抗VEGF药物联合全视网膜光凝治疗糖尿病视网膜病变的疗效及预后

Efficacy and Prognosis of Joint Application of Anti-VEGF Drugs and Total Retinal Photocoagulation in Treating Diabetic Retinopathy

目的探讨抗血管内皮生长因子(Vascular Endothelial Growth Factor, VEGF)药物联合全视网膜光凝治疗糖尿病视网膜病变的疗效及预后。方法回顾性研究2017年6月至2018年6月,糖尿病视网膜病变患者57例62只眼,根据治疗方式不同分为研究组32例35只眼,抗VEGF药物注射后1周进行全视网膜光凝治疗;对照组25例27只眼,采用全视网膜光凝治疗。随访6个月,比较两组患者临床治疗有效率,视网膜新生血管渗漏面积(Retinal Neovascularization Leakage Area, RNV)、黄斑区病变中心厚度(Central Retinal Thickness, CRT)值、血浆VEGF水平、最佳矫正视力(Best Corrected Visual Acuity, BCVA)的改变情况,同时记录不良反应发生情况率。结果研究组和对照组临床治疗有效率分别为94.6%和80.9%,两组比较差异具有统计学意义(P<0.05)。治疗后两组RNV、CRT及血浆VEGF水平与治疗前比较均明显降低;且研究组RNV、CRT及血浆VEGF水平均明显低于对照组,差异具有统计学意义(P<0.05)。治疗后1、3和6个月,研究组BCVA水平明显高于对照组,差异具有统计学意义(P<0.05)。研究组和对照组不良反应发生率分别为9.09%和14.9%,两组比较差异无统计学意义(P>0.05)。结论抗VEGF药物联合全视网膜光凝治疗糖尿病视网膜病变疗效显著,可明显改善患者眼底病变,提高患者视力,降低不良反应发生率、安全性较高、预后良好,值得临床推广。

Objective To investigate the efficacy and prognosis of joint application of anti-vascular endothelial growth factor(VEGF)drugs and total retinal photocoagulation in treating diabetic retinopathy.Methods Totally 57 patients(62 eyes)with diabetic retinopathy treated from Jun.2017 to Jun.2018 were selected as research objects.They were divided into the study group(n=32,35 eyes)and control group(n=25,27 eyes)by treating methods.The patients in the study group were treated jointly with anti-VEGF drugs and total retinal photocoagulation,those in the control group only with total retinal photocoagulation.After 6 months’follow-up,the clinical treatment efficiency of the two groups was compared,and the retinal neovascularization leakage area(RNV),central retinal thickness(CRT)in macular area,plasma VEGF level,best corrected visual acuity(BCVA)and adverse reactions of both groups before and after the treatment were compared.Results The clinical effective rate of the study group and the control group were 94.6%and 80.9%respectively,and the difference was statistically significant(P<0.05).Before the treatment,there was no significant difference between the two groups in RNV,CRT and level of plasma VEGF(P>0.05).After the treatment,the RNV,CRT and level of plasma VEGF dropped significantly in both groups.The RNV,CRT and level of plasma VEGF in the study group were significantly lower than those in the control group,and the difference with statistically significant(P<0.05).Before the treatment,there was no significant difference in the BCVA between the two groups(P>0.05).The BCVA in the study group was significantly higher than that in the control group 1,3 and 6 months after the treatment,and the differences were statistically significant(P<0.05).The incidence of adverse reactions in the study group and control group was 9.09%and 14.9%respectively,and the difference between them was not significant(P>0.05).Conclusions The combination of anti-VEGF drugs and total retinal photocoagulation is highly effective in treating diabetic retinopathy,and will improve remarkably patients’fundus lesions and vision and reduce the incidence of adverse events.As a safe therapy with good prognosis,it is worthy of clinical promotion.