早期糖尿病视网膜病变患者的临床特点及其治疗研究

Clinical features and treatment of early diabetic retinopathy

目的探讨早期糖尿病视网膜病变(DR)患者的临床特点及其治疗。方法选取福建中医药大学附属人民医院眼科门诊2015年6月—2016年6月收治的DR患者88例为DR组,采用随机双盲法分为研究A组和研究B组,各44例。研究A组患者给予常规治疗,研究B组患者在研究A组基础上口服复方丹参滴丸,两组患者均连续治疗8周。另选取同期体检健康者44例为对照组。比较DR组和对照组患者的空腹血糖(FBG)、糖化血红蛋白(Hb A1c)、超敏C反应蛋白(hs-CRP)、细胞间黏附因子1(ICAM-1)、血管内皮素1(ET-1)、内皮依赖性血管舒张功能(FMD),同时比较研究A组和研究B组相关指标。结果 DR组患者FBG、Hb A1c、hs-CRP、ICAM-1、ET-1高于对照组,FMD低于对照组(P<0.05)。治疗前,两组患者FBG、Hb A1c、hs-CRP、ICAM-1、ET-1、FMD比较,差异无统计学意义(P<0.05);治疗后,研究B组患者FBG、Hb A1c、hs-CRP、ICAM-1、ET-1低于研究A组,FMD高于研究A组(P<0.05);两组患者治疗后FBG、Hb A1c、hs-CRP、ICAM-1、ET-1低于治疗前,FMD高于治疗前(P<0.05)。结论 DR可在一定程度上升高血清炎性因子水平,损伤血管内皮细胞功能,而复方丹参滴丸治疗DR可有效改善患者血管内皮功能,抑制炎性反应,疗效确切。

Objective To investigate the clinical features and treatment of early diabetic retinopathy（ DR）. Methods A total of 88 cases of patients with DR were selected from June 2015 to June 2016 in People＇s Hospital of Affiliated to Fujian Traditional Chinese Medicine University as DR group,which were divided into study A group and study B group by random double blind method,44 cases in each group. The study A group was given conventional treatment,study B group was given compound danshen dripping pills on the basis of study A group,two groups of patients were treated for 8 weeks. 44 cases of healthy people were selected as control group. The FBG、Hb A1c、hs-CRP、ICAM-1、ET-1 and FMD were compared between the DR group and control group,and the related indicators were also compared between study A group and study B group.Results DR group of FBG,Hb A1 c,hs-CRP,ICAM-1,ET-1 were higher than control group,FMD was lower than control group（ P〈0. 05）. Before treatment,no statistically significant differences of FBG,Hb A1 c,hs-CRP,ICAM-1,ET-1 or FMD was found between the study A group and study B group（ P〈0. 05）; after treatment,B group of FBG,Hb A1 c,hs-CRP,ICAM-1,ET-1 were lower than study A group,FMD was higher than study A group（ P〈0. 05）; the two groups of FBG,Hb A1 c,hs-C RP,ICAM-1,and ET-1 were lower than prior treatment,FMD was higher than prior treatment（ P〈0. 05）. Conclusion DR can increase the level of serum inflammatory factors and damage the function of vascular endothelial cells in some extent,while the treatment of DR with compound danshen dripping pills can effectively improve the vascular endothelial function and inhibit the inflammatory response,and with a good clinical effect.