羟苯磺酸钙与曲安奈德对糖尿病黄斑水肿患者血清内皮生长因子和细胞间黏附分子-1的影响比较
|
摘要
目的比较羟苯磺酸钙与曲安奈德对糖尿病黄斑水肿(DME)患者血清血管内皮生长因子(VEGF)和细胞间黏附分子-1(ICAM-1)的影响。方法回顾性分析医院2015年6月至2017年6月收治的DME患者102例(102眼)的临床资料,根据治疗方案的不同分为观察组50例和对照组52例。对照组予激光光凝联合羟苯磺酸钙,观察组予激光光凝联合曲安奈德。结果治疗1,6个月后,两组最佳矫正视力均高于治疗前(P <0. 05),黄斑中心凹厚度、血清VEGF和ICAM-1指标水平均低于治疗前(P <0. 05),且观察组变动幅度大于对照组(P <0. 05);治疗前、治疗1个月及6个月后两组眼压对比,差异均无统计学意义(P> 0. 05);治疗6个月后,两组中文版低视力者生活质量量表(CLVQOL)评分均高于治疗前(P <0. 05),观察组增幅大于对照组(P <0. 05);两组不良反应发生率比较无显著差异(P> 0. 05)。结论曲安奈德治疗DME在改善患者视力、降低黄斑中心凹厚度及控制VEGF和ICAM-1水平疗效优于羟苯磺酸钙,但两药治疗安全性无差异。
Objective To compare the effects of calcium dobesilate and triamcinolone acetonide on serum vascular endothelial growthfactor( VEGF) and intercellular adhesion molecule-1( ICAM-1) in patients with diabetic macular edema( DME). Methods The clinicaldata of 102 patients( 102 eyes) with DME from June 2015 to June 2017 were retrospectively analyzed,the patients were divided into theobservation group( n = 50) and the control group( n = 52) according to different treatment regimen. The patients in the control group weregiven laser photocoagulation combined with calcium dobesilate,while the patients in the observation group were given laser photocoagulationcombined triamcinolone acetonide. Results After 1 month and 6 months of treatment,the best corrected visual acuity( BVCA) in the twogroups was higher than that before treatment( P < 0. 05),the macular foveal thickness and the levels of serum VEGF and ICAM-1 inthe two groups were lower than those before treatment( P < 0. 05),and the changes in the observation group were more significant thanthose in the control group( P < 0. 05). There was no statistically significant difference in intraocular pressure between the two groupsbefore treatment and at 1 month and 6 months after treatment( P > 0. 05). After 6 months of treatment,the scores of Chinese-versionLow Vision Quality of Life Questionnaire( CLVQOL) in the two groups were higher than those before treatment( P < 0. 05),and theincrease in the observation group was more significant than that in the control group( P < 0. 05). There was no significant differencein the incidence rate of adverse reactions between the two groups( P > 0. 05). Conclusion Triamcinolone acetonide in the treatment ofDME is superior to calcium dobesilate in improving the visual acuity,reducing the macular foveal thickness,and controlling the levels ofVEGF and ICAM-1,but there is no difference in the safety between the two drugs.
Objective To compare the effects of calcium dobesilate and triamcinolone acetonide on serum vascular endothelial growthfactor( VEGF) and intercellular adhesion molecule-1( ICAM-1) in patients with diabetic macular edema( DME). Methods The clinicaldata of 102 patients( 102 eyes) with DME from June 2015 to June 2017 were retrospectively analyzed,the patients were divided into theobservation group( n = 50) and the control group( n = 52) according to different treatment regimen. The patients in the control group weregiven laser photocoagulation combined with calcium dobesilate,while the patients in the observation group were given laser photocoagulationcombined triamcinolone acetonide. Results After 1 month and 6 months of treatment,the best corrected visual acuity( BVCA) in the twogroups was higher than that before treatment( P < 0. 05),the macular foveal thickness and the levels of serum VEGF and ICAM-1 inthe two groups were lower than those before treatment( P < 0. 05),and the changes in the observation group were more significant thanthose in the control group( P < 0. 05). There was no statistically significant difference in intraocular pressure between the two groupsbefore treatment and at 1 month and 6 months after treatment( P > 0. 05). After 6 months of treatment,the scores of Chinese-versionLow Vision Quality of Life Questionnaire( CLVQOL) in the two groups were higher than those before treatment( P < 0. 05),and theincrease in the observation group was more significant than that in the control group( P < 0. 05). There was no significant differencein the incidence rate of adverse reactions between the two groups( P > 0. 05). Conclusion Triamcinolone acetonide in the treatment ofDME is superior to calcium dobesilate in improving the visual acuity,reducing the macular foveal thickness,and controlling the levels ofVEGF and ICAM-1,but there is no difference in the safety between the two drugs.
引文
[1]许迅,郑颖.重视对糖尿病黄斑水肿的治疗[J].中华眼底病杂志,2016,32(2):119-121.
[2]杨柳,张婧.糖尿病性黄斑水肿治疗方法的选择[J].中华眼科杂志,2017,53(10):724-728.
[3]史勇洪,贾岩龙.不同方法治疗全视网膜光凝后黄斑水肿的疗效比较[J].国际眼科杂志,2016,16(9):1632-1636.
