羟苯磺酸钙联合康柏西普治疗糖尿病性黄斑水肿的疗效和安全性

目的　探讨羟苯磺酸钙联合康柏西普治疗糖尿病性黄斑水肿（diabetic macular edema，DME）的临床疗效和安全性。方法　选取DME患者86例104眼，随机分为康柏西普眼用注射液(conbercept ophthalmic injection，COI)组（43例50眼）和联合组（43例54眼）。COI组给予患者玻璃体内注射COI治疗，联合组在COI组基础上给予患者羟苯磺酸钙胶囊治疗。治疗3个月后，比较两组患者房水血管内皮生长因子（VEGF）、基质细胞衍生因子1（stromal cell derived factor-1，SDF-1）含量以及黄斑中央视网膜厚度（CMT）、最佳矫正视力（BCVA）、并发症发生情况。结果　治疗3个月后，联合组和COI组患者房水VEGF、SDF-1含量均明显低于治疗前，联合组均低于COI组，差异均有统计学意义（均为P<0.05）。治疗1个月、3个月后，联合组和COI组CMT均低于治疗前，且联合组CMT均低于COI组，差异均有统计学意义（均为P<0.05）。治疗1个月、3个月后，联合组和COI组BCVA均明显高于治疗前，联合组BCVA均高于COI组，差异均有统计学意义（均为P<0.05）。治疗中和治疗后，COI组和联合组分别出现眼压升高3眼和2眼，结膜充血各2眼，玻璃体积血各1眼；两组并发症发生率比较，差异无统计学意义（P>0.05）。结论　羟苯磺酸钙联合康柏西普可有效降低DME患者房水VEGF、SDF-1水平，降低CMT，提高BCVA，且安全性好。

Clinical efficacy and safety of calcium dobesilate combined with conbercept in the treatment of diabetic macular edema

Objective To explore the clinical efficacy and safety of calcium dobesilate combined with conbercept in the treatment of diabetic macular edema(DME).Methods The 104 eyes of 86 patients with DME were randomly divided into the conbercept ophthalmic injection(COI)group(50 eyes of 43 patients)and combined group(54 eyes of 43 patients).The COI group was treated with intravitreal COI injection,and the combined group was treated with calcium dobesilate capsules on the basis of the COI group.The levels of vascular endothelial growth factor(VEGF),stromal cell-derived factor-1(SDF-1),central macular retinal thickness(CMT),best corrected visual acuity(BCVA),and complications 3 months after treatment were detected and compared between the two groups.Results After 3 months of treatment,the levels of VEGF and SDF-1 in aqueous humor of the combined group and COI group were significantly lower than those before the treatment,and the combined group was lower than that of the COI group,and the differences were statistically significant(all P<0.05).After 1 month and 3 months of treatment,the CMT of the combined group and the COI group were lower than those of the before treatment,and the CMT of the combined group was lower than that of the COI group,and the differences were statistically significant(all P<0.05).After 1 month and 3 months of treatment,the BCVA of the combined group and the COI group were significantly higher than those of the before treatment,and the BCVA of the combined group was higher than that of the COI group,and the differences were statistically significant(all P<0.05).During and after treatment,there were 3 eyes and 2 eyes with intraocular pressure increased,2 eyes and 2 eyes with high conjunc-tival congestion,1 eye and 1 eye with vitreous hemorrhage in the COI group and the combined group,respectively,but there were no significant differences in the incidence of complications between the two groups(all P>0.05).Conclusion For the DME patients,calcium dobesilate combined with conbercept can effectively reduce the levels of VEGF and SDF-1 in the aqueous humor,reduce CMT,increase BCVA,and has good safety.