目的：探讨玻璃体腔注射康柏西普治疗糖尿病黄斑水肿(diabetic macular edema，DME)的效果。

方法：回顾性分析我院2014-01/2016-12收治入院的DME患者95例95眼，其中42眼予以玻璃体腔注射雷珠单抗(对照组)，53眼予以玻璃体腔注射康柏西普(观察组)。观察两组患者治疗前后视力及黄斑中心凹厚度变化，并比较两组重复给药次数、并发症和医疗费用情况。

结果：治疗前两组患者BCVA比较差异无统计学意义(P>0.05)。两组患者不同时间BCVA比较，差异有统计学意义(F=105.326，P<0.01； F=86.365，P<0.01)。治疗后3mo两组患者BCVA较治疗前提高，差异有统计学意义(P均<0.05)，组间比较差异无统计学意义(P>0.05)。观察组治疗后6mo BCVA较治疗后3mo提高，差异有统计学意义(P<0.05)，对照组治疗后6mo和治疗后3mo BCVA比较无统计学意义(P>0.05)。组间治疗后6mo比较差异有统计学意义(P<0.01)。两组患者治疗前黄斑中心凹厚度比较无统计学差异(P>0.05)，不同时间两组患者黄斑中心凹厚度比较，差异有统计学意义(F=86.365，P<0.01； F=84.235，P<0.01)。两组患者治疗后1、3、6mo黄斑中心凹厚度均明显低于治疗前，差异均有统计学意义(P<0.05)； 两组间治疗后各时间点比较差异均无统计学意义(P>0.05)。随访期间观察组重复用药次数均较对照组少，差异均有统计学意义(P<0.05)，两组患者并发症发生率比较差异无统计学意义(P>0.05)； 观察组平均医疗费用明显较对照组低，差异有统计学意义(P<0.01)。

结论：玻璃体腔注射康柏西普治疗DME，可有效改善黄斑水肿，提高视力，且药效持久，价格低廉，安全性高。

METHODS: Totally 95 patients(95 eyes)with diabetic macular edema treated in our hospital from January 2014 to December 2016 were retrospectively analyzed, and 42 cases received Ranibizumab intravitreal injection were included into control group, 53 cases treated with conbercept intravitreal injection were included into observation group. The changes of preoperative and postoperative follow up visual acuity and macular foveal thickness in the two groups were observed. The repeated medication, complications and medical expenses were also compared.

RESULTS: The preoperative best corrected visual acuity between groups showed no difference(P>0.01). The postoperative best corrected visual acuity between groups showed distinct difference(F=105.326, P<0.01; F=86.365, P<0.01). At 3mo after the operation, visual acuity of two groups sharply improved, a significant difference was shown within the groups(P<0.05), but held no obvious difference between groups(P>0.05). At 6mo after operation, the observation group's visual acuity was evidently higher than that at 3mo(P<0.05). The visual acuity at postoperatively 6mo of the observation group was significantly higher than that of the control group, the difference between groups was statistically marked(P<0.01). The control group's visual acuity at postoperative 3 and 6mo showed no marked difference(P>0.05). The overall changes of foveal thickness between two groups showed a significant difference(F=86.365, P<0.01; F=84.235, P<0.01). The foveal thickness reduced obviously during the postoperative 1, 3 and 6mo of followed up, which showed remarkable difference within groups(P<0.05)but no difference between groups(P>0.05). The repeated medication of observation group during the postoperative 1, 3 and 6mo of followed up was evidently less than that of the control group, the difference between groups was significant(P<0.05). There was no statistical difference between groups in complications after operation(P>0.05). The average medical cost of the observation group was obviously less than that of the control group, and the difference between the two groups was evident(P<0.01).

CONCLUSION: Intravitreal injection of conbercept in the treatment of diabetic macular edema can effectively enhance vision and relieve macular edema, as well as shows lasting efficacy, low cost and high safety.