目的：分析532nm激光全视网膜光凝术(PRP)联合羟苯磺酸钙对糖尿病视网膜病变(DR)患者眼底微循环及黄斑厚度的影响，为DR患者的临床治疗提供试验数据。

方法：将我院2017-01/2019-01期间收治的DR患者174例239眼按非随机临床同期对照研究及患者自愿原则分两组，对照组采用532nm激光PRP治疗，观察组在对照组基础上联合羟苯磺酸钙治疗。比较两组患者治疗前、治疗后(PRP术后3mo时)的BCVA(LogMAR)、临床疗效、眼底微循环、黄斑厚度，并统计治疗期间并发症发生率。

结果：两组患者治疗后BCVA(LogMAR)较治疗前均有改善，且观察组临床疗效优于对照组(均P<0.001)； 治疗后两组患者视网膜中央动脉(CRA)、睫状后动脉(PCA)的阻力指数(RI)较治疗前下降(P<0.05)，收缩期峰值血流速度(PSV)、舒张末期血流速度(EDV)较治疗前上升(P<0.05)，但观察组RI低于对照组，EDV、PSV高于对照组(P<0.001)； 治疗后两组患者黄斑厚度及其他临床指标(血管瘤、出血斑、视野灰度值)较治疗前均下降(P<0.05)，且观察组低于对照组(P<0.001)； 两组并发症发生率(0.8% vs 2.6%)无差异(χ²=0.344，P=0.557)。

结论：较单纯532nm激光PRP治疗DR，联合羟苯磺酸钙疗效更佳，对眼底微循环、黄斑厚度等的改善更显著，且安全性佳。

METHODS: According to the non-randomized clinical concurrent control study and voluntary principle, 174(239 eyes)DR patients were divided into observation group and control group. Both groups were treated with 532nm laser PRP, and the observation group was additionally treated with calcium dobesilate. BCVA(LogMAR)vision, clinical effect, fundus microcirculation, macular thickness and other clinical indexes were compared between the two groups before and after treatment(at 3mo after PRP). The incidence of complications during treatment was statistically analyzed.

RESULTS: After treatment, BCVA in both groups were increased, and it was higher in observation group than control group. The clinical curative effect of observation group was better than that of control group(P<0.001). After treatment, the resistance index(RI)of central retinal artery(CRA)and osterior ciliary artery(PCA)in both groups were decreased(P<0.05), while the peak systolic velocity(PSV)and end diastolic velocity(EDV)were increased(P<0.05). RI in observation group was lower than that in control group, while EDV and PSV were higher than those in control group(P<0.001). After treatment, the macular thicknesses and other clinical indexes(hemangioma, bleeding spots, gray value of visual field)in both groups were decreased(P<0.05), and they were lower in observation group than control group(P<0.001). There was no significant difference in the incidence rate of complications between the two groups(0.8% vs 2.6%)(χ²=0.344, P=0.557).

CONCLUSION: Compared with 532nm PRP in treatment of DR, curative effect of 532nm PRP combined with calcium dobesilate is better. The latter can improve fundus microcirculation and macular thickness more significantly, with high safety.