摘要目的:探讨康柏西普联合视网膜激光光凝治疗糖尿病性黄斑水肿（DME）的疗效及对患者最佳矫正视力、黄斑中心凹厚度和房水血管内皮生长因子（VEGF）、人基质细胞衍生因子1（SDF-1）的影响。方法:选取2016年11月至2019年12月丽水市人民医院收治的DME患者90例，根据随机数字表法分为对照组（视网膜激光光凝治疗）和研究组（对照组的基础上+康柏西普治疗），每组45例。比较两组患者疗效、最佳矫正视力、黄斑中心凹厚度和房水VEGF、SDF-1，记录两组治疗期间并发症发生情况。结果:研究组临床总有效率为88.89%（40/45），高于对照组的68.89%（31/45），差异有统计学意义（χ 2=5.40， P < 0.05）。治疗3个月后，研究组房水VEGF［（138.71±16.82）ng/L］、SDF-1［（415.18±24.87）mg/L］水平均低于对照组［VEGF（276.13±15.96）ng/L、SDF-1（526.06±22.91）mg/L］（ t=39.76、21.98，均 P < 0.001）。治疗3个月后，研究组黄斑中心凹厚度［（339.52±30.12）μm］、最佳矫正视力（0.47±0.08）分别与对照组［（398.65±28.23）μm、（0.36±0.09）］差异有统计学意义（ t=6.13、9.61，均 P < 0.001）。两组并发症发生率差异无统计学意义［13.33%（6/45）比11.11%（5/45），χ 2=0.10， P > 0.05］。 结论:康柏西普联合视网膜激光光凝治疗DME患者，疗效确切，可有效改善患者最佳矫正视力、黄斑中心凹厚度和房水VEGF、SDF-1水平，且不增加并发症发生率，具有一定的临床应用价值。

abstractsObjective:To investigate the therapeutic effects of conbercept combined with retinal laser photocoagulation on diabetic macular edema (DME) and the effects of the combined therapy on best corrected visual acuity, macular fovea thickness, vascular endothelial growth factor (VEGF) and human stromal cell-derived factor 1 (SDF-1) levels in aqueous humor of patients with DME.Methods:Ninety patients with DME who received treatment in Lishui People's Hospital between November 2016 and December 2019 were included in this study. They were randomly assigned to undergo retinal laser photocoagulation (control group, n = 45) or retinal laser photocoagulation combined with conbercept treatment (study group, n = 45). Therapeutic effects, best corrected visual acuity, macular fovea thickness, and VEGF and SDF-1 levels in aqueous humor were compared between the two groups. The incidence of complications was compared between the two groups. Results:Total response rate in the study group was significantly higher than that in the control group [88.89% (40/45) vs. 68.89% (31/45), χ2 = 5.40, P = 0.020]. After 3 months of treatment, VEGF and SDF-1 levels in aqueous humor were (138.71 ± 16.82) ng/L and (415.18 ± 24.87) mg/L, respectively, which were significantly lower than those in the control group [(276.13 ± 15.96) ng/L, (526.06 ± 22.91) mg/L, t = 39.76, 21.98, both P < 0.001]. After 3 months of treatment, macular fovea thickness and best corrected visual acuity in the study group were (339.52 ± 30.12) μm and 0.47 ± 0.08, respectively, which were significantly lower than those in the control group [(398.65 ± 28.23) μm, 0.36 ± 0.09, t = 6.13, 9.61, both P < 0.01]. There was no significant difference in the incidence of complications between the two groups [13.33% (6/45) vs. 11.11% (5/45), χ2 = 0.10, P > 0.05]. Conclusion:Conbercept combined with retinal laser photocoagulation for the treatment of DME has a definite therapeutic effect. The combined therapy can greatly improve the best corrected visual acuity, reduce macular fovea thickness, decrease VEGF and SDF-1 levels in aqueous humor, and does not increase the incidence of complications. Findings from this study have a certain clinical application value.