视网膜光凝术联合康柏西普对DR患者房水VEGF、SDF-1的影响
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摘要
目的:探讨视网膜光凝术联合康柏西普对DR患者房水VEGF、基质细胞衍生因子1(SDF-1)的影响。方法:选取2016-09/2018-09本院DR患者120例,依据随机数字表分为联合组和光凝组,每组60例,光凝组给予视网膜光凝术治疗,联合组给予视网膜光凝术联合康柏西普玻璃体腔注射治疗。比较两组治疗后房水VEGF、SDF-1及BCVA、CMT、并发症。结果:联合组和光凝组术后1d房水VEGF(151.46±18.52、186.74±20.17pg/mL)、SDF-1(466.72±50.21、534.46±56.24mg/L)明显低于术前,且联合组低于光凝组(P<0.05)。两组术后1、3mo CMT、BCVA值明显低于术前,且联合组低于光凝组(P<0.05)。联合组和光凝组术后并发症发生率无差异(6.7%vs 5.0%,P>0.05)。结论:视网膜光凝术联合康柏西普可有效降低DR患者房水VEGF、SDF-1,有利于提高患者治疗疗效,且安全性好。
AIM:To discuss the effect of retinal photocoagulation combined with conbercept on the aqueous humor vascular endothelial growth factor(VEGF) and stromal cell-derived factor-1(SDF-1) in patients with diabetic retinopathy(DR).METHODS: Totally 120 patients with DR were selected from September 2016 to September 2018 in our hospital, according to the random number table, they were divided into combined group and photocoagulation group, 60 cases in each group.The photocoagulation group was treated with retinal photocoagulation, and the combined group was treated with retinal photocoagulation combined intravitreal injection of conbercept.The aqueous humor VEGF, SDF-1, CMT, BCVA and complication were compared between the two groups.RESULTS: The postoperative aqueous humor(151.46±18.52,186.74±20.17 pg/mL), SDF-1(466.72±50.21, 534.46±56.24 mg/L) in the combined group and photocoagulation group were significantly lower than those in the preoperative, the combined group were lower than the photocoagulation group(P<0.05).The 1 and 3mo postoperative CMT, BCVA in the combined group and photocoagulation group were significantly lower than those in the preoperative, the combined group were lower than the photocoagulation group(P<0.05).There was no significant difference of the complication rate between combined group and photocoagulation group(6.7% vs 5.0%, P>0.05).CONCLUSION: Retinal photocoagulation combined with conbercept can effectively reduce the aqueous humor VEGF and SDF-1 in patients with DR, which is conducive to improving the therapeutic effect of patients, and it is safety.
AIM:To discuss the effect of retinal photocoagulation combined with conbercept on the aqueous humor vascular endothelial growth factor(VEGF) and stromal cell-derived factor-1(SDF-1) in patients with diabetic retinopathy(DR).METHODS: Totally 120 patients with DR were selected from September 2016 to September 2018 in our hospital, according to the random number table, they were divided into combined group and photocoagulation group, 60 cases in each group.The photocoagulation group was treated with retinal photocoagulation, and the combined group was treated with retinal photocoagulation combined intravitreal injection of conbercept.The aqueous humor VEGF, SDF-1, CMT, BCVA and complication were compared between the two groups.RESULTS: The postoperative aqueous humor(151.46±18.52,186.74±20.17 pg/mL), SDF-1(466.72±50.21, 534.46±56.24 mg/L) in the combined group and photocoagulation group were significantly lower than those in the preoperative, the combined group were lower than the photocoagulation group(P<0.05).The 1 and 3mo postoperative CMT, BCVA in the combined group and photocoagulation group were significantly lower than those in the preoperative, the combined group were lower than the photocoagulation group(P<0.05).There was no significant difference of the complication rate between combined group and photocoagulation group(6.7% vs 5.0%, P>0.05).CONCLUSION: Retinal photocoagulation combined with conbercept can effectively reduce the aqueous humor VEGF and SDF-1 in patients with DR, which is conducive to improving the therapeutic effect of patients, and it is safety.
