玻璃体腔注射康柏西普联合激光治疗糖尿病黄斑水肿的疗效观察

发布时间：2018-11-08 11:56

【摘要】：目的:本研究旨在对比玻璃体腔内注射康柏西普联合激光治疗,与单纯激光治疗,对于糖尿病黄斑水肿的有效性和安全性。方法:回顾性病例对照研究。选取2015年5月～2016年12月于我院就诊的糖尿病性黄斑水肿患者30例(30只眼)为研究对象,分为对照组(15例,单纯激光治疗)和实验组(15例,玻璃体腔内注射康柏西普联合激光治疗)。比较两组患者在治疗前和治疗后1周、1个月和3个月最佳矫正视力(best corrected visual acuity,BCVA)、6 mm 黄斑区总容积(total macular volume,TMV)和黄斑中心厚度(central macular thickness,CMT),并注意并发症的发生情况。结果:治疗后1周、1个月和3个月患眼的BCVA与治疗前相比,除对照组患眼治疗后1周的BCVA较治疗前无统计学意义(P=0.386),对照组(P=0.020、P=0.008)、实验组(P =0.011、P =0.001、P =0.001)患眼治疗后其余时间 BCVA均较治疗前明显提高,差异有统计学意义。治疗后1周、1个月和3个月,实验组的BCVA较对照组的均提高,差异具有统计学意义(P=0.044、P=0.019、P=0.039)。(2)治疗后1周、1个月和3个月患眼的CMT与治疗前相比,除对照组治疗后1周CMT较治疗前无统计学意义(P=0.242),对照组(P=0.036、P=0.015)、实验组(P=0.028,P=0.010,P=0.001)患眼治疗后其余时间CMT均较治疗前明显降低,差异有统计学意义。治疗后1周、1个月和3个月,实验组患眼CMT较对照组均降低,差异具有统计学意义(P=0.011、P=0.046、P=0.033)。(3)治疗后1周、1个月和3个月患眼的TMV与治疗前相比,除对照组治疗后1周TMV较治疗前无统计学意义(P=0.109),对照组(P=0.001、P=0.001)、实验组(P=0.012,P=0.001,P=0.001)患眼治疗后其余时间TMV均较治疗前明显降低,差异有统计学意义。治疗后1周,两组的TMV差异无统计学意义(P=0.468)。治疗后1个月和3个月,实验组的TMV较对照组均降低,差异具有统计学意义(P=0.010,P=0.008)。(4)治疗后其他并发症情况:实验组出现球结膜下出血1例,未治疗,15天内自行消退;两组未发现眼内炎、视网膜脱离、葡萄膜炎、玻璃体积血、白内障进展、长期高眼压等并发症。结论:在治疗糖尿病黄斑水肿时,与单纯进行激光治疗相比,玻璃体腔注射康柏西普联合激光治疗,能更好地改善患者视力,减轻黄斑水肿情况,减少不良反应,具有更好的疗效和安全性。
[Abstract]:Objective: to compare the efficacy and safety of intravitreous injection of Compactopril and laser alone in the treatment of diabetic macular edema. Methods: retrospective case-control study. From May 2015 to December 2016, 30 patients (30 eyes) with diabetic macular edema were divided into control group (15 cases) and experimental group (15 cases). Intravitreous injection of Corbeseptide combined with laser therapy. The best corrected visual acuity (best corrected visual acuity,BCVA), total macular area volume (total macular volume,TMV) and central macular thickness (central macular thickness,CMT) were compared between the two groups before treatment and 1 week, 1 month and 3 months after treatment. The occurrence of complications was noted. Results: there was no significant difference in BCVA between the control group and the control group at 1 week, 1 month and 3 months after treatment (P0. 386), and in the control group (P0. 020 P0. 008). In the experimental group (P = 0.011, P = 0.001, P = 0.001), the BCVA in the other time after treatment was significantly higher than that before treatment, and the difference was statistically significant. At 1 week, 1 month and 3 months after treatment, the BCVA of the experimental group was significantly higher than that of the control group (P0. 04, P0. 019, P0. 039). (2). There was no significant difference in CMT between 1 month and 3 months after treatment compared with that before treatment (P0. 242), the control group (P0. 036), the experimental group (P0. 028), the control group (P0. 036), the control group (P0. 028). P0. 001) the CMT in other time after treatment was significantly lower than that before treatment, and the difference was statistically significant. At 1 week, 1 month and 3 months after treatment, the CMT of the affected eyes in the experimental group was lower than that in the control group, and the difference was statistically significant (P0. 011, P0. 046, P0. 033). (3). There was no significant difference in TMV between 1 month and 3 months after treatment compared with that before treatment (P0. 109), the control group (P0. 001), the experimental group (P0. 012), the control group (P0. 001), the control group (P0. 001). P0. 001) the TMV in other time after treatment was significantly lower than that before treatment, and the difference was statistically significant. 1 week after treatment, there was no significant difference in TMV between the two groups (P0. 468). One month and three months after treatment, the TMV of the experimental group was lower than that of the control group, and the difference was statistically significant (P < 0.01). Other complications after treatment: subconjunctival hemorrhage occurred in 1 case without treatment in the experimental group. Regression within 15 days; No complications such as endophthalmitis, retinal detachment, uveitis, vitreous volume blood, cataract progression, long-term high intraocular pressure were found in the two groups. Conclusion: in the treatment of diabetic macular edema, compared with laser therapy alone, intravitreal injection of Compactopril combined with laser therapy can improve visual acuity, alleviate macular edema, and reduce adverse reactions in patients with diabetic macular edema. It has better efficacy and safety.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R587.2;R779.63

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