羟苯磺酸钙胶囊对老年糖尿病视网膜病变患者血小板功能的影响

Effects of calcium dobesilate capsules on platelet function of elderly patients with diabetic retinopathy

目的 探讨羟苯磺酸钙胶囊对老年糖尿病视网膜病变（diabetic retinopathy,DR）患者血小板功能的影响,以寻求有效的防治药物.方法 选择的80例（155只眼）老年DR患者,随机分为两组：试验组和对照组,每组40例.两组患者均以糖尿病饮食治疗为基础,对照组患者仅接受基础治疗,试验组患者在接受基础治疗的同时加口服羟苯磺酸钙胶囊,0.5 g/次,3次/d.两组均治疗6m.通过检测视力和眼底变化来观察临床效果;通过检测血小板最大聚集率（MAR）、血小板颗粒膜蛋白-140（GMP-140）和血小板电泳率（PER）,观察血小板功能的变化情况.结果 （1）试验组的显效率、好转率和总有效率均明显高于对照组,差异有统计学意义（均P＜0.01）;（2）治疗6m后试验组和对照组患者的MAR、GMP-140均比治疗前明显降低（P＜0.05、P＜0.01）,且试验组比对照组下降更显著（均P＜0.01）;试验组和对照组患者的PER均比试验治疗前显著升高（P＜0.05、P＜0.01）,试验组比对照组升高更明显（P＜0.01）.结论 羟苯磺酸钙胶囊能抑制血小板的活化,抑制血小板聚集及其黏附于血管内皮的过程,抑制视网膜病变微血栓的形成,从而改善老年糖尿病视网膜病变患者血小板的功能,取得较好的临床疗效.

Objective To investigate the effects of calcium dobesilate capsules on platelet function of elderly patients with diabetic retinopathy （DR） in order to seek effective drugs for treatment and prevention of DR. Methods 80 cases （155 eyes） of elderly DR patients were randomly divided into two groups： experimental group and control group, 40 cases each group. Two groups of patients underwent diabetic diet based therapy. The patients in the control group were only received basic treatment, but the patients in experimental group were received basic therapy and oral calcium dobesilate capsules （0.5 g/time, 3 times / d） for 6 months. Through detecting the vision and fundus changes to observe clinical effect. The maximum platelet aggregation rate （MAR）, platelet granule membrane protein -140 （GMP-140） and platelet electrophoresis rate （PER） were used to detect the changes in platelet function. Results （1） Compared with the control group, the efficiency, improvement rate and total effective rate were significantly increased （P〈0.01）. （2） Compared with pre-treatment, the levels of MAR and GMP-140 of the experimental group and control group after treatment for 6 months were significantly decreased, respectively （P〈 0.05, P〈 0.01） , whereas the decline of the experimental group was higher than the control group （P〈0.01）. Meanwhile, the levels of PER of the experimental group and control group after treatment for 6 months were significantly increased, respectively （P〈0.05, P〈0.01） , but the rise of the experimental group was higher than the control group （P 〈 0.01）. Conclusions Calcium dobesilate capsules can inhibit platelet activation, platelet aggregation and the process of platelet adhesion to vascular endothelial, and the formation of retinal lesions micro thrombosis, which may improve platelet function of elderly patients with DR, and get good clinical curative effect.