引文
1杨乐,薛雨顺,石蕊.玻璃体腔注射雷珠单抗联合超全视网膜光凝治疗视盘新生血管型糖尿病视网膜病变.国际眼科杂志2018;18(9):1710-1712
2 Xu Y,Rong A,Xu W,et al.Comparison of 12-month therapeutic effect of conbercept and ranibizumab for diabetic macular edema:a real-life clinical practice study.BMC Ophthalmol 2017;17(1):158
3王智勇,刘丽萍,高永峰.糖尿病视网膜病变患者血清Gas6、SDF-1α和SDF-1β变化及意义.国际眼科杂志2017;17(5):861-864
4牛红霞,吉昂.玻璃体腔注射康柏西普联合视网膜光凝治疗糖尿病性黄斑水肿的疗效观察.解放军医学杂志2018;43(3):268-270
5 Miller CG,Budoff G,Jeng-Miller KW,et al.Retina specialists treating diabetic macular edema recommend different approaches for patients than they would choose for themselves.Ophthalmic Surg Lasers Imaging Retina 2016;47(6):544-554
6高静,刘晓,王敏哲,等.VEGF、SDF-1在糖尿病视网膜血管病变发生、发展中的作用及机制.新疆医科大学学报2016;39(10):1286-1290
7 Grauslund J.Vascular endothelial growth factor inhibition for proliferative diabetic retinopathy:Et tu,Brute?Acta Ophthalmol 2017;95(8):757-758
8李高春,林咸平,王乐丹,等.视网膜光凝术联合药物治疗糖尿病视网膜病变疗效及其对血管内皮生长因子、类胰岛素一号增长因子水平的影响.中国基层医药2018;25(8):965-968
9 Kaewput W,Thongprayoon C,Rangsin R,et al.Associations of renal function with diabetic retinopathy and visual impairment in type 2 diabetes:A multicenter nationwide cross-sectional study.World J Nephrol 2019;8(2):33-43
10付浴东,王萍,江莉,等.玻璃体腔注射雷珠单抗、全视网膜激光光凝对增生型糖尿病视网膜病变患眼玻璃体切割手术及治疗效果的影响.中华眼底病杂志2015;31(2):143-146
11 Khansari MM,O'Neill W,Penn R,et al.Automated fine structure image analysis method for discrimination of diabetic retinopathy stage using conjunctival microvasculature images.Biomed Opt Express 2016;7(7):2597-2606
12王琛,李东豪,闻毅颐.玻璃体内注射康柏西普联合周边视网膜选择性光凝治疗视网膜静脉阻塞继发黄斑水肿的疗效及安全性.眼科新进展2016;36(5):471-473
13 Pérez-Argandoňa E,Verdaguer J,Zacharías S,et al.Preoperative intravitreal bevacizumab for proliferative diabetic retinopathy patients undergoing vitrectomy-First update.Medwave 2019;19(1):e7512
14吴志勇,姚宜,闵云花,等.康柏西普辅助微创玻璃体切除术治疗增生性糖尿病视网膜病变的临床观察.临床眼科杂志2017;25(2):141-144
15 Luo WJ,Zhang WF.The relationship of blood cell-associated inflammatory indices and diabetic retinopathy:a Meta-analysis and systematic review.Int J Ophthalmol 2019;12(2):312-323
2 Xu Y,Rong A,Xu W,et al.Comparison of 12-month therapeutic effect of conbercept and ranibizumab for diabetic macular edema:a real-life clinical practice study.BMC Ophthalmol 2017;17(1):158
3王智勇,刘丽萍,高永峰.糖尿病视网膜病变患者血清Gas6、SDF-1α和SDF-1β变化及意义.国际眼科杂志2017;17(5):861-864
4牛红霞,吉昂.玻璃体腔注射康柏西普联合视网膜光凝治疗糖尿病性黄斑水肿的疗效观察.解放军医学杂志2018;43(3):268-270
5 Miller CG,Budoff G,Jeng-Miller KW,et al.Retina specialists treating diabetic macular edema recommend different approaches for patients than they would choose for themselves.Ophthalmic Surg Lasers Imaging Retina 2016;47(6):544-554
6高静,刘晓,王敏哲,等.VEGF、SDF-1在糖尿病视网膜血管病变发生、发展中的作用及机制.新疆医科大学学报2016;39(10):1286-1290
7 Grauslund J.Vascular endothelial growth factor inhibition for proliferative diabetic retinopathy:Et tu,Brute?Acta Ophthalmol 2017;95(8):757-758
8李高春,林咸平,王乐丹,等.视网膜光凝术联合药物治疗糖尿病视网膜病变疗效及其对血管内皮生长因子、类胰岛素一号增长因子水平的影响.中国基层医药2018;25(8):965-968
9 Kaewput W,Thongprayoon C,Rangsin R,et al.Associations of renal function with diabetic retinopathy and visual impairment in type 2 diabetes:A multicenter nationwide cross-sectional study.World J Nephrol 2019;8(2):33-43
10付浴东,王萍,江莉,等.玻璃体腔注射雷珠单抗、全视网膜激光光凝对增生型糖尿病视网膜病变患眼玻璃体切割手术及治疗效果的影响.中华眼底病杂志2015;31(2):143-146
11 Khansari MM,O'Neill W,Penn R,et al.Automated fine structure image analysis method for discrimination of diabetic retinopathy stage using conjunctival microvasculature images.Biomed Opt Express 2016;7(7):2597-2606
12王琛,李东豪,闻毅颐.玻璃体内注射康柏西普联合周边视网膜选择性光凝治疗视网膜静脉阻塞继发黄斑水肿的疗效及安全性.眼科新进展2016;36(5):471-473
13 Pérez-Argandoňa E,Verdaguer J,Zacharías S,et al.Preoperative intravitreal bevacizumab for proliferative diabetic retinopathy patients undergoing vitrectomy-First update.Medwave 2019;19(1):e7512
14吴志勇,姚宜,闵云花,等.康柏西普辅助微创玻璃体切除术治疗增生性糖尿病视网膜病变的临床观察.临床眼科杂志2017;25(2):141-144
15 Luo WJ,Zhang WF.The relationship of blood cell-associated inflammatory indices and diabetic retinopathy:a Meta-analysis and systematic review.Int J Ophthalmol 2019;12(2):312-323