摘要
糖尿病眼底并发症中,糖尿病性视网膜病变(DR)的发病率最高。目前,对于增殖期糖尿病视网膜病变(PDR)的治疗方式主要有药物疗法、激光光凝疗法、糖皮质激素疗法、抗血管内皮生长因子(VEGF)疗法以及手术疗法。全视网膜光凝术被认为是DR患者视力恢复的首选方法,但由于激光的损害,可能引起一系列的副作用。相较于激光疗法,药物疗法可以在DR疾病的各个阶段提供干预,且还可以有效维持视网膜的解剖形态,从而降低激光引起的副作用。VEGF药物的作用是通过阻止VEGF的活性,从而阻止眼内新生血管的生成,与此同时,能够降低血管的透明度和减少血液的渗出,这也是当前PDR发展延迟的研究焦点。本篇文章将对VEGF药物在增殖期糖尿病视网膜病变的使用情况进行概述,通过对近几年的研究以及文献报告进行整理,为糖尿病性视网膜病变的治疗方法提供新思路。
关键词: 糖尿病;增殖期糖尿病视网膜病变;抗血管内皮生长因子;研究进展
Abstract
Among diabetic fundus complications, diabetic retinopathy (DR) has the highest incidence. At present, the main treatment methods for proliferative diabetic retinopathy (PDR) include drug therapy, laser photocoagulation therapy, glucocorticoid therapy, anti-vascular endothelial growth factor (VEGF) therapy and surgical therapy. Panretinal photocoagulation is considered as the preferred method for vision restoration in DR Patients, but it may cause a series of side effects due to laser damage. Compared to laser therapy, drug therapy can provide intervention at all stages of DR Disease, and can also effectively maintain the anatomical shape of the retina, thus reducing the side effects caused by laser. VEGF drugs work by blocking the activity of VEGF, thereby preventing the formation of new blood vessels in the eye, and at the same time, can reduce the transparency of blood vessels and reduce blood leakage, which is the focus of current research on the delayed development of PDR. In this paper, the use of VEGF in proliferative diabetic retinopathy will be summarized, and through the review of recent studies and literature reports, new ideas for the treatment of diabetic retinopathy will be provided.
Key words: Diabetes; Proliferative diabetes retinopathy; Anti vascular endothelial growth factor; Research progress
参考文献 References
[1] 李丽萍,徐玉霜,汪懿等.增殖性糖尿病性视网膜病变患者玻璃体切割术前应用抗VEGF药物29例疗效观察[J].药品评价,2023,20(08):976-979.
[2] 叶基森.抗VEGF药物玻璃体腔注射联合25G玻璃体切除术治疗增生期糖尿病性视网膜病变的疗效分析[J].糖尿病新世界,2022,25(13):175-178.
[3] 陈若瑜,曹丹,张良.糖尿病视网膜病变药物治疗研究进展[J].眼科新进展,2022,42(03):244-248.
[4] 韦柳红,何云,梁羽花.中药联合激光及抗VEGF药物治疗糖尿病视网膜病变的临床疗效[J].内蒙古中医药,2021, 40(12):120-121.
[5] 李静,李进明.激光光凝联合抗VEGF药物不同时机治疗糖尿病视网膜病变患者的效果对照研究[J].中国医药指南,2021,19(33):85-86.
[6] 苏锐锋,抗VEGF药物在糖尿病性视网膜病变中的应用.河北省,承德医学院附属医院,2021-11-10.
[7] 高伟,抗VEGF药物联合手术及视网膜光凝治疗新生血管性青光眼的前瞻性研究.内蒙古自治区,内蒙古自治区人民医院,2021-07-23.
[8] 王佳琪.单纯玻璃体切除术与抗VEGF药物联合玻璃体切除术治疗增殖性糖尿病视网膜病变的疗效观察[D].内蒙古医科大学,2021.
[9] 吕娜.激光光凝联合抗VEGF药物不同时机治疗糖尿病视网膜病变的疗效比较[J].糖尿病新世界,2020,23(18): 176-178.
[10] 余日成.加味肾气丸联合抗VEGF药物治疗脾肾两虚型糖尿病视网膜病变的效果观察[J].中国医学创新,2020, 17(23): 73-77.
[11] 龙巧燕,陈玉华,金奎东等.合理使用抗VEGF药物辅助治疗糖尿病视网膜病变[J].北方药学,2020,17(06):174-175.
[12]李亚利,陈莉莉.糖尿病视网膜病变的治疗新进展[J].中国当代医药,2020,27(13):33-36.
[13] 毕双双,姜涛,陈颖等.激光光凝联合抗VEGF药物不同时机治疗糖尿病视网膜病变的疗效比较[J].国际眼科杂志,2020,20(04):613-618.
[14] 赵琼,董祖焱.抗VEGF药物治疗视网膜静脉阻塞眼底病变的临床研究[J].人人健康,2020,(06):5-6.
[15] 赵文丽.视网膜光凝联合眼内注射抗VEGF药物治疗糖尿病视网膜病变临床观察[J].人人健康,2020,(04):8.