2023 年第 9 期 第 18 卷

康柏西普联合眼底激光光凝治疗糖尿病黄斑水肿的临床效果及对M1型巨噬细胞促炎细胞因子表达的影响

Clinical effect of conbercept combined with fundus laser photocoagulation in the treatment of diabetic macular edema and its effect on the expression of proinflammatory cytokines in M1 type macrophages

作者：洪博1王凤翔1崔蓓1曹利群1秦力维1田春雨1江枫2

英文作者：Hong Bo1 Wang Fengxiang1 Cui Bei1 Cao Liqun1 Qin Liwei1 Tian Chunyu1 Jiang Feng2

单位：1解放军总医院第三医学中心眼科医学部，北京100039；2天津医科大学总医院眼科，天津300052

英文单位：1Department of Ophthalmic Medicine the Third Medical Center of PLA General Hospital Beijing 100039 China; 2Department of Ophthalmology Tianjin Medical University General Hospital Tianjin 300052 China

关键词：糖尿病黄斑水肿；康柏西普；M1型巨噬细胞；血管内皮生长因子

英文关键词：Diabeticmacularedema;Conbercept;M1typemacrophages;Vascularendothelialgrowthfactor

• 摘要：

• 目的  康柏西普联合眼底激光光凝治疗糖尿病黄斑水肿（DME）的临床效果及对M1型巨噬细胞促炎细胞因子表达的影响。方法 收集2019年1月至2022年1月解放军总医院第三医学中心接诊的95例DME患者的临床资料展开回顾性研究。根据治疗方法的不同将患者分为对照组（48例）和观察组（47例）。对照组接受眼底激光光凝治疗，观察组在对照组基础上接受康柏西普眼用注射液治疗。比较2组临床疗效、黄斑中心厚度（CMT）、最佳矫正视力（BCVA）、眼底出血面积、黄斑区荧光面积、M1型巨噬细胞促炎细胞因子表达量及血清血小板源性生长因子（PDGF）、血管内皮生长因子（VEGF）水平、不良反应总发生率。结果 观察组总有效率高于对照组，差异有统计学意义［93.6%（44/47）比72.9%（35/48）］（P＜0.05）。治疗后2组CMT、眼底出血面积及黄斑区荧光面积均小于治疗前、且观察组小于对照组，BCVA均优于治疗前、且观察组优于对照组，差异均有统计学意义（均P＜0.05）。治疗后2组白细胞介素6、肿瘤坏死因子α、PDGF及VEGF水平均低于治疗前，且观察组均低于对照组［（82±19）ng/L比（150±25）ng/L、（7.2±1.0）ng/L比（10.9±2.4）ng/L、（3.6±0.4）ng/L比（6.3±0.9）ng/L、（93±16）ng/L比（157±20）ng/L］，差异均有统计学意义（均P＜0.05）。2组不良反应总发生率差异无统计学意义（P>0.05）。结论 康柏西普联合眼底激光光凝可有效缓解DME患者黄斑水肿、视力减退等症状，抑制M1型巨噬细胞释放促炎因子，降低血清PDGF、VEGF水平，且治疗期间患者出现的不良反应较少，安全性可。

• Objective To analyze the effect of conbercept combined with fundus laser photocoagulation in the treatment of diabetic macular edema(DME) and its effect on the expression of proinflammatory cytokines in M1 type macrophages. Methods A retrospective study was conducted on the clinical data of 95 DME patients admitted to the Third Medical Center of PLA General Hospital from January 2019 to January 2022. According to different treatment methods , they were divided into a control group(48 cases) and an observation group(47 cases). The control group received fundus laser photocoagulation treatment, while the observation group received conbercept ophthalmic injection treatment on the basis of the control group. Clinical efficacy, macular central thickness(CMT), best corrected visual acuity(BCVA), fundus bleeding area, macular fluorescence area, M1 type macrophage proinflammatory cytokine expression, serum platelet-derived growth factor(PDGF), vascular endothelial growth factor(VEGF), and total incidence of adverse reactions were compared between the two groups. Results The total effective rate of observation group was higher than that of control group［93.6%（44/47） vs 72.9%（35/48）］(P<0.05). After treatment, the CMT, fundus bleeding area, and macular fluorescence area of the two groups were all smaller than those before treatment, and the observation group was smaller than the control group; BCVA was better than that before treatment, and the observation group was better than the control group (all P<0.05). The levels of interleukin-6, tumor necrosis factor-α, PDGF and VEGF in two groups after treatment were lower than those before treatment, and the observation group was lower than the control group［（82±19）ng/L vs （150±25）ng/L, （7.2±1.0）ng/L vs （10.9±2.4）ng/L, （3.6±0.4）ng/L vs （6.3±0.9）ng/L, （93±16）ng/L vs （157±20）ng/L］(all P<0.05). There was no statistically significant difference in the total incidence of adverse reactions between the two groups(P>0.05). Conclusions  sConbercept combined with fundus laser photocoagulation can effectively relieve the symptoms of macular edema and vision loss in DME patients, inhibit the release of pro-inflammatory factors by M1 type macrophages, reduce the levels of serum PDGF and VEGF, and there are few adverse reactions in patients during treatment, safety is acceptable.