577 nm微脉冲激光联合抗血管内皮生长因子药物治疗糖尿病黄斑水肿的研究

Study of 577 nm micropulse laser combined with anti-vascular endothelial growth factor drug in the treatment of diabetic macular edema

目的探讨577 nm微脉冲激光联合抗血管内皮生长因子(anti-VEGF)药物治疗糖尿病黄斑水肿(DME)的效果。方法选取2018年4月至2021年4月于江西医学高等专科学校第一附属医院确诊的60例(60眼)DME患者作为研究对象,按照随机数字表法分为观察组与对照组,每组30例(30眼)。对照组给予璃体腔注射anti-VEGF药物治疗,观察组给予577 nm阈下微脉冲激光联合anti-VEGF药物治疗。比较两组临床疗效、最佳矫正视力[BCVA(logMAR)]、黄斑中心区视网膜厚度(CMT)、不良反应发生情况。结果观察组治疗总有效率为96.67%,高于对照组的73.33%,差异有统计学意义(P<0.05)。治疗后1、3、6个月,两组BCVA均低于前一时间点,CMT均薄于前一时间点,且观察组BCVA低于对照组,CMT薄于对照组,差异有统计学意义(P<0.05)。两组不良反应发生率比较差异无统计学意义。结论577 nm微脉冲激光联合anti-VEGF药物治疗DME的效果显著,可改善患者视力水平,减少黄斑厚度,且不良反应少,值得临床推广应用。

Objective To explore the curative effect of 577 nm micropulse laser combined with anti-vascular endothelial growth factor(anti-VEGF)drug in the treatment of diabetic macular edema(DME).Methods A total of 60 patients(60 eyes)with DME confirmed in the First Affiliat-ed Hospital of Jiangxi Medical College from April 2018 to April 2021 were selected as the research subjects,they were divided into the observation group and the control group according to random number table method,with 30 cases(30 eyes)in each group.The control group was given intravitre-al injection of anti-VEGF drug treatment,while the observation group was additionally treated with 577 nm micropulse laser.The clinical curative ef-fect,best corrected visual acuity(BCVA[logMAR]),central macular thickness(CMT)and the occurrence of adverse reactions were compared be-tween the two groups.Results The total effective rate of treatment in the observation group was 96.67%,which was higher than 73.33%in the con-trol group,and the difference was statistically significant(P<0.05).At 1,3 and 6 months after treatment,the BCVA of the two groups was lower than that at the previous time point,and the CMT was thinner than that at the previous time point,and the BCVA in the observation group was lower than that in the control group,and the CMT was thinner than that in the control group,the differences were statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups.Conclusion Curative effect of 577 nm micropulse laser combined with anti-VEGF drug is significant in the treatment of DME,which can improve visual acuity,reduce macular thickness,with few adverse reactions,which is worthy of clinical promotion and application.