全视网膜光凝联合复方血栓通与复方樟柳碱治疗增殖型糖尿病视网膜病变临床效果观察

The clinical effects of panretinal photocoagulation combined with compound Xueshuantong and compound anisodine in the treatment of patients with PDR

目的探讨全视网膜光凝(PRP)联合复方血栓通(FXT)与复方樟柳碱治疗对增殖型糖尿病视网膜病变(PDR患者的视力、视网膜电图(ERG)及血清视黄醇结合蛋白4(RBP4)、高敏C反应蛋白(hs-CRP)、骨形态发生蛋白2(BMP2)水平的影响。方法我院收治的80例PDR患者(94眼),按随机数字表法分为观察组(PRP+FXT+复方樟柳碱) 40例(46眼)与对照组(PRP+FXT) 40例(48眼)。观察两组ERG、眼底检查结果及视力改善情况,检测两组血清RBP4、hs-CRP、BMP2水平,统计治疗不良反应率。结果首次PRP治疗后两组EGR检查中a A、b A均显著降低;治疗2个月后,两组a A、b A水平均有所上升,且观察组高于对照组(P <0. 05);观察组出血斑、微血管瘤及视网膜渗出情况、视力改善情况优于对照组(P <0. 05);两组血清RBP4、hs-CRP及BMP2水平均下降,且观察组低于对照组(P <0. 05);两组治疗不良反应率差异无统计学意义(P>0. 05)。结论 PRP联合复方樟柳碱与FXT治疗可有效修复PRP对视网膜造成的损伤,缓解PDR患者临床症状、提高其视力,并可有效控制病情,值得临床推广。

Objective To explore the effects of panretinal photocoagulation(PRP)combined with compound Xueshuantong(FXT)and compound anisodine on ETDRS,ERG and serum levels of retinoid-binding protein 4(RBP4),high-sensitivity C-reactive protein(hs-CRP)and bone morphogenetic protein 2(BMP2)in patients with proliferative diabetic retinopathy(PDR).Methods Eighty PDR patients(94 affected eyes)admitted to our hospital were randomly divided into observation group(PRP+FXT+compound anisodine,n=40,46 affected eyes)and control group(PRP+FXT,n=40,48 affected eyes).The ERG results,fundus examination results and visual acuity improvement were observed.The levels of serum RBP4,hs-CRP and BMP2 were measured,and the rate of adverse treatment reactions was statistically analyzed.Results After the first PRP treatment,the levels of aA and bA of EGR examination in the two groups were significantly decreased(P<0.05).The levels of aA and bA were increased after 2 months of treatment(P<0.05),and the levels of aA and bA in the observation group were significantly higher than those in the control group(P<0.05).After 2 months of treatment,bleeding spots,microaneurysm,retinal exudation and visual acuity improvement in the observation group were significantly better than those in the control group(P<0.05).After 2 months of treatment,serum levels of RBP4,hs-CRP and BMP2 were significantly decreased(P<0.05),and the levels of the proteins were lower in the observation group than those in the control group(P<0.05).There was no significant difference in the rate of adverse reactions between the two groups(P>0.05).Conclusion PRP combined with FXT and compound anisodine can effectively repair the damage caused by PRP to the retina,relieve the clinical symptoms of PDR patients,improve the visual acuity,and effectively control the condition.Thus,it is worthy of clinical promotion.