目的：探究玻璃体内注射康柏西普辅助玻璃体切除(PPV)治疗增生型糖尿病视网膜病变(PDR)及对玻璃体内炎症因子和血管生成素样蛋白4(ANGPTL4)的影响。

方法：选取2016-01/2018-12我院收治的行PPV治疗的PDR患者90例99眼作为研究对象，根据是否采用玻璃体内注射康柏西普(IVC)将患者分为PPV组和IVC辅助PPV组； 观察两组患者术后3mo内的BCVA(LogMAR)及术后玻璃体内积血(POVCH)发生率； 测定两组患者玻璃体中IL-6、IL-10、C反应蛋白(CRP)等炎症因子及ANGPTL4的含量。

结果：IVC辅助PPV组患者手术时间、术中严重出血(需用电凝笔的出血)率、医源性视网膜裂孔及术后硅油填充率均显著优于PPV组(P<0.05)； 术前两组患者BVCA无差异(P>0.05)，术后1、3mo时两组患者视力显著好转，术后各时段IVC联合PPV组BCVA值显著低于单纯PPV组(P<0.05)； POVCH的发生率显著降低(P<0.05)，玻璃体中IL-6、IL-10及CRP的含量显著降低(P<0.05)，ANGPTL4含量显著升高(P<0.05)。

结论：PPV术前玻璃体注射康柏西普治疗PDR，能够减少术中及术后并发症的发生，促进患者视力的康复，并减轻玻璃体中炎症反应，增加ANGPTL4的含量。

METHODS: Totally 90 patients with PDR(99 eyes)who underwent PPV treatment in our hospital from January to February 2018 were selected as subjects, and were divided into PPV group and IVC/PPV group according to whether intravitreal injection of conbercept(IVC).The surgical indexes of the two groups, the best corrected visual acuity(BCVA, LogMAR)and the incidence of postoperative vitreous hemorrhage(POVCH)were observed within 3mo after surgery were observed. The levels of interleukin-6(IL-6), interleukin-10(IL-10), C-reactive protein(CRP)and other inflammatory factors and ANGPTL4 in the vitreous of the two groups were measured.

RESULTS: In the IVC-assisted PPV group, the operation time, intraoperative severe hemorrhage(bleeding with electrocoagulation pen), iatrogenic retinal tears and postoperative silicone oil filling rate were significantly better than those in the PPV group(P<0.05). There was no significant difference in BVCA between the two groups(P>0.05). There was no significant difference in BVCA between the two groups(P>0.05). At 1 and 3mo after operation, BCVA decreased significantly in both groups. Visual acuity improved significantly. The BCVA(LogMAR)of the IVC combined with the PPV group was significantly lower than that of the group. Simple PPV group(P<0.05). The occurrence of POVCH The rate was significantly decreased(P<0.05), the contents of IL-6, IL-10 and CRP in the vitreous were significantly decreased(P<0.05), and the content of ANGPTL4 was significantly increased(P<0.05).

CONCLUSION: Preoperative vitreous injection of conbercept in the treatment of PDR can reduce the occurrence of intraoperative and postoperative complications, promote the recovery of visual acuity, reduce the inflammatory response in the vitreous and increase the content of ANGPTL4.