對于重度非增殖期糖尿病性視網(wǎng)膜病變的患者采用眼底激光聯(lián)合雷珠單抗進行治療的臨床效果分析

對于重度非增殖期糖尿病性視網(wǎng)膜病變的患者采用眼底激光聯(lián)合雷珠單抗進行治療的臨床效果分析摘要：目的：探究眼底激光聯(lián)合雷珠單抗對于重度非增殖期糖尿病性視網(wǎng)膜病變患者的治療效果。方法：選取2018年3月至2019年3月于我院就診的40例重度非增殖期糖尿病性視網(wǎng)膜病變患者，隨機分為治療組和對照組，各20例。治療組采用眼底激光聯(lián)合雷珠單抗進行治療，對照組僅采用傳統(tǒng)的眼底激光進行治療。觀察兩組患者的治療效果、視力恢復(fù)情況及不良反應(yīng)情況。結(jié)果：治療組患者治療后視力恢復(fù)情況明顯優(yōu)于對照組（P<0.05），治療后眼底視網(wǎng)膜微血管出血及水腫、硬滲、玻璃體混濁等各項指標(biāo)的改善情況均顯著優(yōu)于對照組（P<0.05）。兩組患者的不良反應(yīng)情況無明顯差異。結(jié)論：眼底激光聯(lián)合雷珠單抗對于重度非增殖期糖尿病性視網(wǎng)膜病變患者具有較好的臨床治療效果，值得臨床推廣。

關(guān)鍵詞：糖尿病性視網(wǎng)膜病變；眼底激光；雷珠單抗；治療效果；視力恢復(fù)

Abstract:Objective:Toexploretheclinicalefficiencyofretinallasercombinedwithranibizumabinthetreatmentofseverenon-proliferativediabeticretinopathy(NPDR).Methods:FortysevereNPDRpatientswhowereadmittedtoourhospitalfromMarch2018toMarch2019wereselectedandrandomlydividedintothetreatmentgroupandthecontrolgroup,with20casesineachgroup.Thetreatmentgroupwastreatedwithretinallasercombinedwithranibizumab,whilethecontrolgroupwastreatedwithtraditionalretinallaseronly.Thetherapeuticeffect,visualacuityrestoration,andadversereactionswereobservedinbothgroups.Results:Thevisualacuityrestorationofthetreatmentgroupwassignificantlybetterthanthatofthecontrolgroupaftertreatment(P<0.05).Theimprovementofretinalmicrovascularhemorrhage,edema,hardexudate,andvitreousturbidityweresignificantlybetterinthetreatmentgroupcomparedwiththecontrolgroup(P<0.05).Therewasnosignificantdifferenceintheadversereactionbetweenthetwogroups.Conclusion:Retinallasercombinedwithranibizumabhasgoodclinicaleffectinthetreatmentofseverenon-proliferativediabeticretinopathy,anditisrecommendedforclinicalapplication.

Keywords:diabeticretinopathy,retinallaser,ranibizumab,therapeuticeffect,visualacuityrestorationDiabeticretinopathyisacommoncomplicationofdiabetes,andseverenon-proliferativediabeticretinopathycanleadtoirreversiblevisionlossifleftuntreated.Thecurrentstandardofcareforseverenon-proliferativediabeticretinopathyisretinallaserphotocoagulation,whichhelpstopreventfurthervisionlossbutmaynotimprovevision.Inrecentyears,theuseofanti-vascularendothelialgrowthfactor(anti-VEGF)agents,suchasranibizumab,hasshownpromisingresultsintreatingdiabeticretinopathy.

Thisstudyaimedtoevaluatethetherapeuticeffectofcombiningretinallaserandranibizumabinthetreatmentofseverenon-proliferativediabeticretinopathy.Theresultsshowedthatthetreatmentgrouphadasignificantlyhigherproportionofpatientswithimprovedvisualacuitycomparedtothecontrolgroup.Inaddition,thetreatmentgrouphadagreaterreductioninretinalthicknessandmacularedema,aswellasbettertreousturbiditycomparedtothecontrolgroup.

Overall,thecombinationofretinallaserandranibizumabwasfoundtobeasafeandeffectivetreatmentforseverenon-proliferativediabeticretinopathy.Thistreatmenthasthepotentialtonotonlypreventfurthervisionlossbutalsoimprovevisualacuity.Therefore,itisrecommendedforclinicalapplicationinthemanagementofseverenon-proliferativediabeticretinopathyInadditiontothecombinationtherapyofretinallaserandranibizumab,otherpotentialtreatmentoptionsforseverenon-proliferativediabeticretinopathyincludevitrectomy,intravitrealsteroids,andoralmedicationssuchasmetforminandaspirin.

Vitrectomyisasurgicalprocedurethatinvolvesremovingthevitreousgelthatfillstheeyeandreplacingitwithaclearsolution.Thiscanbenefitpatientswithseverenon-proliferativediabeticretinopathywhohavesignificanttractionalretinaldetachmentorpersistentvitreoushemorrhage.Studieshaveshownthatvitrectomycanimprovevisualacuityandreducetheriskoffurthercomplicationsinthesepatients.

Intravitrealsteroids,suchasdexamethasoneandtriamcinolone,havealsobeenusedtotreatseverenon-proliferativediabeticretinopathy.Thesemedicationsworkbyreducinginflammationandimprovingvascularpermeabilityintheretina.However,theyareassociatedwithahigherriskofcomplicationssuchascataractsandglaucoma,andmaynotbeeffectiveinallpatients.

Oralmedicationssuchasmetforminandaspirinhavebeeninvestigatedfortheirpotentialtopreventordelaytheprogressionofdiabeticretinopathy.Metformin,acommonlyusedmedicationfortype2diabetes,hasbeenshowntoreducetheincidenceofdiabeticretinopathyinseverallargeclinicaltrials.Aspirin,ablood-thinningmedication,mayalsobebeneficialinreducingtheriskofdiabeticretinopathyinpatientswithdiabetes.However,moreresearchisneededtoconfirmthesafetyandeffectivenessofthesetreatments.

Inconclusion,severenon-proliferativediabeticretinopathyisaseriouscomplicationofdiabetesthatcanleadtopermanentvisionloss.Treatmentoptionsincluderetinallaser,ranibizumab,vitrectomy,intravitrealsteroids,andoralmedications.Thecombinationofretinallaserandranibizumabhasshownpromisingresultsinclinicaltrialsandisrecommendedforclinicalapplicationinthemanagementofseverenon-proliferativediabeticretinopathy.EarlydiagnosisandappropriatetreatmentareessentialforpreservingvisioninpatientswithdiabeticretinopathyInadditiontotheaforementionedtreatments,lifestylemodificationsandregulareyeexamsarealsoimportantformanagingdiabeticretinopathy.Patientswithdiabetesshouldmaintainahealthydiet,exerciseregularly,andmonitortheirbloodsugarlevelstopreventfurtherdamagetothebloodvesselsintheretina.Additionally,regulareyeexamscanhelpdetectearlysignsofdiabeticretinopathybeforeirreversibledamageoccurs.Itisrecommendedthatpatientswithdiabetesundergodilatedeyeexamsatleastonceayear,ormorefrequentlyifrecommendedbytheirhealthcareprovider.

Inconclusion,diabeticretinopathyisaseriouscomplicationofdiabetesthatcanleadtopermanentvisionlossifleftuntreated.Theconditioniscausedbydamagetothebloodvesselsintheretina,whichcanresultinbleeding,swelling,andthegrowthofabnormalbloodvessels.Treatmentoptionsincluderetinallaser,ranibizumab,vitrectomy,intra