复方血栓通联合羟苯黄酸钙治疗非增殖期糖尿病视网膜病变对HIF-1α和SDF-1水平的影响

Effects of compound Xueshuantong combined with calcium dobesilate on the levels of HIF-1 and SDF-1 in patients with non-proliferative diabetic retinopathy

目的观察复方血栓通联合羟苯黄酸钙治疗非增殖期糖尿病视网膜病变(NPDR)的疗效及其对血清低氧诱导因子-1α(HIF-1α)和基质细胞衍生因子1(SDF-1)水平的影响。方法选择2015年1月至2016年12月就诊的NPDR患者90例,按照随机数字法将患者分为观察组和对照组,每组45例。对照组予以羟苯黄酸钙治疗,观察组在对照组的基础上予以复方血栓通治疗。比较2组治疗后的疗效,治疗前后眼动脉(OA)和视网膜中央动脉(CRA)血流动力学指标,HIF-1α、SDF-1α和SDF-1β水平的变化。结果治疗后观察组的总有效率为97.78%明显高于对照组的80.00%(χ~2=5.513,P<0.05)。2组治疗前OA和CRA的PSV,EDV和RI水平,差异无统计学意义(P>0.05),治疗后2组的PSV和EDV水平较治疗前明显升高(P<0.01),RI较治疗前明显降低(P<0.01),而观察组的升高或者降低水平更为明显(P<0.01)。2组治疗前HIF-1α、SDF-1α和SDF-1β水平差异无统计学意义(P>0.05),治疗后2组的HIF-1α、SDF-1α和SDF-1β水平较治疗前明显降低(P<0.01),而观察组的降低水平较对照组更为明显(P<0.01)。结论复方血栓通联合羟苯黄酸钙治疗NPDR疗效显著,与复方血栓通能够提高视网膜血管的血流有关,其机理可能与下调HIF-1α、SDF-1α和SDF-1β水平有关。

Objective To observe the effects of compound Xueshuantong combined with calcium dobesilate on he levels of serum hypoxia-inducible factor-1α（ HIF-1α） and stromal cell-derived factor 1（ SDF-1） in patients with non-proliferative diabetic retinopathy（ NPDR）. Methods Ninety patients with NPDR who were treated in our hospital from January 2015 to December 2016 were divided into observation group（ n = 45） and control group（ n = 45） according to random number table. The patients in control group were treated by calcium dobesilate,however,the patients in obervation group,on the basis of control group,were treated by compound Xueshuantong. The therapeutic effects,the hemodynamic parameters including ophthalmic artery（ OA） and central retinal artery（ CRA）,the levels HIF-1α,SDF-1α and SDF-1β before and after treatment were observed and compared between the two groups. Results The total effective rate in observation group was97. 78%. which was significantly higher than that（ 80. 00%） in control group（ χ2= 5. 513,P〈 0. 05）. There were no significant differences in the levels of PSV,EDV and RI of OA and CRA before treatment between two groups（ P〈 0. 05）,however,after treatment the levels of PSV and EDV were significantly increased in both groups（ P〈 0. 01）,but the levels of RI were significantly decreased（ P〈 0. 01）,moreover,the increase or decrease extent in observation group was more obvious than that in control group（ P〈 0. 01）. Before treatment,there were no significant differences in the levels of HIF-1α,SDF-1αand SDF-1βbetween two groups（ P〈 0. 05）,however,after treatment,the levels of these indexes were significantly decreased in both groups（ P〈 0. 01）,moreover,the decrease extent in observation group was more obvious than that in control group（ P〈 0. 01）. Conclusion The compound Xueshuantong combined with calcium dobesilate can obtain obvious therapeutic effects on NPDR,and its action mechanism may be correlated with increase of blood flow of retinal vessels and with the dow-regulation of the levels of HIF-1α,SDF-1αand SDF-1β.