方法：选择本院2015-01/2016-12收治的DR患者100例136眼，均行532nm激光治疗，统计治疗后视力变化和并发症发生率，比较治疗前后黄斑中心凹视网膜厚度、患眼血流动力学变化情况，并比较分析不同糖尿病类型、DR分期、糖化血红蛋白(HbA1c)患者激光治疗效果。

结果：与治疗前比较，患者治疗后黄斑中心凹视网膜厚度、舒张末期血流速度(end diastolic velocity，EDV)、搏动指数(pulsatility index，PI)、视网膜中央动脉(central retinal artery，CRA)、平均血流速度(mean flow velocity，Vm)均显著降低，差异有统计学意义(P<0.05)； 治疗后发生出血、牵拉性视网膜脱离各2例2眼； 视力改善113眼(有效率83.1%)，不同糖尿病类型(1型60.0% vs 2型84.9%)、DR分期(增殖前期92.3%，早期增殖期85.1%，高危PDR 54.2%)、HbA1c水平(<8%者91.8% vs ≥8%者73.0%)DR患者视力改善有效率比较，差异均有统计学意义(P<0.05)。

结论：532nm激光治疗DR疗效较好，能明显改善患眼视网膜血流动力学、视力和黄斑水肿，同时糖尿病分型、DR分期和血糖控制水平可能影响激光治疗效果。

METHODS: A total of 100 patients(136 eyes)with DR who were admitted to our hospital during January 2015 to December 2016 were enrolled in the study. All patients were given 532nm laser treatment. Changes of visual acuity and the incidence of complications were statistically analyzed after treatment, and the macula central fovea retinal thickness and hemodynamic changes of affected eyes were compared before and after treatment. The effects of laser treatment were compared among patients with different types of diabetes, patients in different DR stages and patients with different glycosylated hemoglobin(HbAlc)levels.

RESULTS: After treatment, the macula central fovea retinal thickness, end diastolic velocity(EDV), pulsatility index(PI)and central retinal artery(CRA), mean flow velocity(Vm)significantly decreased(P<0.05). After treatment, there were 2 cases(2 eyes)of bleeding and 2 cases(2 eyes)of tractional retinal detachment. The effective improvement rate of visual acuity was 83.1%. There were significant differences in the improvement rate of visual acuity among patients with different types of diabetes \〖type 1(60.0%)vs type 2(84.9%)\〗, patients in different DR stages \〖preproliferative diabetic retinopathy(NPDR)92.3%, early proliferative stage(PDR)85.1%, high-risk PDR 54.2%\〗 and patients with different HbAlc levels(< 8% 91.8% vs ≥8% 73.0%)(P<0.05).

CONCLUSION: The 532nm laser treatment is effective for DR. It can significantly improve the retinal hemodynamics and visual acuity and relieve macular edema. Types of diabetes mellitus, stages of DR and blood glucose control effect may affect the effects of laser treatment.