【摘要】：目的比較577 nm、532 nm激光全視網(wǎng)膜激光光凝(panretinal photocoagulation,PRP)治療重度非增生型糖尿病視網(wǎng)膜病變(non-proliferative diabetic retinopathy,NPDR)的臨床療效。方法前瞻性臨床對照研究。納入重度NPDR患者42例64眼,隨機(jī)分為577 nm組和532 nm組,采用單點(diǎn)模式行PRP,術(shù)前及術(shù)后1 d、1個月、3個月、6個月檢查最佳矯正視力(best corrected visual acuity,BCVA)、眼底、光學(xué)相干斷層掃描(optical coherence tomography,OCT)、全視野閃光視網(wǎng)膜電圖(flash electroretinogram,F-ERG),術(shù)后3個月、6個月行眼底熒光血管造影(fundus fluorescein angiography,FFA)檢查。結(jié)果 577 nm組和532nm組光斑點(diǎn)數(shù)分別為(1969.25±278.19)點(diǎn)、(2098.16±289.27)點(diǎn);激光功率分別為(425.23±50.15)m W、(438.15±38.48)m W;能量密度分別為(7.54±1.54)m W·ms-1·μm-2、(7.68±3.01)m W·ms-1·μm-2,平均光斑數(shù)(t=2.68)、平均激光功率(t=1.46)、平均能量密度(t=2.15)的組間差異均無統(tǒng)計學(xué)意義(均為P0.05)。兩組患者術(shù)后1個月、3個月、6個月,組間黃斑中心凹厚度(central macular thickness,CMT)差異均無統(tǒng)計學(xué)意義(t=1.98、1.88、1.81,均為P0.05);兩組患者術(shù)后1個月、3個月、6個月F-ERG振幅(a波:t=5.94、5.19、6.97;b波:t=5.67、4.56、5.12)組間差異均有統(tǒng)計學(xué)意義(均為P0.05)。術(shù)后6個月兩組患者治療有效率分別為87.5%、46.9%,差異有統(tǒng)計學(xué)意義(χ2=7.56,P0.05)。結(jié)論 577 nm激光比532nm激光治療重度NPDR有效率更高,視功能損傷程度更小。
[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 鹵278.19) points and (2098.16 鹵289.27) points, respectively, and the laser power was (425.23 鹵50.15) m W, () 438.15 鹵38.48) m W; energy density was (7.54 鹵1.54) m W ms-1 渭 m -2), (7.68 鹵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.
【作者單位】： 川北醫(yī)學(xué)院附屬醫(yī)院眼科;
【基金】：四川省教育廳基金項(xiàng)目(編號:15SB0113)~~
【分類號】：R587.2;R779.63

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