改良全视网膜激光光凝术治疗糖尿病性视网膜病变的临床效果及对血清VEGF水平的影响

doi:10.7517/issn.1674-0475.190916

摘要/Abstract

摘要： 为探讨改良全视网膜激光光凝术治疗糖尿病性视网膜病变（DR）的临床效果，以及对患者血清血管内皮生长因子（VEGF）水平的影响，本研究选取2018年1月~2019年1月我院收治的DR患者168例（212眼），随机分为对照组和观察组，各84例（106眼）。对照组给予常规全视网膜激光光凝术治疗，观察组给予改良全视网膜激光光凝术治疗，光凝治疗间隔为1周，持续4周完成治疗。随访6个月，观察两组患者的临床疗效，比较治疗前后患者的最佳矫正视力、眼压、视网膜毛细血管无灌注区和新生血管消退情况，以及血清VEGF和ET-1水平。治疗后6个月，观察组治疗总有效率为92.45%，明显高于对照组的75.47%，差异有统计学意义（P<0.05）。两组最佳矫正视力、眼压，与治疗前及组间比较差异均无统计学意义（P>0.05）。观察组视网膜毛细血管无灌注区和新生血管消退率均明显高于对照组，差异有统计学意义（P<0.05）。两组血清VEGF、ET-1水平较治疗前均降低，且观察组血清VEGF、ET-1水平均明显低于对照组，差异有统计学意义（P<0.05）。两组随访期间均未出现视力严重下降、眼压升高、黄斑水肿明显增加或玻璃体出血等严重并发症。表明改良全视网膜激光光凝术治疗DR安全有效，有助于促进视网膜无灌注区和新生血管消退，降低VEGF水平，改善视网膜缺血缺氧状态，控制病变的进一步发展。

关键词: 糖尿病性视网膜病变(DR), 改良全视网膜激光光凝术, 血管内皮生长因子(VEGF)

Abstract: To investigate the clinical effect of modified panretinal photocoagulation in the treatment of diabetic retinopathy (DR) and its effect on serum vascular endothelial growth factor (VEGF), this study selected 168 DR patients (212 eyes) admitted to our hospital from January 2018 to January 2019 were randomly divided into control group and observation group, 84 cases (106 eyes) in each group. The control group was treated with whole retina laser photocoagulation, while the observation group was treated with improved whole retina laser photocoagulation. The interval of photocoagulation therapy was 1 week, the treatment lasted 4 weeks. Following up for 6 months, the clinical effects of the two groups were observed; Before and after treatment, the best corrected visual acuity, intraocular pressure, retinal capillary non-perfusion area and regression of neovascularization were compared, and serum levels of vascular endothelial growth factor and ET-1 were compared. 6 months after treatment, the total effective rate of the observation group (92.45%) was significantly higher than that of the control group (75.47%), and the difference was statistically significant (P<0.05). There was no significant difference in the best corrected visual acuity and intraocular pressure between the two groups before and after treatment (P>0.05). Retinal capillary non-perfusion area and the regression rate of neovascularization in the observation group were significantly higher than those in the control group (P<0.05). The levels of serum VEGF and ET-1 in both groups were lower than those before treatment, and the levels of serum VEGF and ET-1 in the observation group were significantly lower than those in the control group (P<0.05). During the follow-up period, no serious complications such as visual acuity decrease, intraocular pressure increase, macular edema increase or vitreous hemorrhage occurred in both groups. The results show that, the modified panretinal photocoagulation is safe and effective in the treatment of DR. It is helpful to promote the regression of retinal non-perfusion area and neovascularization, reduce the level of vascular endothelial growth factor, improve the status of retinal ischemia and hypoxia, and control the further development of retinal lesions.

Key words: diabetic retinopathy(DR), modified panretinal photocoagulation, vascular endothelial growth factor

中图分类号:

徐建龙, 马青. 改良全视网膜激光光凝术治疗糖尿病性视网膜病变的临床效果及对血清VEGF水平的影响[J]. 影像科学与光化学, 2020, 38(2): 301-306.

XU Jianlong, MA Qing. Clinical Effect of Modified Panretinal Photocoagulation on Diabetic Retinopathy and Its Effect on Serum Level of Vascular Endothelial Growth Factor[J]. Imaging Science and Photochemistry, 2020, 38(2): 301-306.

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