阿司匹林联合雷珠单抗治疗对糖尿病视网膜病变患者临床效果及视力水平的影响

孙大量

【摘要】 目的：探討阿司匹林联合雷珠单抗治疗对糖尿病视网膜病变患者的临床效果及视力水平的影响。方法：选取2018年10月-2020年8月112例本院的糖尿病视网膜病变患者，根据随机数字表法分为对照组和研究组，每组56例。对照组应用羟苯磺酸钙和阿司匹林，研究组在对照组的基础上加用雷珠单抗。比较两组治疗前后的视力水平、视网膜厚度、Ang-1、Ang-2、VEGF及并发症发生情况。结果：治疗前，两组视力水平和视网膜厚度比较，差异均无统计学意义（P>0.05）;治疗后，两组视力水平均高于治疗前，视网膜厚度低于治疗前，且研究组视力水平为（0.55±0.17）高于对照组的（0.38±0.15），视网膜厚度为（304.1±34.1）μm低于对照组的（366.3±31.2）μm，差异均有统计学意义（P<0.05）。治疗前，两组Ang-1、Ang-2、VEGF比较，差异均无统计学意义（P>0.05）;治疗后，研究组Ang-1为（13.99±2.57）μg/L高于对照组（10.61±2.36）μg/L，Ang-2、VEGF分别为（4.22±0.93）μg/L、（92.33±22.78）μg/L低于对照组的（5.28±1.04）μg/L、（125.61±25.64）μg/L，差异均有统计学意义（P<0.05）。研究组并发症发生率为7.1%低于对照组的23.2%，差异有统计学意义（P<0.05）。结论：糖尿病视网膜病变患者联合应用阿司匹林和雷珠单抗效果较好，可以改善降低视网膜厚度，改善视力水平和眼底微循环，提高治疗效果，且不良反应少，安全性高。

【关键词】 阿司匹林 雷珠单抗 糖尿病视网膜病变

[Abstract] Objective： To investigate the clinical effect of Aspirin combined with Ranibizumab and its influence of visual acuity of patients with diabetic retinopathy. Method： A total of 112 patients with diabetic retinopathy in our hospital from October 2018 to August 2020 were selected， and they were divided into control group and study group according to random number table method， 56 cases in each group. The control group was treated with Calcium Dobesilate and Aspirin， the study group was treated with Ranibizumab on the basis of the control group. The visual acuity， retinal thickness， Ang-1， Ang-2， VEGF before and after treatment were compared between two groups， the incidence of complications was compared between two groups. Result： Before treatment， there were no significant differences in visual acuity and retinal thickness between two groups （P>0.05）; after treatment， the visual acuity of both groups were higher than those before treatment， and the retinal thickness were lower than those before treatment， and the visual acuity of the study group was （0.55±0.17）， which was higher than （0.38±0.15） of the control group， and the retinal thickness was （304.1±34.1） μm， which was lower than （366.3±31.2） μm of the control group， the differences were statistically significant （P<0.05）. Before treatment， there were no significant differences in Ang-1， Ang-2 and VEGF between two groups （P>0.05）; after treatment， Ang-1 of the study group was （13.99±2.57） μg/L， which was higher than （10.61±2.36） μg/L of the control group， Ang-2 and VEGF were （4.22±0.93） μg/L and （92.33±22.78） μg/L， respectively， which were lower than （5.28±1.04） μg/L and （125.61±25.64） μg/L of the control group， the differences were statistically significant （P<0.05）. The complication rate of the study group was 7.1%， which was lower than 23.2% of the control group， the difference was statistically significant （P<0.05）. Conclusion： The application of Aspirin and Ranibizumab in patients with diabetic retinopathy has a good effect， which can improve and reduce retinal thickness， improve visual acuity and fundus microcirculation， and improve the therapeutic effect， with fewer adverse reactions and high safety.

[Key words] Aspirin Ranibizumab Diabetic retinopathy

First-author’s address： The 4th People’s Hospital of Shenyang， Shenyang 110000， China

doi：10.3969/j.issn.1674-4985.2021.25.016

生活、饮食习惯的改变导致糖尿病（DM）患者越来越多，而糖尿病视网膜病变是糖尿病引发的一种严重的并发症，也是导致成年人视力丧失的主要原因[1]。目前，临床中暂时没有糖尿病视网膜病变（DR）的发病机制，也没有特效的治疗方法，因此需要早发现、早治疗用以延缓DR的进展，最大程度保留患者的视力[2]。……