基因组学与应用生物学

为了探讨羟苯磺酸钙与曲安奈德治疗对糖尿病黄斑水肿(DME)患者血清血管内皮生长因子(VEGF)和细胞间黏附分子-1(ICAM-1)的影响,本研究回顾性分析2015年6月至2017年6月间收治的102例(102眼)DME患者临床资料,根据治疗方案分为观察组(n=50)和对照组(n=52)。对照组应用激光光凝治疗+羟苯磺酸钙,观察组应用激光光凝治疗+曲安奈德。评估治疗前、治疗1月及6月时两组患者视力、黄斑中心凹厚度、眼压及血清因子(VEGF,ICAM-1),记录治疗前、治疗6月后两组生活质量[中文版低视力者生活质量量表(CLVQOL)],记录患者不良反应发生率。研究结果表明,治疗1月、6月时,2组BVCA均高于治疗前(p<0.05),2组黄斑中心凹厚度、血清因子(VEGF,ICAM-1)指标水平均低于治疗前(p<0.05),观察组变动幅度大于对照组(p<0.05);治疗前、治疗1月及6月时2组眼压对比,差异均无统计学意义(p>0.05);治疗6月后,2组CLVQOL评分均高于治疗前(p<0.05),观察组增幅大于对照组(p<0.05);两组不良反应发生率对比,差异无统计学意义(p>0.05)。本研究初步结论表明:曲安奈德治疗DME在改善患者视力,降低黄斑中心凹厚度及控制VEGF、ICAM-1水平疗效优于羟苯磺酸钙,但两药治疗安全性无差异。

To explore the effects of calcium dobesilate and triamcinolone acetonide on serum vascular endothelial growth factor(VEGF) and intercellular adhesion molecule-1(ICAM-1) in patients with diabetic macular edema(DME),the clinical data of 102 patients(102 eyes) treated with DME from June 2015 to June 2017 were retrospectively analyzed,and the patients were divided into observation group(n=50) and control group(n=52) according to treatment regimen.Control group was given laser photocoagulation and calcium dobesilate,and observation group was given laser photocoagulation and triamcinolone acetonide.The visual acuity,macular foveal thickness,intraocular pressure,and serum factors(VEGF,ICAM-1) were evaluated before treatment and at 1 month and 6 months of treatment.And the quality of life [Chinease-version low vision quality of life questionnaire(CLVQOL)]was recorded before treatment and after 6 months of treatment,and the incidence rate of adverse reactions was recorded.The results showed that at 1 month and 6 months of treatment,the BVCA in the two groups was higher than that beforetreatment(p <0.05),and the macular foveal thickness and serum factor indexes(VEGF,ICAM-1)in the two groups were lower than those before treatment(p <0.05),and the changes in observation group were greater than those in control group(p<0.05).There was no statistically significant difference in intraocular pressure between the two groups before treatment and at 1 month and 6 months of treatment(p>0.05).After 6 months of treatment,the CLVQOL score in the two groups was higher than that before treatment(p<0.05),and the decrease in observation group was higher than that in control group(p<0.05).There was no significant difference in the incidence rate of adverse reactions between the two groups(p>0.05).Preliminary conclusions indicated that triamcinolone acetonide for DME should be superior to calcium dobesilate in improving the visual acuity,reducing the macular foveal thickness,and controlling the levels of VEGF and ICAM-1,but there was no difference in the treatment safety of two drugs.