| 李天柔,梁莉聪,乐 源,蒋 萌,赵 媛,陆 方.SS-OCT在不同肾功能状态DME患者抗VEGF疗效评价中应用分析[J].,2023,(12):2257-2262 |
| SS-OCT在不同肾功能状态DME患者抗VEGF疗效评价中应用分析 |
| Application and Analysis of SS-OCT/OCTA in the Evaluation of Anti-VEGF Efficacy in DME Patients with Different Renal Function States |
| 投稿时间：2022-11-28 修订日期：2022-12-23 |
| DOI：10.13241/j.cnki.pmb.2023.12.010 |
| 中文关键词: 扫频源光学相干层析成像 糖尿病黄斑水肿 血管内皮生长因子 疗效 |
| 英文关键词: Sweep source optical coherence tomography Diabetic macular edema Vascular endothelial growth factor Curative effect |
| 基金项目:国家自然科学基金项目（81570863）； 四川省科技厅科技支撑计划项目（2016SZ0024） |
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| 中文摘要: |
| 摘要 目的：探讨扫频源光学相干层析成像（SS-OCT）在不同肾功能状态糖尿病黄斑水肿（DME）患者抗血管内皮生长因子（VEGF）治疗疗效的应用价值。方法：选择2020年1月至2022年1月我院收治的80例DME患者，根据尿白蛋白含量将患者分为正常蛋白尿组（35例，＜30 mg）, 微量蛋白尿组（28例，30～300 mg）和大量蛋白尿组（17例，＞300 mg）。所有患者均接受抗VEGF治疗，比较不同肾功能状态临床疗效差异，SS-OCT技术测量治疗前后黄斑区中央视网膜厚度（CRT）、中心凹无血管区（FAZ）面积、FAZ周长、中心凹旁300 μm血流密度（FD-300）、旁中心凹浅层及深层视网膜血流密度的变化。结果：大量蛋白尿组治疗总有效率低于正常蛋白尿组、微量蛋白尿组（35.29% vs 60.71%、85.71%，P＜0.05）。三组治疗后CRT、FAZ面积、FAZ周长均较治疗前降低（P＜0.05），FD-300、旁中心凹浅层血流密度、深层血流密度均较治疗前增加（P＜0.05）。大量蛋白尿组治疗前、后CRT、FAZ面积、FAZ周长大于正常蛋白尿组、微量蛋白尿组（P＜0.05），且微量蛋白尿组大于正常蛋白尿组（P＜0.05）；大量蛋白尿组治疗前、后FD-300、旁中心凹浅层血流密度、深层血流密度低于正常蛋白尿组、微量蛋白尿组（P＜0.05），且微量蛋白尿组低于正常蛋白尿组（P＜0.05）。结论：SS-OCT可准确定量评估不同肾功能状态DME患者抗VEGF治疗前后CRT、FAZ形态以及血流灌注的变化，可用于评估抗VEGF疗效。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the application value of frequency scanning optical coherence tomography (SS-OCT) in the anti-vascular endothelial growth factor (VEGF) treatment of diabetic macular edema (DME) in different renal function states. Methods: 80 DME patients admitted to our hospital from January 2020 to January 2022 were selected. According to the urinary albumin content, patients were divided into normal proteinuria group (35 cases, < 30 mg), microproteinuria group (28 cases, 30-300 mg) and macroproteinuria group (17 cases, > 300 mg). All patients received anti-VEGF therapy, and the clinical efficacy differences of different renal function states were compared. The changes of central retinal thickness (CRT) in macular area, vascularless area in fovea (FAZ), FAZ circumference, 300 μm parafotal blood flow density (FD-300), superficial and deep retinal blood flow density in parafotal foveal area were measured by SS-OCT technique before and after treatment. Results: The total effective rate of massive proteinuria group was lower than that of normal proteinuria group and microproteinuria group (35.29% vs 60.71%, 85.71%, P<0.05). After treatment, CRT, FAZ area and FAZ circumference in three groups were decreased compared with before treatment (P<0.05), FD-300, superficial and deep blood flow density in para-fovea were increased compared with before treatment (P<0.05). Before and after treatment, the CRT, FAZ area and FAZ circumference of the proteinuria group were higher than those of normoalbuminuria group and microproteinuria group (P<0.05), and the microproteinuria group was higher than that of normoalbuminuria group (P<0.05). After treatment, FD-300, para-fovea superficial and deep blood flow density in the proteinuria group were lower than those in the normoproteinuria group and the microproteinuria group (P<0.05), and the microproteinuria group was lower than the normoproteinuria group (P<0.05). Conclusion: SS-OCT can accurately and quantitatively evaluate the changes of CRT, FAZ morphology and blood perfusion in DME patients with different renal function states before and after anti-VEGF therapy, and can be used to evaluate the anti-VEGF efficacy. |
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