目的 观察普罗布考治疗高血脂非增生型糖尿病视网膜病变(DR)的临床效果.方法 临床确诊为高血脂非增生型DR的52例患者104只眼纳入研究.将患者随机分为普罗布考治疗组(治疗组)和对照组,分别为26例52只眼.给予两组患者饮食、运动指导的同时进行口服降糖药和(或)胰岛素强化治疗.治疗组在控制血糖、血压基础上给予普罗布考0.5g,2次/d;对照组在控制血糖、血压基础上口服阿托伐他汀10 mg,1次/d.总疗程12个月.治疗前及治疗后1、3、6、12个月,所有患者均行视力、检眼镜、荧光素眼底血管造影、相关血液及尿液检查.对比观察治疗前后两组患者视力、眼底、黄斑水肿、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDLC)、高密度脂蛋白胆固醇(HDLC)及8-羟基脱氧鸟苷(8-0HdG)的变化情况.结果 治疗后治疗组、对照组视力预后总有效率分别为44.23％、40.38％,二者比较,差异无统计学意义(Z＝-0.335,P＞0.05).治疗组、对照组视网膜出血及微动脉瘤均较治疗前减轻,其眼底预后总有效率分别为65.38％、36.54％,二者比较,差异有统计学意义(Z=-2.973,P＜0.05).治疗组、对照组合并黄斑水肿分别为6、5只眼,均较治疗前显著减少,差异有统计学意义(x2=4.833、4.300,P＜0.05);两组合并黄斑水肿眼数比较,差异无统计学意义(x2 =0.102,P＞0.0S).治疗后12个月,治疗组(t=15.653、7.634、14.871)、对照组(t=13.275、7.415、13.632)TG、TC和LDLC均较治疗前有所降低,差异有统计学意义(P＜0.05);HDLC较治疗前无明显变化,差异无统计学意义(t=0.584、0.275,P＞0.05).治疗组、对照组之间TG、TC、LDLC、HDLC比较,差异均无统计学意义(t=1.857、0.133、1.671、0.875,P＞0.05).治疗后1、3、6、12个月,治疗组(t=7.352、15.581、27.324、28.143)及对照组(t=6.877、8.672、14.671、14.855)8-0HdG较治疗前呈逐渐降低趋势,差异有统计学意义(P＜0.05).治疗后1个月,治疗组及对照组8-0HdG比较,差异无统计学意义(t=0.513,P＞0.05);治疗后3、6、12个月,治疗组8-0HdG较对照组降低,差异有统计学意义(t=3.434、5.917、5.226,P＜0.05).结论 普罗布考治疗高血脂非增生型DR可降低血脂、稳定视功能、减轻黄斑水肿.
目的 觀察普囉佈攷治療高血脂非增生型糖尿病視網膜病變(DR)的臨床效果.方法 臨床確診為高血脂非增生型DR的52例患者104隻眼納入研究.將患者隨機分為普囉佈攷治療組(治療組)和對照組,分彆為26例52隻眼.給予兩組患者飲食、運動指導的同時進行口服降糖藥和(或)胰島素彊化治療.治療組在控製血糖、血壓基礎上給予普囉佈攷0.5g,2次/d;對照組在控製血糖、血壓基礎上口服阿託伐他汀10 mg,1次/d.總療程12箇月.治療前及治療後1、3、6、12箇月,所有患者均行視力、檢眼鏡、熒光素眼底血管造影、相關血液及尿液檢查.對比觀察治療前後兩組患者視力、眼底、黃斑水腫、甘油三酯(TG)、總膽固醇(TC)、低密度脂蛋白膽固醇(LDLC)、高密度脂蛋白膽固醇(HDLC)及8-羥基脫氧鳥苷(8-0HdG)的變化情況.結果 治療後治療組、對照組視力預後總有效率分彆為44.23％、40.38％,二者比較,差異無統計學意義(Z＝-0.335,P＞0.05).治療組、對照組視網膜齣血及微動脈瘤均較治療前減輕,其眼底預後總有效率分彆為65.38％、36.54％,二者比較,差異有統計學意義(Z=-2.973,P＜0.05).治療組、對照組閤併黃斑水腫分彆為6、5隻眼,均較治療前顯著減少,差異有統計學意義(x2=4.833、4.300,P＜0.05);兩組閤併黃斑水腫眼數比較,差異無統計學意義(x2 =0.102,P＞0.0S).治療後12箇月,治療組(t=15.653、7.634、14.871)、對照組(t=13.275、7.415、13.632)TG、TC和LDLC均較治療前有所降低,差異有統計學意義(P＜0.05);HDLC較治療前無明顯變化,差異無統計學意義(t=0.584、0.275,P＞0.05).治療組、對照組之間TG、TC、LDLC、HDLC比較,差異均無統計學意義(t=1.857、0.133、1.671、0.875,P＞0.05).治療後1、3、6、12箇月,治療組(t=7.352、15.581、27.324、28.143)及對照組(t=6.877、8.672、14.671、14.855)8-0HdG較治療前呈逐漸降低趨勢,差異有統計學意義(P＜0.05).治療後1箇月,治療組及對照組8-0HdG比較,差異無統計學意義(t=0.513,P＞0.05);治療後3、6、12箇月,治療組8-0HdG較對照組降低,差異有統計學意義(t=3.434、5.917、5.226,P＜0.05).結論 普囉佈攷治療高血脂非增生型DR可降低血脂、穩定視功能、減輕黃斑水腫.
