非诺贝特治疗中心性浆液性脉络膜视网膜病变的临床研究

Fenofibrate for central serous chorioretinopathy

目的观察非诺贝特治疗中心性浆液性脉络膜视网膜病变的(central serous chorioretinopathy,CSC)临床疗效。方法 72例(72眼)CSC患者随机分为两组,对照组(36例36眼)口服安慰剂维生素C片0.1 g,每日3次,试验组36例(36眼)口服非诺贝特胶囊0.2 g,每日3次,饭前0.5 h口服,连续用28 d,比较观察患者治疗前后视力、眼底镜检查、眼底荧光血管造影检查及光学相干断层扫描的变化。结果两组患者一般情况比较差异均无统计学意义(均为P>0.05);治疗28 d后,两组药物对甘油三酯、低密度脂蛋白影响的比较差异均有统计学意义(均为P<0.05);视力提高或无变化53眼,其中对照组21眼(39.6%),试验组32眼(60.4%),两组视力与治疗前比较差异有统计学意义(χ2=8.651,P<0.05)。对照组治愈率为16.7%,总有效率58.3%;试验组治愈率66.7%,总有效率88.9%;两组总有效率比较差异有统计学意义(χ2=24.669,P<0.05)。治疗后2周和4周,试验组视网膜脱离面积减小为(123 221±86 431)μm2、(43 246±34 321)μm2,减小幅度大于对照组(213 241±102 548)μm2、(1521 245±87 326)μm2,差异均有统计学意义意义(均为P<0.05),两组均无不良反应发生。结论非诺贝特可提高CSC患者视力,有效改善CSC症状,缩短治疗时间。

Objective To observe the clinical effects of fenofl- brate for central serous chorioretinopathy （CSC）, Methods Seven- two patients （72 eyes ）with CSC were random divided into two groups： control group （36 eyes were given placebo vitamin C, 0.1 g, once per day） and treating group （36 eyes were given fenoflbrate, 0.5 g, once per day）. The vitamin C and fenofibrate were taken be- fore meals haft an hour for 28 days, the change of visual acuity, fun- duscope, fundus fluorescence angiography （FFA） and optical coher- ence tomography （OCT） were observed. Results There was no significant difference in general information between two groups （all P 〉 0.05）. After treatment for 28 days, there were significant differ- ences in triglycerides and low-density lipoprotein between two groups （ all P 〈 0.05 ） ; The visual acuity of 53 eyes were increased or un- changed, including 21 eyes （39. 6% ） in control group, 32 eyes （60.4%） in treating group, there was statistical difference compared with pre-operation （χ2 = 8. 651, P 〈 0.05 ）. After treatment, the cure rate of control group was 16.7 % , total effective rate was 58.3% , while the cure rate of treating group was 66.7 % , total effective rate was 88.9 % , there was statistical difference in total effective rate be- tween two groups （χ2 = 24. 659, P 〈 0.05 ）. At 2 weeks and 4 weeks after treatment, the area of retinal detachment in treating group de- creased significantly to （123 221 ± 86 431 ）μm2 and （43 246 ± 34 321 ）μm2, which in control group decreased to （213 241 ± 102 548） μm2 and （1521 245 ±87 326）μm2, the decreased area in treating group was more than that in control group, there were statistical differences （ all P 〈 0. 05 ）. No obvious adverse reactions occurred in both two groups. Conclusion Fenofibrate can shorten the therapy time, improve the vision and symptoms of patients with CSC.