目的：探讨眼底激光联合抗VEGF药物治疗对糖尿病黄斑水肿患者血清NOS、VEGF和IL-6的影响。

方法：选取2015-05/2016-05我院收治的糖尿病视网膜病变伴黄斑水肿患者106例156眼为研究对象，按照随机数表法分为观察组(56例84眼)和对照组(50例72眼)。对照组给予眼底激光治疗，观察组在对照组的基础上联合抗VEGF药物治疗，比较两组患者临床疗效、最佳矫正视力、黄斑厚度、并发症情况和血清一氧化氮合酶(NOS)、血管内皮生长因子(VEGF)和白介素-6(IL-6)的水平。

结果：与治疗前比较，观察组最佳矫正视力明显改善，黄斑厚度明显降低(P<0.05)； 与对照组比较，观察组最佳矫正视力、黄斑厚度改善情况明显优于对照组(P<0.05)。治疗前，两组患者血清NOS、VEGF和IL-6水平差异均无统计学意义(P>0.05)； 治疗后，两组患者NOS水平均明显上升，VEGF、IL-6水平均明显下降(P<0.05)； 观察组血清NOS、VEGF和IL-6改善情况均优于对照组(P<0.05)。对照组临床治疗总有效率(80.6%)低于观察组(94.0%)，差异有统计学意义(P<0.05)。对照组并发症发生率(9.7%)与观察组(7.1%)比较，差异无统计学意义(P>0.05)。

结论：眼底激光联合抗VEGF药物治疗糖尿病黄斑水肿安全、有效，能够有效改善血清NOS、VEGF和IL-6水平。

METHODS: From May 2015 to May 2016, 106 cases(156 eyes)of patients with diabetic macular edema in hospital were be selected as the research object. According to the random number table method, 84 eyes of 56 cases were in observation group, 72 eyes of 50 cases in the control group. The control group was given retinal laser treatment, the observation group was treated by retinal laser combined with anti-VEGF therapy. We compared two groups of clinical efficiency, the best corrected visual acuity, macular thickness, complications and serum NOS, VEGF and IL-6.

RESULTS: The best corrected visual acuity significantly increased and the macular thickness significantly decreased in the observation group(P<0.05). The improvement of the best corrected visual acuity and macular thickness in the observation group was obviously better than that of the control group(P<0.05). The level of NOS, VEGF and IL-6 was not different between the two groups before treatment(P>0.05). After treatment, the levels of NOS increased significantly and VEGF and IL-6 decreased significantly in the two groups(P<0.05). The improvement of serum NOS, VEGF and IL-6 in the observation group was better than those in the control group(P<0.05). The total effective rate of clinical treatment in the control group(80.6%)was lower than that of the observation group(94.0%, P<0.05). The incidence of complications in the control group(9.7%)and the incidence of complications in the observation group(7.1%)were not significantly different(P>0.05).

CONCLUSION: This is a safe and effective treatment of fundus laser combined with anti-VEGF drugs in the treatment of diabetic macular edema. It can effectively improve serum NOS, VEGF and IL-6 levels.