辛伐他汀对非增生期糖尿病视网膜病变患者外周血内皮祖细胞数量和视网膜病变的影响

The effect of simvastain on the number of peripheral endothelial progenitor cells and retinopathy in nonproliferative diabetic retinopathy patients

目的观察辛伐他汀对非增生期糖尿病视网膜病变(NPDR)患者外周血内皮祖细胞(EPCs)数量以及视网膜病变的影响,以评估其临床疗效。方法 NPDR患者60例(117只眼)随机分为干预组与对照组。对照组常规降糖、降压治疗,干预组在对照组基础上给予辛伐他汀20 mg/d,连续3个月。实验前后测定空腹血糖、糖化血红蛋白及外周血EPCs数量,并行最佳矫正视力、眼底照相及荧光素眼底血管造影检查。结果干预组治疗后空腹血糖、糖化血红蛋白与治疗前相比无明显差异(P>0.05)。干预组治疗后外周血EPCs数量显著高于治疗前及对照组(P<0.05)。干预组眼底病变分期进展率为3.45%,小于对照组21.05%;且干预组缓解率为12.07%,对照组无患眼缓解。干预组治疗后最佳矫正视力提高率为24.14%,对照组均无视力提高。结论辛伐他汀可以动员NPDR患者体内EPCs入血,对NPDR治疗具有一定的疗效。

Objective To evaluate the effect of simvastain on the number of endothelial progenitor cells（ EPCs）in peripheral blood and retinopathy in nonproliferative diabetic retinopathy（ NPDR） patients. Methods 60 patients（ 117 eyes） with NPDR were randomly divided into control group and observation group. The control group received the conventional medicine for diabetes and hypertension,and the observation group was given simvastain（ 20 mg/d,once daily for 3 months） on the basis of control group. Fast blood glucose,glycosylated hemoglobin,the number of peripheral EPCs,best corrected visual acuity,fundus photography and fluorescence fundus angiography were observed. Results Fast blood glucose and glycosylatedhemoglobin of patients in observation group before and after showed no significant difference（ P〈0. 05）. The number of peripheral EPCs after therapy in observation group was significantly higher than before and control group（ P〈0. 05）. The staging progress rate of diabetic retinopathy of observation group was 3. 45%,which was lower than 21. 05% of control group. Additionally,the staging progress rate of observation group was 12. 07% while none of eyes in the control group showed progress. The improvement rate of best corrected visual acuity of the observation group was24. 14%,while none of eyes in the control group showed improvement. Conclusions Simvastain can promote EPCs mobilization to the peripheral blood in patients with NPDR and has a certain therapeutic effect on NPDR.