目的：评价复方樟柳碱联合激光光凝治疗糖尿病视网膜病变(DR)的疗效、安全性及血液流变学情况。

方法：采用前瞻性队列研究方法，选取2023-05/07就诊于首都医科大学附属北京同仁医院和北京市大兴区人民医院，并诊断为重度非增殖期DR(NPDR)和增殖期DR(PDR)的患者80例160眼，采用随机数字表法分为对照组40例80眼和观察组40例80眼，对照组仅接受532 nm激光全视网膜激光光凝(PRP)治疗，观察组PRP治疗同时联合复方樟柳碱颞浅皮下注射。观察治疗前，治疗后2 mo两组临床疗效、血液流变学变化、眼底血管的变化及不良反应发生率情况。

结果：治疗前后对两组患者的视力、眼底变化情况、血液流变学指标进行分析，发现治疗前两组患者均无显著性差异(均P>0.05)； 治疗后2 mo观察组的最佳矫正视力水平优于对照组(P<0.05)，眼底临床疗效较对照组恢复更好(均P<0.05)，观察组的视网膜中央动脉血流的流变学指标：收缩期峰值流速和舒张末期流速高于对照组(均P<0.05)，血流阻力指数低于对照组(P<0.05)。

结论：复方樟柳碱注射液联合532 nm激光光凝治疗DR可以使视网膜中央动脉血液流变学指标好转，且安全有效。

METHODS: A prospective cohort study was used to select 80 patients(160 eyes)diagnosed with severe non-proliferative diabetic retinopathy(NPDR)and proliferative diabetic retinopathy(PDR)in Beijing Tongren Hospital, Capital MedTcal University and Beijing Daxing District People's Hospital from May 2023 to July 2023. They were divided into control group(40 cases, 80 eyes)and observation group(40 cases, 80 eyes)by random number table method. The control group only received 532 nm laser panretinal photocoagulation(PRP)treatment, while the observation group received PRP treatment together with superficial temporal subcutaneous injection of compound anisodine. The clinical efficacy, changes in hemorheology, changes in retinal blood vessels, and incidence of adverse reactions in the two groups were observed before and at 2 mo after treatment.

RESULTS: The visual acuity, fundus changes and hemorheological parameters of the two groups were analyzed before and after treatment. There were no significant differences in the two groups before treatment(all P>0.05). The best corrected visual acuity of the observation group was better than that of the control group at 2 mo after treatment(P<0.05), and the clinical curative effect of fundus was also better than that of the control group(all P<0.05). The hemorheological indexes of central retinal artery blood flow(peak systolic velocity and end diastolic velocity)in the observation group were higher than those of the control group(all P<0.05), and the blood flow resistance index was lower than that of the control group(P<0.05).

CONCLUSION: Compound anisodine combined with 532 nm laser photocoagulation is safe and effective in the treatment of DR, and the visual recovery effect is better.