本文選題：抗血管內(nèi)皮生長(zhǎng)因子　切入點(diǎn)：糖皮質(zhì)激素　出處：《華北理工大學(xué)》2017年碩士論文

【摘要】：目的探討抗血管內(nèi)皮生長(zhǎng)因子(vascular endothelial growth factor,VEGF)藥物聯(lián)合糖皮質(zhì)激素治療糖尿病黃斑水腫(diabetic macular edema,DME)的療效;為糖尿病黃斑水腫患者找到更有效的治療方法。方法將我院眼科中被診斷為糖尿病黃斑水腫的病人96例按照匹配的方法分為單純糖皮質(zhì)激素組和抗VEGF藥物聯(lián)合糖皮質(zhì)激素聯(lián)合治療組,每組48例,其中男性26例,平均(50.4±4.2)歲;女性22例,平均(53.7±3.9)歲。入選標(biāo)準(zhǔn):所有病例均確診為糖尿病,且經(jīng)光學(xué)相干斷層掃描技術(shù)及熒光素眼底血管造影證實(shí)有DME,并排除影響OCT檢查的其他眼部疾病。單純糖皮質(zhì)激素組給予單純糖皮質(zhì)激素玻璃體注射治療,聯(lián)合治療組采用抗VEGF藥物與糖皮質(zhì)激素組聯(lián)合玻璃體注射治療,注射前常規(guī)的每天滴入含有加替沙星的眼藥水4次,連續(xù)滴3天。通過(guò)觀察兩組患者在接受不同治療前后的BCVA、TMV、CRT值的變化、黃斑水腫輕重程度的改變以及滲漏分型改變情況,研究?jī)山M的視力變化情況,探討兩種治療方法對(duì)治療糖尿病黃斑水腫的治療效果。結(jié)果經(jīng)過(guò)12個(gè)月的治療,單純糖皮質(zhì)激素組和抗VEGF藥物聯(lián)合糖皮質(zhì)激素聯(lián)合治療組的BCVA、TMV、CRT、黃斑水腫輕重程度以及滲漏分型等指標(biāo)分別與治療前相比較,均有統(tǒng)計(jì)學(xué)意義差異(P0.05),說(shuō)明兩組藥物對(duì)糖尿病黃斑水腫均有效;聯(lián)合治療組與單純糖皮質(zhì)激素治療組相比較(P0.05),差異有統(tǒng)計(jì)學(xué)意義,且聯(lián)合治療組的療效相對(duì)單純糖皮質(zhì)激素組更高。結(jié)論1單純糖皮質(zhì)激素治療和抗VEGF藥物聯(lián)合糖皮質(zhì)激素治療的方法均對(duì)DME患者的視力有改善作用;2抗VEGF藥物聯(lián)合糖皮質(zhì)激素治療組療效優(yōu)于單純糖皮質(zhì)激素治療組,聯(lián)合治療組的治療效果更明顯,更有利于DME患者的病情的好轉(zhuǎn)。
[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.

【學(xué)位授予單位】：華北理工大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R587.2;R774.5

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本文編號(hào)：1694068