阿柏西普治疗糖尿病性视网膜病变黄斑囊样水肿的效果

Effect of Aflibercept in the Treatment of Cystoid Macular Edema in Diabetic Retinopathy

目的:探讨阿柏西普治疗糖尿病性视网膜病变黄斑囊样水肿的临床效果。方法:选取2020年1月—2022年1月临清市中医院收治的100例糖尿病性视网膜病变黄斑囊样水肿患者,使用随机数字表法分为观察组(n=50)及对照组(n=50)。对照组接受玻璃体内注射曲安奈德治疗,观察组接受玻璃体内注射阿柏西普治疗,对比两组的临床指标、眼部相关指标、血管生成相关指标及并发症发生率。结果:两组的视网膜水肿时间、出血时间及水肿渗出吸收时间相较差异均无统计学意义(P>0.05)。术后7 d,两组的最佳矫正视力均上升,黄斑中心厚度、黄斑区荧光面积、眼底出血面积均降低,视网膜循环时间均缩短,差异均有统计学意义(P<0.05);但术后7 d两组上述指标相较差异均无统计学意义(P>0.05)。术后7 d,两组的血管内皮生长因子(VEGF)、促血管生成素-2(Ang-2)及一氧化氮合成酶(NOS)均降低,促血管生成素-1(Ang-1)均上升(P<0.05);术后7 d,观察组的Ang-2及NOS均低于对照组,Ang-1高于对照组(P<0.05),两组VEGF水平相较差异无统计学意义(P>0.05)。观察组的并发症发生率(2.00%)低于对照组(14.00%)(P<0.05)。结论:玻璃体内注射曲安奈德与阿柏西普均可促进糖尿病性视网膜病变黄斑囊样水肿患者视力水平改善,显著减轻黄斑水肿,但阿柏西普更有助于改善眼底循环,减少并发症,安全性较高。

Objective:To investigate the clinical effects of Aflibercept in the treatment of cystoid macular edema in diabetic retinopathy.Method:One hundred patients with diabetic retinopathy cystoid macular edema admitted to Linqing Hospital of Traditional Chinese Medicine from January 2020 to January 2022 were selected,they were divided into observation group(n=50)and control group(n=50)by random number table method.The control group received intravitreal injection of Triamcinolone Acetonide and the observation group received intravitreal injection of Aflibercept.The clinical indicators,ocular-related indicators,angiogenesis-related indicators and complication rates of the two groups were compared.Result:There were no significant differences in retinal edema time,bleeding time and edema exudation absorption time between the two groups(P>0.05).7 d after surgery,the optimal corrected visual acuity of both groups increased,the central thickness of macula,the fluorescence area of macula and the area of fundus bleeding decreased,and the retinal circulation time were shortened,the differences were statistically significant(P<0.05);however,there were no significant differences in the above indexes between the two groups 7 d after surgery(P>0.05).7 d after surgery,vascular endothelial growth factor(VEGF),angiopoietin-2(Ang-2)and nitric oxide synthase(NOS)were all decreased,while angiopoietin-1(Ang-1)were increased in both groups(P<0.05);7 d after surgery,Ang-2 and NOS in the observation group were lower than those in the control group,and Ang-1 was higher than that in the control group(P<0.05),there was no significant difference in VEGF levels between the two groups(P>0.05).The complication rate in the observation group(2.00%)was lower than that in the control group(14.00%)(P<0.05).Conclusion:Intravitreal injection of Triamcinolone Acetonide and Aflibercept can improve the visual acuity of patients with cystoid macular edema of diabetic retinopathy and significantly reduce macular edema,but Aflibercept is more helpful to improve fundus circulation,reduce complications and have high safety.