抗VEGF药物联合糖皮质激素治疗糖尿病黄斑水肿的疗效观察

发布时间：2018-04-01 05:03

本文选题：抗血管内皮生长因子　切入点：糖皮质激素　出处：《华北理工大学》2017年硕士论文

【摘要】：目的探讨抗血管内皮生长因子(vascular endothelial growth factor,VEGF)药物联合糖皮质激素治疗糖尿病黄斑水肿(diabetic macular edema,DME)的疗效;为糖尿病黄斑水肿患者找到更有效的治疗方法。方法将我院眼科中被诊断为糖尿病黄斑水肿的病人96例按照匹配的方法分为单纯糖皮质激素组和抗VEGF药物联合糖皮质激素联合治疗组,每组48例,其中男性26例,平均(50.4±4.2)岁;女性22例,平均(53.7±3.9)岁。入选标准:所有病例均确诊为糖尿病,且经光学相干断层扫描技术及荧光素眼底血管造影证实有DME,并排除影响OCT检查的其他眼部疾病。单纯糖皮质激素组给予单纯糖皮质激素玻璃体注射治疗,联合治疗组采用抗VEGF药物与糖皮质激素组联合玻璃体注射治疗,注射前常规的每天滴入含有加替沙星的眼药水4次,连续滴3天。通过观察两组患者在接受不同治疗前后的BCVA、TMV、CRT值的变化、黄斑水肿轻重程度的改变以及渗漏分型改变情况,研究两组的视力变化情况,探讨两种治疗方法对治疗糖尿病黄斑水肿的治疗效果。结果经过12个月的治疗,单纯糖皮质激素组和抗VEGF药物联合糖皮质激素联合治疗组的BCVA、TMV、CRT、黄斑水肿轻重程度以及渗漏分型等指标分别与治疗前相比较,均有统计学意义差异(P0.05),说明两组药物对糖尿病黄斑水肿均有效;联合治疗组与单纯糖皮质激素治疗组相比较(P0.05),差异有统计学意义,且联合治疗组的疗效相对单纯糖皮质激素组更高。结论1单纯糖皮质激素治疗和抗VEGF药物联合糖皮质激素治疗的方法均对DME患者的视力有改善作用;2抗VEGF药物联合糖皮质激素治疗组疗效优于单纯糖皮质激素治疗组,联合治疗组的治疗效果更明显,更有利于DME患者的病情的好转。
[Abstract]:Objective to investigate the anti vascular endothelial growth factor (vascular endothelial, growth factor, VEGF) drugs combined with glucocorticoids in the treatment of diabetic macular edema (diabetic macular, edema, DME) effect; find a more effective treatment for patients with diabetic macular edema. Methods in our hospital were diagnosed as diabetic macular edema in 96 patients, according to the the method is divided into simple glucocorticoid group and anti VEGF drugs combined with glucocorticoid combined treatment group, 48 cases in each group, there were 26 males, average (50.4 + 4.2) years; 22 were female, the average (53.7 + 3.9) years old. Inclusion criteria: all patients were diagnosed with diabetes, and the optical coherence tomography and fundus fluorescein angiography confirmed the effect of DME, OCT and other eye diseases examination excluded. Single glucocorticoid group treated with corticosteroid injection in the treatment of combined treatment of vitreous body. A group of anti VEGF drugs and glucocorticoid group combined with vitreous body injection, injection of conventional daily drops containing gatifloxacin eye drops 4 times, continuous infusion for 3 days. By observing the two groups of patients before and after receiving different treatment of BCVA, TMV, CRT changes, weight change of the degree of macular edema and leakage type change, study of visual acuity in two groups, the therapeutic effect of two treatment methods on treatment of diabetic macular edema. Results after 12 months of treatment, simple glucocorticoid group and anti VEGF drugs combined with glucocorticoid combined treatment group BCVA, TMV, CRT, and the degree of macular edema leakage type indicators were compared with before treatment, there was statistically significant difference (P0.05), two groups of drugs were effective for diabetic macular edema; combined treatment group and simple glucocorticoid treatment group compared (P0.05) , the difference was statistically significant, and the effect of the combined treatment group relatively simple glucocorticoid group higher. Conclusion 1 pure corticosteroid therapy and anti VEGF drugs combined with glucocorticoid therapy for DME patients in improving the vision effect; 2 anti VEGF drugs combined with glucocorticoid treatment group curative effect is better than pure sugar glucocorticoid treatment group, combined treatment group the treatment effect is more obvious, more conducive to the improvement of disease in patients with DME.

【学位授予单位】：华北理工大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R587.2;R774.5

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