目的：探究不同抗血管内皮生长因子(VEGF)药物治疗糖尿病性黄斑水肿(DME)临床疗效，并分析其与光学相干断层扫描(OCT)分型的关系。

方法：选取45例进行雷珠单抗治疗的DME患者(本院于2020-02/2022-02收治)作为雷珠单抗组，同期45例进行康柏西普治疗的DME患者作为康柏西普组。其中雷珠单抗组给予视网膜光凝术联合雷珠单抗治疗，康柏西普组给予视网膜光凝术联合康柏西普治疗。比较两组患者症状改善情况(黄斑水肿改善时间、视网膜厚度恢复正常时间、新生血管消失时间及眼底出血吸收时间)，血清白细胞介素-6(IL-6)、VEGF水平，黄斑中心凹视网膜厚度(CMT)、最佳矫正视力(BCVA)水平及并发症发生情况，并分析其临床疗效与不同OCT分型的关系。

结果：两组黄斑水肿改善时间、视网膜厚度恢复正常时间、新生血管消失时间及眼底出血吸收时间比较均无明显差异(P>0.05)； 与治疗前比较，两组治疗后血清IL-6、VEGF、BCVA值均明显降低(P<0.01)，但组间比较均无明显差异(P>0.05)； 与治疗前比较，两组治疗后CMT均明显降低(P<0.05)，且与雷珠单抗组比较，康柏西普组明显降低(P<0.01)； 两组患者并发症发生率比较无明显差异(P>0.05)； 浆液性视网膜脱离(SRD)、黄斑囊样水肿(CME)、视网膜弥漫性增厚(DRT)型患者总有效率比较有明显差异(P<0.05)，其中DRT型最高，SRD型最低。

结论：康柏西普与雷珠单抗治疗DME均可有效改善患者临床症状，减轻炎症反应，且对DRT型DME患者治疗效果更好，但是康柏西普能够更好地降低CMT水平。

METHODS: A total of 45 DME patients treated with ranibizumab(admitted to our hospital from February 2020 to February 2022)were selected as the ranibizumab group, and 45 DME patients treated with conbercept during the same period were selected as the conbercept group. The ranibizumab group was treated with retinal photocoagulation combined with ranibizumab, and the conbercept group was treated with retinal photocoagulation combined with conbercept. The improvement of symptoms(improvement time of macular edema, time of retinal thickness returning to normal, disappearance time of neovascularization and absorption time of fundus hemorrhage), levels of serum interleukin-6(IL-6)and VEGF, central macular thickness(CMT), best corrected visual acuity(BCVA), and complications were compared between the two groups, and the relationship between their clinical efficacy and different OCT types were analyzed.

RESULTS: There was no significant difference in the improvement time of macular edema, time of retinal thickness returning to normal, disappearance time of neovascularization and absorption time of fundus hemorrhage between the two groups(P>0.05); After treatment, the values of IL-6, VEGF and BCVA in the two groups were significantly lower than those before treatment(P<0.01), but there was no significant difference between the two groups(P>0.05); compared with before treatment, CMT was significantly decreased in both groups after treatment(P<0.05), and compared with ranibizumab group, the CMT was significantly decreased in the conbercept group(P<0.01); there was no significant difference in the incidence of complications between two groups(P>0.05); there were significant differences in the total effective rate among patients with serous retinal detachment(SRD), cystoid macular edema(CME)and diffuse retinal thickening(DRT; P<0.05), among which DRT had the highest total effective rate and SRD had the lowest total effective rate.

CONCLUSION: Both conbercept and ranibizumab in the treatment of DME can effectively improve the clinical symptoms of patients and reduce the inflammatory response, but conbercept can better reduce the level of CMT, and has better treatment effect on DRT-type DME patients.