IVA+PRP治疗增殖性糖尿病视网膜病变的疗效及对视网膜各层次厚度、视力的影响

Efficacy of IVA+PRP in the Treatment of Proliferative Diabetic Retinopathy and Its Effect on Retinal Thickness and Visual Acuity at Various Levels of the Retina

目的 针对增殖性糖尿病视网膜病变者应用玻璃体腔注射阿柏西普(intravitreous injection of arbacicept, IVA)、全视网膜光凝(panretinal photocoagulation, PRP)的疗效及对视网膜各层次厚度、视力的影响。方法 方便选取2021年9月—2022年9月泰州市中医院收治的96例增殖性糖尿病视网膜病变患者作为研究对象,以随机数表法分为观察组(48例,IVA+PRP治疗)与对照组(48例,PRP治疗),比较两组视网膜各层次厚度、中心黄斑厚度、最佳矫正视力、血清指标、治疗效果、不良事件发生率。结果 术前及术后30 d,两组黄斑区视网膜神经纤维层、神经节细胞层、内丛状层厚度比较,差异无统计学意义(P>0.05)。术前,两组中心黄斑厚度、最佳矫正视力比较,差异无统计学意义(P>0.05);术后30 d,观察组中心黄斑厚度、最佳矫正视力均低于对照组,差异有统计学意义(P<0.05)。术前,两组血清同型半胱氨酸、血清视黄醇结合蛋白4水平比较,差异无统计学意义(P>0.05);术后30 d,观察组血清同型半胱氨酸、血清视黄醇结合蛋白4水平均较对照组低,差异有统计学意义(P<0.05)。观察组治疗有效率97.92%高于对照组83.33%,差异有统计学意义(χ^(2)=4.512,P<0.05)。两组不良事件发生率比较,差异无统计学意义(P>0.05)。结论 对增殖性糖尿病视网膜病变患者实行IVA+PRP治疗,能有效改善中心黄斑厚度,提升其最佳矫正视力,调节其血清指标,其临床治疗效果更理想,可推广。

Objective The therapeutic efficacy of vitreous cavity injection of appercept(IVA)and panretinal photocoagulation(PRP),and their effects on retinal thickness and visual acuity in proliferative diabetic retinopathy.Methods 96 patients with proliferative Diabetic retinopathy admitted to Taizhou Hospital of Traditional Chinese Medicine from September 2021 to September 2022 were conveniently selected as the research objects.They were randomly divided into the observation group(48 cases,IVA+PRP treatment)and the control group(48 cases,PRP treatment).The retinal thickness at all levels,central macular thickness,best corrected visual acuity,serum indicators,treatment effect,and incidence of adverse events of the two groups were compared.Results There was no statistically significant difference in the thickness of retinal nerve fiber layer,ganglion cell layer and inner plexus layer in the macular area between the two groups before and 30 days after surgery(P>0.05).Before surgery,there was no statistically significant difference in central macular thickness and optimal corrected visual acuity between the two groups(P>0.05);30 days after surgery,the central macular thickness and optimal corrected visual acuity in the observation group were lower than those in the control group,and the difference was statistically significant(P<0.05).Before operation,there was no statistically significant difference in the levels of serum homocysteine and serum retinol binding protein 4 between the two groups(P>0.05);30 days after operation,the levels of serum homocysteine and serum retinol binding protein 4 in the observation group were lower than those in the control group,and the difference was statistically significant(P<0.05).The effective rate of treatment in the observation group was 97.92%higher than that in the control group,which was 83.33%,and the difference was statistically significant(χ^(2)=4.512,P<0.05).There was no statistically significant difference in the incidence of adverse events between the two groups(P>0.05).Conclusion IVA+PRP treatment for patients with proliferative diabetic retinopathy can effectively improve the central macular thickness,improve their best corrected vision,and adjust their serum indicators.Its clinical treatment effect is more ideal and can be promoted.