摘要目的:探讨阈值下微脉冲激光光凝对增殖性糖尿病视网膜病变(PDR)患者血清丙二醛(MDA)及趋化素水平的影响。方法:选取丽水市人民医院2014年10月至2016年2月治疗的PDR患者102例为研究对象，采用随机数字表法分为对照组51例、观察组51例。对照组采用传统格栅样激光术治疗，观察组采用阈值下微脉冲激光光凝治疗。比较两组治疗前后MDA、趋化素水平，观察两组视力变化及临床疗效。结果:观察组总有效率为90.20%(46/51)，高于对照组的76.47%(39/51)(χ 2＝19.585， P<0.01)。治疗前，两组血清MDA、趋化素及视力水平均差异无统计学意义(均 P>0.05)；治疗后，观察组血清MDA、趋化素分别为(8.57±2.48)μmol/L、(1.58±0.51)ng/L，对照组分别为(10.92±3.16)μmol/L、(2.83±0.92)ng/L，两组均低于治疗前(均 P<0.05)，观察组均低于对照组( t＝4.178、8.486，均 P<0.05)；观察组视力为(0.66±0.19)，高于对照组的(0.43±0.13)( t＝7.135， P<0.05)。 结论:采用阈值下微脉冲激光光凝治疗可有效缓解增殖性糖尿病视网膜病变患者氧化应激状态，降低血清MDA及趋化素水平。

abstractsObjective:To investigate the effects of micropulse laser photocoagulation under threshold on serum malondialdehyde(MDA) and chemokine levels in patients with proliferative diabetic retinopathy(PDR).Methods:From October 2014 to February 2016, 102 patients with PDR who were treated in Lishui People's Hospital were selected and divided into two groups by random number table method, with 51 cases in each group.The patients in the control group were treated with traditional grating laser, and the patients in the observation group were treated with micropulse laser photocoagulation under threshold.The levels of MDA and chemokine were compared before and after treatment, and the changes of vision and clinical efficacy were observed.Results:The total effective rate of the observation group was 90.20%(46/51), which was higher than that of the control group [76.47%(39/51)](χ 2=19.585, P<0.01). Before treatment, there were no statistically significant differences in serum MDA, chemokine and visual acuity between the two groups(all P>0.05). After treatment, the serum MDA and chemokines in the observation group were (8.57±2.48)μmol/L and (1.58±0.51)ng/L, respectively, which were lower than those in the control group [(10.92±3.16)μmol/L and (2.83±0.92)ng/L]( t=4.178, 8.486, all P<0.05), which in both two groups after treatment were lower than those before treatment(all P<0.05). The visual acuity of the observation group was (0.66±0.19), which was higher than that of the control group(0.43±0.13)( t=7.135, P<0.05). Conclusion:Micropulse laser photocoagulation under threshold can effectively alleviate oxidative stress and reduce serum MDA and chemokine levels in patients with PDR.