不同波长激光治疗重度非增生型糖尿病视网膜病变的疗效观察

发布时间：2018-09-12 17:20

【摘要】：目的比较577 nm、532 nm激光全视网膜激光光凝(panretinal photocoagulation,PRP)治疗重度非增生型糖尿病视网膜病变(non-proliferative diabetic retinopathy,NPDR)的临床疗效。方法前瞻性临床对照研究。纳入重度NPDR患者42例64眼,随机分为577 nm组和532 nm组,采用单点模式行PRP,术前及术后1 d、1个月、3个月、6个月检查最佳矫正视力(best corrected visual acuity,BCVA)、眼底、光学相干断层扫描(optical coherence tomography,OCT)、全视野闪光视网膜电图(flash electroretinogram,F-ERG),术后3个月、6个月行眼底荧光血管造影(fundus fluorescein angiography,FFA)检查。结果 577 nm组和532nm组光斑点数分别为(1969.25±278.19)点、(2098.16±289.27)点;激光功率分别为(425.23±50.15)m W、(438.15±38.48)m W;能量密度分别为(7.54±1.54)m W·ms-1·μm-2、(7.68±3.01)m W·ms-1·μm-2,平均光斑数(t=2.68)、平均激光功率(t=1.46)、平均能量密度(t=2.15)的组间差异均无统计学意义(均为P0.05)。两组患者术后1个月、3个月、6个月,组间黄斑中心凹厚度(central macular thickness,CMT)差异均无统计学意义(t=1.98、1.88、1.81,均为P0.05);两组患者术后1个月、3个月、6个月F-ERG振幅(a波:t=5.94、5.19、6.97;b波:t=5.67、4.56、5.12)组间差异均有统计学意义(均为P0.05)。术后6个月两组患者治疗有效率分别为87.5%、46.9%,差异有统计学意义(χ2=7.56,P0.05)。结论 577 nm激光比532nm激光治疗重度NPDR有效率更高,视功能损伤程度更小。
[Abstract]:Objective to compare the clinical efficacy of 577 nm,532 nm laser total retinal laser photocoagulation (panretinal photocoagulation,PRP) in the treatment of severe nonproliferative diabetic retinopathy (non-proliferative diabetic retinopathy,NPDR). Methods prospective clinical controlled study. Forty-two patients (64 eyes) with severe NPDR were randomly divided into 577 nm group and 532 nm group. The best corrected visual acuity (best corrected visual acuity,BCVA) was examined before and 1 day, 1 month, 3 months and 6 months after PRP, with single point mode. Optical coherence tomography (optical coherence tomography,OCT), full field flash electroretinogram (flash electroretinogram,F-ERG) and fundus fluorescein angiography (fundus fluorescein angiography,FFA) were performed 3 months and 6 months after operation. Results the number of spot points in 577 nm group and 532nm group were (1969.25 卤278.19) points and (2098.16 卤289.27) points, respectively, and the laser power was (425.23 卤50.15) m W, () 438.15 卤38.48) m W; energy density was (7.54 卤1.54) m W ms-1 渭 m -2), (7.68 卤3.01) m W ms-1 渭 m -2), average spot number (t 2.68), average laser power (t 1. 46) and mean energy density (t = 2.15) had no statistical significance (P0.05). Two groups of patients 1 month, 3 months, 6 months after surgery, There was no significant difference in macular foveal thickness (central macular thickness,CMT) between the two groups (t = 1.98, 1.88 or 1.81, all P 0.05), but the amplitude of F-ERG was significantly different between the two groups at 1 month, 3 months and 6 months after operation (a wave: t 5.945.195.195.196.97kW / t 5.674.55.12) (P0.05). Six months after operation, the effective rate of treatment was 87.5% and 46.9%, respectively, and the difference was statistically significant (蠂 ~ 2, 7.5g, P 0.05). Conclusion 577 nm laser is more effective than 532nm laser in the treatment of severe NPDR.
【作者单位】：川北医学院附属医院眼科;
【基金】：四川省教育厅基金项目(编号:15SB0113)~~
【分类号】：R587.2;R779.63

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