【摘要】 目的观察玻璃体腔注射雷珠单抗联合氪激光光凝治疗糖尿病视网膜病变黄斑水肿(DME)的临床疗效。方法筛选出2013年1月至2014年11月我院收治的符合纳入标准的DME患者25例(单纯激光组15例,24只眼;玻璃体腔注药术联合激光组10例,13只眼),对照组给予单纯氪激光(510 nm红激光、483 nm黄激光)格栅样或大"C"字形光凝术,观察组在氪激光光凝后给予玻璃体腔注射雷珠单抗。随访期末采用国际标准视力表检查患者治疗前后视力,使用光学相干断层扫描仪(OCT)检查患者治疗前后黄斑区视网膜厚度变化情况。结果治疗前2组患者视力比较,差异无统计学意义(P>0.05);与治疗前视力相比,治疗后2组患者视力均显著提高(P<0.05);治疗后视力组间比较,观察组视力好于对照组(P<0.05)。观察组和对照组治疗前黄斑区视网膜厚度分别为(510.75±61.06)μm、(487.47±43.41)μm,2组间差异无统计学意义(P>0.05);治疗后黄斑区视网膜厚度分别为(253.41±39.12)μm、(358.81±43.24)μm,较治疗前均降低(P<0.05)。治疗后黄斑区视网膜厚度组间比较,观察组视力均好于对照组(P<0.05)。结论单纯氪激光光凝与玻璃体腔注射雷珠单抗联合氪激光光凝对DME均有疗效。但玻璃体腔注射雷珠单抗联合氪激光光凝相对于单纯氪激光光凝,其治疗DME的术后视力恢复更显著,黄斑水肿吸收效果更明显。更多还原

【Abstract】 Objective To observe the clinical efficacy of bevacizumab intravitreal injection combined with laser photocoagulation for diabetic retinopathy macular edema( DME). Methods 25 DME patients(15 patients,24 eyes in control group and 10 patients,13 eyes in treatment group) were selected from January 2013 to November 2014 in our hospital. The control group received single Krypton laser(510 nm red and 483 nm yellow) grid photocoagulation or big"C"photocoagulation,while the treatment group received bevacizumab intravitreal injection after Krypton laser photocoagulation. The visual acuity were checked,and the macular retinal thickness was detected by optical coherence tomography( OCT). Results The difference in preoperative visual acuity between the two groups was not statistically significant( P > 0. 05). All visual acuity improved significantly( P < 0. 05) after treatment and the treatment group got a better result compared to the control group( P < 0. 05). The preoperative macular retinal thickness in treatment and control groups were respectively( 510. 75 ±61. 06) μm and(487. 47 ± 43. 41) μm,and the difference between them was not statistically significant( P > 0. 05). And the macular retinal thickness were respectively( 253. 41 ± 39. 12) μm and( 358. 81 ± 43. 24) μm after treatment,which were all decreased than before(P < 0. 05). The macular retinal thickness of the treatment group was better than that of the treatment group after treatment(P < 0. 05).Conclusion Single Krypton laser photocoagulation and bevacizumab intravitreal injection combined with Krypton laser photocoagulation are all effective for DME. But treatment combined with Krypton laser photocoagulation could get significantly better postoperative visual acuity recovery and significantly faster absorption of macular edema.更多还原