[4]秦艳,游志鹏,胡娇莉,等.糖尿病性黄斑水肿的药物治疗进展[J].眼科新进展,2018,38(3):281-284.
[5]中华医学会糖尿病学分会.中国2型糖尿病防治指南(2013年版)[J].中华内分泌代谢杂志,2014,30(10):26-89.
[6]管欢,张茸,王海波.光凝联合抗VEGF用药治疗黄斑水肿对患者房水血管活性分子表达的影响[J].临床和实验医学杂志,2018,17(4):425-428.
[7]郑惠兰,卢秀兰,郑晓燕,等.老年低视力患者生活质量与护理服务需求的研究[J].国际眼科杂志,2018,18(1):137-139.
[8]李玮.糖尿病黄斑水肿及其危险因素的研究进展[J].中华实验眼科杂志,2017,35(7):664-668.
[9]朱振涛.眼底激光联合羟苯磺酸钙治疗糖尿病视网膜病变[J].国际眼科杂志,2017,17(2):288-290.
[10]宋青山,王丁丁,陈子林.两种剂量曲安奈德玻璃体腔注射治疗糖尿病性黄斑水肿的疗效及安全性对比[J].临床眼科杂志,2016,24(3):219-221.
[11]寇豆,郝晓琳,张仲臣.糖尿病黄斑水肿的治疗进展[J].国际眼科杂志,2016,16(5):864-868.
[12]李晓慧,陈宝霞,申勇智,等.曲安奈德皮损内注射对兔耳创面瘢痕形成影响的实验研究[J].河北医药,2017,39(23):3626-3628.
[13]胡菁,杨贵丽,顾丽萍.羟苯磺酸钙胶囊治疗老年糖尿病视网膜病变的疗效及其对VEGF、IGF-1水平的影响[J].实用老年医学,2017,31(5):451-453.
[14]胡利梅,闫武超,任卫东,等.糖尿病视网膜病变患者血清VEGF、ES、TKLK、TSP、s ICAM-1水平的变化及意义[J].国际眼科杂志,2017,17(12):2304-2307.
[15]卜莉,韩磊.曲安奈德联合激光光凝治疗糖尿病黄斑水肿患者疗效及对生活质量影响的观察[J].药物流行病学杂志,2017,26(7):446-449.
[16]周荣乐.雷珠单抗与曲安奈德治疗糖尿病性黄斑水肿41例对照观察[J].陕西医学杂志,2016,45(1):91-92.
[2]杨柳,张婧.糖尿病性黄斑水肿治疗方法的选择[J].中华眼科杂志,2017,53(10):724-728.
[3]史勇洪,贾岩龙.不同方法治疗全视网膜光凝后黄斑水肿的疗效比较[J].国际眼科杂志,2016,16(9):1632-1636.
[4]秦艳,游志鹏,胡娇莉,等.糖尿病性黄斑水肿的药物治疗进展[J].眼科新进展,2018,38(3):281-284.
[5]中华医学会糖尿病学分会.中国2型糖尿病防治指南(2013年版)[J].中华内分泌代谢杂志,2014,30(10):26-89.
[6]管欢,张茸,王海波.光凝联合抗VEGF用药治疗黄斑水肿对患者房水血管活性分子表达的影响[J].临床和实验医学杂志,2018,17(4):425-428.
[7]郑惠兰,卢秀兰,郑晓燕,等.老年低视力患者生活质量与护理服务需求的研究[J].国际眼科杂志,2018,18(1):137-139.
[8]李玮.糖尿病黄斑水肿及其危险因素的研究进展[J].中华实验眼科杂志,2017,35(7):664-668.
[9]朱振涛.眼底激光联合羟苯磺酸钙治疗糖尿病视网膜病变[J].国际眼科杂志,2017,17(2):288-290.
[10]宋青山,王丁丁,陈子林.两种剂量曲安奈德玻璃体腔注射治疗糖尿病性黄斑水肿的疗效及安全性对比[J].临床眼科杂志,2016,24(3):219-221.
[11]寇豆,郝晓琳,张仲臣.糖尿病黄斑水肿的治疗进展[J].国际眼科杂志,2016,16(5):864-868.
[12]李晓慧,陈宝霞,申勇智,等.曲安奈德皮损内注射对兔耳创面瘢痕形成影响的实验研究[J].河北医药,2017,39(23):3626-3628.
[13]胡菁,杨贵丽,顾丽萍.羟苯磺酸钙胶囊治疗老年糖尿病视网膜病变的疗效及其对VEGF、IGF-1水平的影响[J].实用老年医学,2017,31(5):451-453.
[14]胡利梅,闫武超,任卫东,等.糖尿病视网膜病变患者血清VEGF、ES、TKLK、TSP、s ICAM-1水平的变化及意义[J].国际眼科杂志,2017,17(12):2304-2307.
[15]卜莉,韩磊.曲安奈德联合激光光凝治疗糖尿病黄斑水肿患者疗效及对生活质量影响的观察[J].药物流行病学杂志,2017,26(7):446-449.
[16]周荣乐.雷珠单抗与曲安奈德治疗糖尿病性黄斑水肿41例对照观察[J].陕西医学杂志,2016,45(1):91-92.