术前玻璃体腔注射康柏西普联合25G+玻璃体切割术治疗增殖性糖尿病视网膜病变

Efficacy of preoperative intravitreal injection of Conbercept combined with 25G+pars plana vitrectomy in the treatment of proliferative diabetic retinopathy

目的:探讨术前玻璃体腔注射康柏西普联合25G+玻璃体切割术(PPV)治疗增殖性糖尿病视网膜(PDR)病变的疗效。方法:回顾性分析。收集2019-01/2021-06我院收治的PDR患者154例176眼临床资料。根据治疗方法分为联合治疗组80例92眼采用术前玻璃体腔注射康柏西普联合25G+PPV治疗,对照组74例84眼仅采用25G+PPV治疗。比较两组患者治疗后临床疗效,手术前后血清脂肪因子[脂联素(APN)、视黄醇结合蛋白4(RBP4)]水平。结果:术后1mo联合治疗组临床疗效优于对照组(P<0.05)。术后3mo,两组RBP4水平低于术前(P<0.05),且联合治疗组术后低于对照组(P<0.05);两组血清APN显著高于术前(P<0.05),联合治疗组高于对照组(P<0.05)。随访3mo,联合治疗组视网膜增殖、术后并发症发生率低于对照组(P<0.05)。结论:术前玻璃体腔注射康柏西普联合25G+PPV有利于提高PDR治疗效果,降低并发症发生率,可能与调控脂肪因子的表达有关。

AIM:To explore the efficacy of preoperative intravitreal injection of conbercept combined with 25G+pars plana vitrectomy(PPV)in the treatment of proliferative diabetic retinopathy(PDR).METHODS:The clinical data of 154 patients(176 eyes)with PDR admitted to our hospital from January 2019 to June 2021 were collected for retrospective analysis.According to the treatment methods,80 patients(92 eyes)in combined treatment group were treated with preoperative intravitreal injection of conbercept combined with 25G+PPV,and 74 patients(84 eyes)in control group were given 25G+PPV only.The postoperative clinical efficacy and levels of adipokines[adiponectin(APN),retinol binding protein 4(RBP4)]before and after surgery were compared between both groups of patients.RESULTS:The combined treatment group showed better clinical efficacy than the control group at 1mo after surgery(P<0.05).Both groups had lower RBP4 levels at 3mo after surgery(P<0.05),with the combined treatment group showing a lower level than the control group(P<0.05).Serum APN levels significantly increased in both groups after surgery(P<0.05),with the combined treatment group having a higher level than the control group(P<0.05).The combined treatment group had lower incidence rates of retinal proliferation and postoperative complications after than the control group 3mo of follow-up(P<0.05).CONCLUSION:Preoperative intravitreal injection of conbercept combined with 25G+PPV is beneficial in improving the therapeutic effect of PDR and reducing the incidence rates of complications,which may be related to the regulations of the expressions of adipokines.