前列地尔联合雷珠单抗治疗糖尿病视网膜病变的疗效及对眼部血流动力学的影响

Efficacy of alprostadil combined with ranzumab in the treatment of diabetes retinopathy and its effect on ocular hemodynamics

目的探究前列地尔联合雷珠单抗治疗糖尿病视网膜病变的疗效及对眼部血流动力学的影响。方法选取2019年1月至2022年3月该院收治的糖尿病视网膜病变患者106例作为研究对象,采用随机数字表法分为研究组和对照组,每组53例,对照组采用雷珠单抗治疗,研究组在对照组的基础上加用前列地尔治疗,比较两组治疗后疗效、不良反应,比较两组治疗前后血管内皮生长因子(VEGF)、内皮素-1(ET-1)、一氧化氮(NO)、收缩期峰值血流速度(PSV)、舒张末期血流速度(EDV)、搏动指数(PI)、视力、黄斑中心凹厚度(CMT)、视野灰度值等。结果研究组总有效率为94.34%,明显高于对照组的81.13%,差异有统计学意义(P<0.05);研究组治疗后CMT、视野灰度值明显低于治疗前及对照组治疗后,视力明显高于治疗前及对照组治疗后,差异有统计学意义(P<0.05);研究组治疗后PI、VEGF、ET-1水平均明显低于治疗前及对照组治疗后,PSV、EDV、NO明显高于治疗前及对照组治疗后,差异有统计学意义(P<0.05);两组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论雷珠单抗联合前列地尔治疗糖尿病视网膜病变,能提高患者视力及治疗总疗效率,明显改善患者眼部血流动力学。

Objective To explore the efficacy of alprostadil combined with ranzumab in the treatment of diabetes retinopathy and its effect on ocular hemodynamics.Methods A total of 106 patients with diabetic retinopathy admitted to Shenmu Hospital from January 2019 to March 2022 were selected as the study objects and divided into study group and control group by random number table method,with 53 cases in each group.The control group was treated with ranzumab,and the study group was treated with alprostadil on the basis of the control group.The therapeutic efficacy and adverse reactions of the two groups were compared.Vascular endothelial growth factor(VEGF),endothelin-1(ET-1),nitric oxide(NO),peak systolic blood flow velocity(PSV),end-diastolic blood flow velocity(EDV),pulse index(PI),visual acuity,macular foveal thickness(CMT)and visual field gray value were compared before and after treatment.Results The effective rate of the study group was 94.34%,which was significantly higher than that of the control group(81.13%),with statistical significance(P<0.05).The CMT and visual field gray in the study group after treatment were significantly lower than those before treatment and in the control group after treatment,and the visual acuity was significantly higher than that before treatment and in the control group after treatment,the differences were statistically significant(P<0.05).The levels of PI,VEGF and ET-1 in the study group after treatment were significantly lower than those before treatment and in the control group after treatment,while PSV,EDV and NO were significantly higher than those before treatment and in the control group after treatment,with statistical significance(P<0.05).There was no significant difference on the incidence rate of adverse reactions between the two groups(P>0.05).Conclusion The combination of ranzumab and alprostadil in the treatment of diabetes retinopathy can improve the visual acuity and the overall therapeutic effect,and improve significantly the ocular hemodynamics.