目的：对曲安奈德与雷珠单抗用于弥漫性糖尿病性黄斑水肿(DME)的临床疗效观察比较。

方法：将2016-02/2017-05我院收治的84例弥漫性DME患者作为研究对象，遵循1：1的配对原则将患者分为Ⅰ、Ⅱ两组，两组均采用激光光凝手术治疗，Ⅰ组光凝术前予以曲安奈德辅助治疗，Ⅱ组术前予以雷珠单抗辅助治疗，对两组临床疗效作回顾性分析与比较。

结果：Ⅱ组患者治疗后3mo临床总有效率为93%，高于Ⅰ组总有效率77%(χ²=4.981，P=0.025)； 与治疗前相比，两组治疗后各时间段BCVA、CMT均得到明显改善(P<0.05)； Ⅱ组治疗后1、3mo BCVA指标改善优于Ⅰ组(P<0.05)； Ⅱ组治疗后1、3、6mo CMT改善更优于Ⅰ组，差异有统计学意义(P<0.05)； Ⅰ组与Ⅱ组不良反应发生率分别为17%、13%，差异无统计学意义(χ²=0.243，P=0.621)。两组均未发生视网膜脱落、眼内炎、白内障等严重的不良反应。

结论：与曲安奈德相比较，雷珠单抗用于弥漫性DME的疗效更佳，具有较高的临床应用价值。

METHODS: We collected 84 cases of patients with diffuse DME treated in our hospital from February 2016 to May 2017. According to 1:1 matching method, they were divided into Ⅰ, Ⅱ groups. They were all treated with laser photocoagulation. Preoperative auxiliary application of triamcinolone acetonide was given to Group Ⅰ, while Group Ⅱ received preoperative application of ranibizumab. After treatment, the efficacy of the two groups were analyzed and compared.

RESULTS: The total clinical efficiency of Group Ⅱ at 3mo after treatment was 93%, higher than that of Group Ⅰ(77%; χ²=4.981, P=0.025). Compared with before treatment, BCVA and CMT of the two groups at each time after treatment were significantly improved(P<0.05). BCVA of Group Ⅱ at 1 and 3mo after treatment was better than that of Group Ⅰ(P<0.05); CMT of Group Ⅱ at 1, 3 and 6mo after treatment improved more than that of Group Ⅰ, with significant difference(P<0.05); occurrence rate of adverse reactions Group Ⅰ and Group Ⅱ were 17% and 13% with no significant statistical difference(χ²=0.243, P=0.621). There were no serious adverse reactions such as retinal detachment, endophthalmitis or cataract in the two groups.

CONCLUSION: Compared with triamcinolone acetonide, the effect of ranibizumab on diffuse diabetic macular edema is better, and has high clinical value.