艾塞那肽联合川芎嗪治疗糖尿病视网膜病变临床观察

Clinical Observation of Exenatide Combined with Ligustrazine in Treatment of Diabetic Retinopathy

目的观察艾塞那肽联合川芎嗪对糖尿病视网膜病变(DR)患者球后动脉血流动力学变化情况及临床疗效。方法选择2014年2月—2015年8月收治的DR 80例,按治疗方法分为观察组和对照组,每组40例。两组均给予艾塞那肽+二甲双胍+羟苯磺酸钙胶囊,观察组在此基础上给予磷酸川芎嗪片,治疗30 d。观察两组空腹血糖(FPG)、餐后2 h血糖(2 h PBG)及视网膜中央动脉(CRA)、睫状后动脉(PCA)、眼动脉(OA)收缩期最高血流速度(PSV)、舒张末期最低血流速度(EDV)、阻力指数(RI)的变化情况,记录治疗过程中的不良反应并评估临床疗效。结果两组治疗后Hb A1c、FPG、2 h PBG均较治疗前降低(P<0.05),但两组间比较差异无统计学意义(P>0.05)。治疗后两组CRA、PCA、OA PSV及EDV均高于治疗前,RI低于治疗前(P<0.01);治疗后观察组CRA、PCA、OA PSV及EDV均高于对照组,RI低于对照组(P<0.05)。观察组临床疗效优于对照组(P<0.05)。两组均未发生严重不良反应,且发生率比较差异无统计学意义(P>0.05)。结论艾塞那肽联合川芎嗪治疗DR能有效改善球后动脉血流,提高临床疗效,安全性高。

Objective To observe clinical effect of Exenatide combined with Ligustrazine on changes of retrobulbar dynamics of arterial flow in patients with diabetic retinopathy（ DR）. Methods A total of 80 DR patients admitted during February 2014 and Augest 2015 were divided into observation group（ n = 40） and control group（ n = 40） according to therapic methods. All patients were treated with Exenatide ＋ Metformin ＋ Calcium Dobesilate Capsules,and observation group was added Ligustrazine on the basis of treatment,and all patients were treated for 30 d. Changes of fasting plasma glucose（ FBG）,2 h postprandial blood glucose（ 2 hPBG）,central retinal artery（ CRA）,posterior ciliary artery（ PCA）,end diastolic velocity（ EDV） and peak systolic velocity（ PSV） of arteria ophthalmica（ AO） and resistivity index（ RI） were observed,and adverse events（ AEs） during treatment were recorded,and clinical effects were evaluated between the two groups. Results After treatment,levels of glycated hemoglobin（ Hb A1c）,FPG and 2 hPBG were decreased compared with those before treatment in both groups（ P〈0. 05）,but the differences in the levels were not statistically significant between the two groups（ P〉0. 05）; levels of CRA,PCA,PSV and EDV of AO were increased,while RI level was decreased compared with those before treatment between the two groups（ P〈 0. 01）. After treatment,levels of CRA,PCA,PSV and EDV of AO were higher,while RI level was lower in observation group than those in control group（ P〈0. 05）. Clinical effect in observation group was better than that in control group（ P〈0. 05）. There was no severe adverse reaction,and the difference in incidence rate was not statistically significant between the two groups（ P〉0. 05）. Conclusion Exenatide combined with Ligustrazine in treatment of diabetic retinopathy can effectively improve retrobulbar dynamics of arterial flow and clinical effect with safe.