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目的观察重组人促红素(erythropoietin,EPO)对中度非增生期或重度非增生期糖尿病视网膜病变(diabetic retinopathy,DR)患者视网膜光凝术后的最佳矫正视力(BCVA)与黄斑水肿的干预效果。方法中度非增生期或重度非增生期DR患者行视网膜局部光凝或全视网膜光凝90例,随机选择30例30只眼光凝术后Tenon囊下注射EPO,30例30只眼光凝术后口服迈之灵药物(内含七叶皂苷成分),30例30只眼仅光凝治疗。治疗前均检查裸眼视力,最佳矫正视力(BCVA)、眼底彩色照相、眼底荧光血管造影(FFA)以及光学相干断层扫描(OCT)。结果治疗平均6周后EPO加光凝治疗组BCVA提高21例21只眼(70.0%),迈之灵加光凝治疗组30例30只眼BCVA提高15例15只眼(50.0%),光凝治疗组BCVA仅提高8例8只眼(26.7%)。平均治疗6周后黄斑水肿OCT测量结果比较,EPO加光凝治疗组治疗后黄斑水肿(243±15)μm与治疗前比较差异有显著性意义(P<0.01)。迈之灵加光凝治疗组治疗后黄斑水肿(267±16)μm与治疗前比较差异有意义(P<0.05)。光凝治疗组治疗后黄斑水肿(281±13)μm与治疗前比较差异无显著性意义(P>0.05)。治疗后三组黄斑水肿改变比较差异有显著性意义(P<0.05)。结论 EPO注射液可以用于DR患者光凝的干预治疗,对减轻光凝引起的黄斑水肿,防止DR病情进展,提高患者光凝后的视功能有积极作用。
Objective To observe the effects of erythropoietin (EPO) on the best corrected visual acuity (BCVA) and macular edema after retinal photocoagulation in patients with moderate or non - proliferative diabetic retinopathy (DR) Intervention effect. Methods 90 patients with moderate or severe non-proliferative phase DR undergoing retinal local photocoagulation or panretinal photocoagulation were randomly selected. Thirty patients (30 eyes) underwent photocoagulation with Tenon’s subcutaneous injection of EPO and 30 patients underwent photocoagulation Oral matrine drugs (including aesculin ingredients), 30 cases of 30 eyes only photocoagulation treatment. Uncorrected visual acuity, best corrected visual acuity (BCVA), fundus color photography, fundus fluorescein angiography (FFA), and optical coherence tomography (OCT) were examined before treatment. Results The average BCVA of EPO plus photocoagulation group was 21 eyes (70.0%) after 21 weeks of treatment and 30 eyes (30.0% BCVA in coagulation group only increased in 8 cases and 8 eyes (26.7%). Compared with OCT measurement of macular edema after 6 weeks of average treatment, the difference of macular edema (243 ± 15) μm in EPO plus photocoagulation group after treatment was statistically significant (P <0.01). Maizhiling plus photocoagulation treatment group after treatment of macular edema (267 ± 16) μm compared with the difference before treatment was significant (P <0.05). There was no significant difference between the photocoagulation group (281 ± 13) μm after treatment and before treatment (P> 0.05). There were significant differences in the changes of macular edema between the three groups after treatment (P <0.05). Conclusion EPO injection can be used in the treatment of photocoagulation in patients with DR, which can reduce the macular edema caused by photocoagulation, prevent the progression of DR, and improve the visual function after photocoagulation.