全视网膜光凝联合羟苯磺酸钙对DR患者眼底微循环及视网膜神经纤维层厚度的影响

摘要

目的:研究全视网膜光凝( panretinal photocoagulation, PRP)联合羟苯磺酸钙治疗对糖尿病视网膜病变( diabetic retinopathy,DR)患者眼底微循环和视网膜神经纤维层( retinal nerve fiber layer,RNFL)厚度的影响.方法:选取2015-10/2017-10于我院眼科就诊的DR患者166例,按照随机数字表法分为对照组( A组)和研究组( B组) ,每组83例. A组患者行PRP术治疗,B组患者在A组的基础上口服羟苯磺酸钙胶囊,观察并对比两组患者临床疗效、PRP术后并发症发生率及治疗前后最佳矫正视力( BCVA) 、血液流变学指标[红细胞压积( Hct ) 、血沉 ( ESR) 、红细胞变形指数( DE) 、血浆粘度( PV) 、红细胞聚集指数( AE) ] 、血流动力学指标[中央动脉( CRA)的阻力指数( RI) 、舒张末期平均血流速度( EDV) 、收缩期峰值平均流速( PSV) ]和视盘上方、鼻侧、下方、颞侧4 个象限及视盘中心平均RNFL厚度情况.结果:治疗后,两组患者BCVA均较治疗前明显改善,差异均有统计学意义(P0. 05);B组患者治疗总有效率明显高于A组(P0. 05).与治疗前相比,两组患者治疗后CRA的EDV、PSV值均提高( P0. 05), and the effective rate in Group B was significantly higher than that in Group A (P0. 05). Compared with those before treatment, the EDV and PSV values of two groups increased after treatment (P<0. 05), and RI value decreased (P<0. 05). After treatment, the EDV and PSV values of CRA in Group B were significantly higher than those in Group A (P<0. 05), and the values of RI and Hct, ESR, PV, DE and AE were significantly lower than those of Group A ( P<0. 05 ). After treatment, the average, inferior and superior RNFL of the two groups were all thinner than those before the treatment (P<0. 05). The decrease of average, inferior, superior and nasal RNFL of Group A was more than those in the Group B (P<0. 05). ·CONCLUSION: Retinal photocoagulation combined with calcium dobesilate in the treatment of DR is effective and safe. It can effectively improve the fundus microcirculation and reduce the damage of PRP to DR patients' visual acuity and retinal nerve fiber layer thickness.