目的：探讨激光光凝术、血管内皮生长因子抑制剂单用或联用对糖尿病性黄斑水肿(diabetic macular edema，DME)患者疗效和安全性的影响。

方法：研究对象选取我院2014-10/2016-10收治的DME患者150例156眼，以随机数字表法分为A组50例52眼，B组50例51眼和C组50例53眼，分别采用激光光凝术单用、血管内皮生长因子抑制剂单用和激光光凝术+血管内皮生长因子抑制剂联合方案治疗。比较三组患者治疗前后最佳矫正视力、黄斑中心凹厚度、视网膜新生血管渗漏面积和并发症发生率。

结果：B、C组患者治疗后3、6、12mo最佳矫正视力水平较A组均显著提高(P<0.05)； B、C组患者治疗后3、6、12mo黄斑中心凹厚度较A组均显著降低(P<0.05)； B、C组患者治疗后3mo视网膜新生血管渗漏面积较A组均显著缩小(P<0.05)； C组患者治疗后6mo和12mo视网膜新生血管渗漏面积较A、B组均显著缩小(P<0.05)； 同时三组患者术后并发症发生率比较，差异无统计学意义(P>0.05)。

结论：激光光凝术联合血管内皮生长因子抑制剂治疗DME可有效改善视力水平，降低黄斑中心凹厚度，控制视网膜新生血管渗漏，且未增加不良反应，效果优于激光光凝术和血管内皮生长因子抑制剂单用。

METHODS: Totally 150 patients(156 eyes)with DME were chosen in the period from October 2014 to October 2016 in our hospital and randomly divided into both group including Group A(50 patients 52 eyes)with laser photocoagulation used alone, Group B(50 patients 51 eyes)with VEGF antagonists used alone and Group C(50 patients 53 eyes)with combination therapy; and the best corrected visual acuity, macular fovea thickness and retinal neovascularization leakage area before and after treatment and the complications incidence of both groups were compared.

RESULTS: The best corrected visual acuity of Group B and Group C in 3, 6 and 12mo after treatment were significant better than that of Group A(P<0.05). The macular fovea thickness of Group B and Group C in 3, 6 and 12mo after treatment were significant lower than that of Group A(P<0.05). The retinal neovascularization leakage area of Group B and Group C in 3mo after treatment were significant smaller than that of Group A(P<0.05). The retinal neovascularization leakage area of Group C in 6 and 12mo after treatment were significant smaller than that of Group A and Group B(P<0.05). There was no significant difference in the complications incidence among 3 groups(P>0.05).

CONCLUSION: Laser photocoagulation combined with VEGF antagonists in the treatment of patients with DME can efficiently improve visual acuity, reduce macular foveal thickness, control retinal neovascularization leakage and not increase adverse reactions.