery,and the two indicators of observation group were respectively lower than them of control group,with statistically significant differences(t=3.374,t=2.049,P<0.05).There was no statistically significant difference in the incidence of postoperative complications between the two groups.The postoperative recurrence rate in the observation group(2.50%)was significantly lower than that in the control group(15.00%),and the difference was statistically significant(x^(2)=0.048,P<0.05).Conclusion:Compared with simple retinal laser photocoagulation,the clinically curative effect of Leizumab-assisted retinal laser photocoagulation is better in treating DR with VH,which can significantly improve the postoperative vision of patients,and reduce the postoperative HbA1c and mAlb levels.