贝伐单抗联合曲安奈德玻璃体腔内注射治疗DME的疗效

目的:探讨贝伐单抗联合曲安奈德玻璃体腔内注射治疗糖尿病性黄斑水肿(diabetic macular edema,DME)的临床疗效。方法:将105例105眼DME患者随机分为贝伐单抗联合曲安奈德组、单纯曲安奈德组和单纯激光组各35例35眼,三组分别采用玻璃体腔内注射贝伐单抗联合曲安奈德注射液、玻璃体腔内注射曲安奈德注射液和多波长激光光凝的不同治疗方法。结果:所有患者在治疗后均进行6mo的随访,根据患者视力、眼压、裂隙灯、FFA和OCT等检查结果进行疗效判定。激光组中,显效12例(34.3%),有效14例(40.0%),无效9例(25.7%),总有效率74.3%。曲安奈德组中,显效15例(42.9%),有效18例(51.4%),无效2例(5.7%),总有效率94.3%。贝伐单抗联合曲安奈德组中,显效23例(65.7%),有效12例(34.3%),没有无效病例,总有效率100%。经统计学处理,贝伐单抗联合曲安奈德组的有效率高于曲安奈德组和激光组,差异均具有统计学差异(P<0.05,P<0.01),贝伐单抗联合曲安奈德组和曲安奈德组的总有效率均显著高于激光组(P<0.01,P<0.01),贝伐单抗联合曲安奈德组和曲安奈德组之间的总有效率相比较,无统计学差异(P>0.05)。结论:贝伐单抗联合曲安奈德玻璃体腔内注射治疗DME的临床疗效显著,值得进一步研究和应用。

Investigation on effects of intravitreal injection of bevacizumab and triarncinolone acetonide for diabetes macular edema

AIM:To investigate clinical effect of intravitreal injection of bevacizumab and triarncinolone acetonide for diabetes macular edema(DME).

METHODS: There were 105 cases suffering diabetic macular edema. They were divided into three groups randomly, bevacizumab with triarncinolone group(35 cases), triarncinolone acetonide group(35 cases), and laser group(35 cases). Bevacizumab with triarncinolone group patients were given intravitreal injection of bevacizumab and triarncinolone acetonide. Triarncinolone acetonide group patients were given intravitreal injection of triarncinolone. Laser group were given laser photocoagulation.

RESULTS: All patients were followed up for 6 months. We observed patients' visual acuity, intraocular pressure, slit lamp, FFA and OCT. Among laser group patients, excellent in 12 cases(34.3%), effective 14 cases(40.0%), ineffective 9 cases(25.7%), total effective rate was 74.3%. Among triarncinolone group patients, excellent in 15 cases(42.9%), effective 18 cases(51.4%), ineffective 2 cases(5.7%), total effective rate was 94.3%. Among bevacizumab and triarncinolone group patients, excellent in 23 cases(65.7%), effective 12 cases(34.3%), ineffective 0 case, total effective rate was 100%. We analyzed these data by statistic method. We found excellence rate of bevacizumab and triarncinolone group was higher than other two groups', and the two differences were significant(P<0.05 and P<0.01). Total effective rate of bevacizumab with triarncinolone group and triarncinolone group both were significantly higher than laser group(P<0.01 and P<0.01). There were no significant differences between the total effective rates of evacizumab with triarncinolone group and triarncinolone group.

CONCLUSION: The clinical effects of intravitreal injection of bevacizumab and triarncinolone acetonide for DME is significant, and this method is worthy of studying and application.