目的:比较分析全视网膜光凝联合雷珠单抗与曲安奈德(TA)玻璃体腔注射治疗糖尿病黄斑水肿的疗效及医疗费用.方法:收集我院糖尿病视网膜病变伴黄斑水肿患者48例48眼.所有患者行全视网膜激光光凝后随机分为两组.雷珠单抗组:玻璃体腔注射雷珠单抗0.5mg,4wk 1次.共3次.TA组:注射曲安奈德4mg/0.1mL.治疗12wk后若黄斑中心凹视网膜厚度(CMT)≥400μm,则再次注射各组对应药物.随访6mo,对比观察两组患者治疗前及注射药物后的最佳矫正视力(BCVA)、CMT、眼压及相关治疗费用.结果:两组患者BCVA和CMT均无显著统计学差异(P>0.05),不同测量时间点BCVA和CMT具有显著统计学差异,不同治疗方法和时间点BCVA及CMT均存在交互作用(P0.05); BCVA and CMT among different time points were significantly different(P<0.05);the treatments and the time points had significant interaction on BCVA (P<0.05). BCVA was improved in two groups at all the time after injection(P<0.05),except 1wk after injection of TA (P=0.33). There was significant difference between the two groups at 12wk and 16wk on BCVA and that injected with ranibizumab was better (P=0.03,0.045). CMT decreased in two groups at all the time after injection (P<0.05). There was significant difference only between the two groups at 1wk (P< 0. 01). All intraocular pressures were in the normal range, except one needed ocular hypotensive agents. The medical costs (yuan) of the ranibizumab group in 12wk and 24wk were 38 736 and 42 564,which of the TA group were 5 790 and 7 053,respectively. ·CONCLUSION:Both PRP combined with ranibizumab or TA for DME can effectively control disease progression in short time. Therapeutic effect is not significant between two methods, but PRP combined with TA is more economic.
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