摘要目的:探究高压氧(HBO)治疗对老年糖尿病视网膜病变患者血清VEGF、IGF-1水平的影响。方法:选取2016年5月至2018年5月临沂市中心医院内分泌科就诊的114例老年糖尿病视网膜病变患者，采用随机数字表法分为观察组和对照组，每组57例。对照组患者给予羟苯磺酸钙等常规治疗，观察组在对照组治疗的基础上联合HBO治疗。治疗3个疗程后，分别比较2组患者的临床疗效及治疗前后血清高敏C-反应蛋白(hs-CRP)、血管内皮生长因子(VEGF)、胰岛素样生长因子-1(IGF-1)的变化，并观察2组治疗后不同视网膜病变分级患者血清hs-CRP、VEGF、IGF-1水平的变化。结果:观察组患者治疗后有效率(78.39%)明显高于对照组有效率(56.77%)，差异有统计学意义( χ2＝4.524， P<0.05)；治疗3个疗程后，2组患者血清hs-CRP、VEGF、IGF-1表达均较治疗前明显下降，且观察组患者血清hs-CRP、VEGF、IGF-1表达水平较对照组明显下降，差异均有统计学意义( P<0.01)。观察组Ⅰ、Ⅱ级患者血清hs-CRP、VEGF、IGF-1较对照组明显下降，差异有统计学意义( P<0.05)，观察组Ⅲ级患者较对照组无明显改变( P>0.05)。 结论:HBO辅助羟苯磺酸钙治疗老年糖尿病视网膜病变患者较单纯服用羟苯磺酸钙治疗具有更好的临床疗效。

abstractsObjective:To explore the effect of hyperbaric oxygen (HBO) therapy on serum VEGF and IGF-1 in patients with elder diabetic retinopathy.Methods:A total of 114 patients with elder diabetic retinopathy admitted in Linyi Central Hospital from the May of 2016 to the May of 2018 were selected and randomly divided into observation group and control group according to the random number table method, with 57 patients in each group. The control group received routine treatments, i. e. calcium dobesilate, while the observation group received HBO combined with the routine treatment as the control group. After 3 courses of treatment, the changes of serum high-sensitivity C-reactive protein (hs-CRP), vascular endothelial growth factor (VEGF), and type-1 insulin like growth factor (IGF-1) of each group were compared before and after the treatment. The effects of retinopathy severity after treatment in each group on the levels of serum hs-CRP, VEGF, and IGF-1 were also observed.Results:The therapeutic efficacy rate of the observation group (78.39%) was significantly higher than that of the control group (56.77%), with statistical difference ( χ2=4.524, P<0.05). After 3 courses of the treatment, the expression levels of hs-CRP, VEGF, and IGF-1 of the two groups were significantly lower than those before the treatment. Furthermore, the expression levels of hs-CRP, VEGF and IGF-1 in the observation group were significantly lower than those in the control group, with statistical difference( P<0.01). Among the patients with Grade I and II retinopathy, the serum hs-CRP, VEGF, and IGF-1 in the observation group were significantly lower than those in the control group, and the differences were statistically significant ( P<0.05). Among the patients with Grade III and IV retinopathy, there was no statistical difference comparing those values between the two groups ( P>0.05). Conclusion:In the treatment of elder diabetic retinopathy, HBO assisting calcium dobesilate is more effective than singly using calcium dobesilate, and decreases serum hs-CRP, VEGF and IGF-1 levels.