【摘要】：目的:本研究旨在對(duì)比玻璃體腔內(nèi)注射康柏西普聯(lián)合激光治療,與單純激光治療,對(duì)于糖尿病黃斑水腫的有效性和安全性。方法:回顧性病例對(duì)照研究。選取2015年5月～2016年12月于我院就診的糖尿病性黃斑水腫患者30例(30只眼)為研究對(duì)象,分為對(duì)照組(15例,單純激光治療)和實(shí)驗(yàn)組(15例,玻璃體腔內(nèi)注射康柏西普聯(lián)合激光治療)。比較兩組患者在治療前和治療后1周、1個(gè)月和3個(gè)月最佳矯正視力(best corrected visual acuity,BCVA)、6 mm 黃斑區(qū)總?cè)莘e(total macular volume,TMV)和黃斑中心厚度(central macular thickness,CMT),并注意并發(fā)癥的發(fā)生情況。結(jié)果:治療后1周、1個(gè)月和3個(gè)月患眼的BCVA與治療前相比,除對(duì)照組患眼治療后1周的BCVA較治療前無(wú)統(tǒng)計(jì)學(xué)意義(P=0.386),對(duì)照組(P=0.020、P=0.008)、實(shí)驗(yàn)組(P =0.011、P =0.001、P =0.001)患眼治療后其余時(shí)間 BCVA均較治療前明顯提高,差異有統(tǒng)計(jì)學(xué)意義。治療后1周、1個(gè)月和3個(gè)月,實(shí)驗(yàn)組的BCVA較對(duì)照組的均提高,差異具有統(tǒng)計(jì)學(xué)意義(P=0.044、P=0.019、P=0.039)。(2)治療后1周、1個(gè)月和3個(gè)月患眼的CMT與治療前相比,除對(duì)照組治療后1周CMT較治療前無(wú)統(tǒng)計(jì)學(xué)意義(P=0.242),對(duì)照組(P=0.036、P=0.015)、實(shí)驗(yàn)組(P=0.028,P=0.010,P=0.001)患眼治療后其余時(shí)間CMT均較治療前明顯降低,差異有統(tǒng)計(jì)學(xué)意義。治療后1周、1個(gè)月和3個(gè)月,實(shí)驗(yàn)組患眼CMT較對(duì)照組均降低,差異具有統(tǒng)計(jì)學(xué)意義(P=0.011、P=0.046、P=0.033)。(3)治療后1周、1個(gè)月和3個(gè)月患眼的TMV與治療前相比,除對(duì)照組治療后1周TMV較治療前無(wú)統(tǒng)計(jì)學(xué)意義(P=0.109),對(duì)照組(P=0.001、P=0.001)、實(shí)驗(yàn)組(P=0.012,P=0.001,P=0.001)患眼治療后其余時(shí)間TMV均較治療前明顯降低,差異有統(tǒng)計(jì)學(xué)意義。治療后1周,兩組的TMV差異無(wú)統(tǒng)計(jì)學(xué)意義(P=0.468)。治療后1個(gè)月和3個(gè)月,實(shí)驗(yàn)組的TMV較對(duì)照組均降低,差異具有統(tǒng)計(jì)學(xué)意義(P=0.010,P=0.008)。(4)治療后其他并發(fā)癥情況:實(shí)驗(yàn)組出現(xiàn)球結(jié)膜下出血1例,未治療,15天內(nèi)自行消退;兩組未發(fā)現(xiàn)眼內(nèi)炎、視網(wǎng)膜脫離、葡萄膜炎、玻璃體積血、白內(nèi)障進(jìn)展、長(zhǎng)期高眼壓等并發(fā)癥。結(jié)論:在治療糖尿病黃斑水腫時(shí),與單純進(jìn)行激光治療相比,玻璃體腔注射康柏西普聯(lián)合激光治療,能更好地改善患者視力,減輕黃斑水腫情況,減少不良反應(yīng),具有更好的療效和安全性。
[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.
【學(xué)位授予單位】：大連醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R587.2;R779.63

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