목적 관찰보라포고치료고혈지비증생형당뇨병시망막병변(DR)적림상효과.방법 림상학진위고혈지비증생형DR적52례환자104지안납입연구.장환자수궤분위보라포고치료조(치료조)화대조조,분별위26례52지안.급여량조환자음식、운동지도적동시진행구복강당약화(혹)이도소강화치료.치료조재공제혈당、혈압기출상급여보라포고0.5g,2차/d;대조조재공제혈당、혈압기출상구복아탁벌타정10 mg,1차/d.총료정12개월.치료전급치료후1、3、6、12개월,소유환자균행시력、검안경、형광소안저혈관조영、상관혈액급뇨액검사.대비관찰치료전후량조환자시력、안저、황반수종、감유삼지(TG)、총담고순(TC)、저밀도지단백담고순(LDLC)、고밀도지단백담고순(HDLC)급8-간기탈양조감(8-0HdG)적변화정황.결과 치료후치료조、대조조시력예후총유효솔분별위44.23％、40.38％,이자비교,차이무통계학의의(Z＝-0.335,P＞0.05).치료조、대조조시망막출혈급미동맥류균교치료전감경,기안저예후총유효솔분별위65.38％、36.54％,이자비교,차이유통계학의의(Z=-2.973,P＜0.05).치료조、대조조합병황반수종분별위6、5지안,균교치료전현저감소,차이유통계학의의(x2=4.833、4.300,P＜0.05);량조합병황반수종안수비교,차이무통계학의의(x2 =0.102,P＞0.0S).치료후12개월,치료조(t=15.653、7.634、14.871)、대조조(t=13.275、7.415、13.632)TG、TC화LDLC균교치료전유소강저,차이유통계학의의(P＜0.05);HDLC교치료전무명현변화,차이무통계학의의(t=0.584、0.275,P＞0.05).치료조、대조조지간TG、TC、LDLC、HDLC비교,차이균무통계학의의(t=1.857、0.133、1.671、0.875,P＞0.05).치료후1、3、6、12개월,치료조(t=7.352、15.581、27.324、28.143)급대조조(t=6.877、8.672、14.671、14.855)8-0HdG교치료전정축점강저추세,차이유통계학의의(P＜0.05).치료후1개월,치료조급대조조8-0HdG비교,차이무통계학의의(t=0.513,P＞0.05);치료후3、6、12개월,치료조8-0HdG교대조조강저,차이유통계학의의(t=3.434、5.917、5.226,P＜0.05).결론 보라포고치료고혈지비증생형DR가강저혈지、은정시공능、감경황반수종.
Objective To observe the effectiveness of probucol for non-proliferative diabetic retinopathy (NPDR) with hyperlipidemia.Methods Fifty-two patients (104 eyes) of NPDR with hyperlipidemia were enrolled in this study.The patients were randomly divided into treatment group and control group,26 patients (52 eyes) in each group.Both groups received diet and exercise guidance,oral hypoglycemic agents and (or) intensive insulin therapy.After blood sugar and blood pressure were controlled,the treatment group received probucol 0.5 g,two times per day; and the control group received atorvastatin of 10 mg,one time per day.The total course was 12 months.Before and after one,three,six and 12 months,all patients underwent vision,ophthalmoscope,fundus fluorescein angiography,blood and urine tested.Variations of visual acuity,fundus condition,macular edema,triglyceride (TG),total cholesterol (TC),low-density lipoprotein cholesterol (LDLC),high-density lipoprotein cholesterol (HDLC) and 8-0HdG were observed before and after treatment.Results The total effective rate of visual prognosis were 44.23％ and 40.38％ in the treatment group and the control group,the difference had no statistical significacy (Z＝-0.335,P＞0.05).Retinal hemorrhages and microaneurysms alleviated after treatment in both groups.The total efficiency of fundus prognosis was 65.38％ in the treatment group and 36.54％ in the control group,and the difference was statistically significant (Z=-2.973,P＜0.05).Macular edema was in six and five eyes in the treatment group and the control group respectively,which were lower than before treatment,the difference was statisticaly significant (x2=4.833,4.300; P＜0.05).Between the two groups,the difference was not statistically significant (x2 =0.102,P＞ 0.05).Twelve months after treatment,TG,TC and LDLC were decreased in the treatment group (t=15.653,7.634,14.871) and control group (t=13.275,7.415,13.632),and the difference was statistically significant (P＜0.05).HDLC showed no significant difference than before in the two groups (t=0.584,0.275; P＞0.05).TG,TC,LDLC and HDLC showed no difference between the two groups (t＝1.857,0.133,1.671,0.875; P＞0.05).8-0HdG decreased gradually during the one,three,six and 12 months in the treatment group (t=7.352,15.581,27.324,28.143) and control group (t =6.877,8.672,14.671,14.855) after treatment,and the difference was statistically significant (P＜0.05).In the first month aftertreatment,8 0HdG showed no difference between the two groups (t=0.513,P＞0.05).In the 3,6,and 12 months after treatment,the 8 0HdG was lower in the treatment group than that in the control group,and the difference was statistically significant (t =3.434,5.917,5.226; P＜0.05).Conclusion In the treatment of NPDR with hyperlipidemia,probucol can reduce blood lipid,stable visual function and relieve macular edema.
