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抗血管内皮生长因子药物对糖尿病视网膜病变-微动脉瘤的影响:一项相关性研究。

Effect of Anti-VEGF drugs on diabetic Retinopathy-Microaneurysms: A correlation study.

作者信息

Li Tianhang, Gu Zhaohui, Zhang Yueling, Li Jie, Du Juan, Fu Yan

机构信息

Tianhang Li, Ward of Ophthalmology 2nd Department, Baoding No.1 Central Hospital, Baoing 071000, Hebei, China.

Zhaohui Gu, Ward of Ophthalmology 2nd Department, Baoding No.1 Central Hospital, Baoing 071000, Hebei, China.

出版信息

Pak J Med Sci. 2024 Dec;40(11):2648-2652. doi: 10.12669/pjms.40.11.9439.

DOI:10.12669/pjms.40.11.9439
PMID:39634892
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11613385/
Abstract

OBJECTIVE

To investigate the efficacy of anti-vascular endothelial growth factor (VEGF) drugs in diabetic retinopathy (DR)-retinal microaneurysms, and its prognosis.

METHOD

This was a retrospectively study in which total of 120 patients with DR in Baoding No.1 Central Hospital from June 2020 to June 2022 were retrospectively analyzed. According to different treatment methods based on macular edema, they were divided into an injection group and a control group. The control group was treated routinely, while the injection group was additionally intravitreally injected with an anti-VEGF drug. The patients were followed up for one year, and the changes in the number of retinal microaneurysms, best corrected visual acuity (BCVA) and central retinal thickness (CRT) were compared between the two groups. The effect on retinal microaneurysms was analyzed.

RESULT

After treatment for 12 months, the total efficacy of the injection group was 95.00%, which was higher than 80.00% of the control group ( 0.05). After one, three, six and twelve months of treatment, both CRT and the number of retinal microaneurysms reduced in the injection group compared with those before treatment. After treatment for one, three, six and twelve months, BCVA showed increases in the injection group, but no obvious changes in the control group compared with that before treatment.

CONCLUSION

For patients with DR complicated with macular edema, early use of anti-VEGF drugs can significantly improve the fundus lesions, reduce the CRT and number of retinal microaneurysms, and improve the BCVA of the patients, with high clinical efficacy.

摘要

目的

探讨抗血管内皮生长因子(VEGF)药物治疗糖尿病视网膜病变(DR)视网膜微动脉瘤的疗效及其预后。

方法

本研究为回顾性研究,对2020年6月至2022年6月在保定市第一中心医院就诊的120例DR患者进行回顾性分析。根据黄斑水肿的不同治疗方法,将患者分为注射组和对照组。对照组采用常规治疗,注射组在此基础上额外玻璃体腔内注射抗VEGF药物。对患者进行为期一年的随访,比较两组视网膜微动脉瘤数量、最佳矫正视力(BCVA)和中心视网膜厚度(CRT)的变化情况,并分析其对视网膜微动脉瘤的治疗效果。

结果

治疗12个月后,注射组总有效率为95.00%,高于对照组的80.00%(P<0.05)。治疗1、3、6和12个月后,注射组的CRT和视网膜微动脉瘤数量均较治疗前减少。治疗1、3、6和12个月后,注射组的BCVA有所提高,而对照组与治疗前相比无明显变化。

结论

对于合并黄斑水肿的DR患者,早期使用抗VEGF药物可显著改善眼底病变,降低CRT和视网膜微动脉瘤数量,提高患者的BCVA,临床疗效高。

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本文引用的文献

1
Diabetic Macular Edema: Current Understanding, Molecular Mechanisms and Therapeutic Implications.糖尿病性黄斑水肿:当前认识、分子机制及治疗意义。
Cells. 2022 Oct 25;11(21):3362. doi: 10.3390/cells11213362.
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A Paradigm Shift in the Management Approaches of Proliferative Diabetic Retinopathy: Role of Anti-VEGF Therapy.增殖性糖尿病视网膜病变管理方法的范式转变:抗血管内皮生长因子治疗的作用
Clin Ophthalmol. 2022 Sep 8;16:3005-3017. doi: 10.2147/OPTH.S374165. eCollection 2022.
3
Efficacy and mechanism of anti-vascular endothelial growth factor drugs for diabetic macular edema patients.抗血管内皮生长因子药物治疗糖尿病性黄斑水肿患者的疗效及机制
World J Diabetes. 2022 Jul 15;13(7):532-542. doi: 10.4239/wjd.v13.i7.532.
4
Efficacy and safety of intravitreal anti-VEGF therapy in diabetic retinopathy: what we have learned and what should we learn further?抗血管内皮生长因子药物玻璃体腔内注射治疗糖尿病视网膜病变的疗效和安全性:我们已经学到了什么,还应该进一步学习什么?
Expert Opin Biol Ther. 2022 Oct;22(10):1275-1291. doi: 10.1080/14712598.2022.2100694. Epub 2022 Jul 17.
5
Ischemia modified albumin as a useful marker for diagnoses and management of diabetic retinopathy.缺血修饰白蛋白作为糖尿病视网膜病变诊断和管理的有用标志物。
Pak J Med Sci. 2022 Mar-Apr;38(4Part-II):1043-1047. doi: 10.12669/pjms.38.4.4813.
6
Effectiveness of Panretinal Photocoagulation Plus Intravitreal Anti-VEGF Treatment Against PRP Alone for Diabetic Retinopathy: A Systematic Review With Meta-Analysis.全视网膜光凝联合玻璃体内抗血管内皮生长因子治疗与单纯 PRP 治疗糖尿病视网膜病变的疗效比较:系统评价与荟萃分析。
Front Endocrinol (Lausanne). 2022 Mar 29;13:807687. doi: 10.3389/fendo.2022.807687. eCollection 2022.
7
IDF Diabetes Atlas: Global, regional and country-level diabetes prevalence estimates for 2021 and projections for 2045.国际糖尿病联盟(IDF)糖尿病地图集:2021 年全球、区域和国家糖尿病患病率估算值以及 2045 年预测值。
Diabetes Res Clin Pract. 2022 Jan;183:109119. doi: 10.1016/j.diabres.2021.109119. Epub 2021 Dec 6.
8
Integrated lipidomics, transcriptomics and network pharmacology analysis to reveal the mechanisms of Danggui Buxue Decoction in the treatment of diabetic nephropathy in type 2 diabetes mellitus.综合脂质组学、转录组学和网络药理学分析揭示当归补血汤治疗 2 型糖尿病糖尿病肾病的机制。
J Ethnopharmacol. 2022 Jan 30;283:114699. doi: 10.1016/j.jep.2021.114699. Epub 2021 Oct 2.
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MicroRNA and diabetic retinopathy-biomarkers and novel therapeutics.微小RNA与糖尿病视网膜病变——生物标志物与新型疗法
Ann Transl Med. 2021 Aug;9(15):1280. doi: 10.21037/atm-20-5189.
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Intravitreal Anti-Vascular Endothelial Growth Factor Agents for the Treatment of Diabetic Retinopathy: A Review of the Literature.玻璃体内注射抗血管内皮生长因子药物治疗糖尿病视网膜病变:文献综述
Pharmaceutics. 2021 Jul 26;13(8):1137. doi: 10.3390/pharmaceutics13081137.