胰岛素强化治疗联合己酮可可碱对2型糖尿病视网膜病变患者的疗效观察

Therapeutic effect of intensive insulin therapy combined with pentoxifylline on patients with type 2 diabetic retinopathy

目的观察胰岛素强化治疗联合己酮可可碱对2型糖尿病视网膜病变患者的临床疗效。方法将50例2型糖尿病视网膜病变患者随机分为对照组和治疗组,每组25例。2组均给予常规饮食控制及运动疗法,并予以胰岛素强化治疗,血糖控制达标后开始本试验。治疗组在此基础上加用己酮可可碱缓释片。2个月后观察患者临床疗效及对血小板参数的影响。结果 2组用药后PLT、MPV、PDW、PCT均低于治疗前,差异有统计学意义(P<0.05)。治疗组治疗后PLT、MPV、PDW、PCT水平均低于低于对照组,且治疗前后差值均低于对照组,差异均有统计学意义(P<0.05)。2组治疗前眼底分期比较,差异无统计学意义(P>0.05)。治疗组治疗后Ⅰ期患者数量多于对照组,Ⅲ期少于对照组,差异均有统计学意义(P<0.05)。治疗组治疗后Ⅱ期患者数量少于对照组,但差异无统计学意义(P>0.05)。2组治疗前眼底表现差异无统计学意义(P>0.05)。治疗组治疗后无微血管瘤、出血、渗出患者发生率高于治疗前,且高于对照组治疗后,差异均有统计学意义(P<0.05)。治疗组显效率、总有效率显著高于对照组,差异有统计学意义(P<0.05)。结论胰岛素强化治疗联合己酮可可碱对2型糖尿病视网膜病变患者临床症状有明显改善作用,且能够显著降低血小板参数水平,对防治2型糖尿病视网膜病变的发生发展具有重要意义。

Objective To observe the clinical efficacy of intensive insulin therapy combined with pentoxifylline in patients with type 2 diabetic retinopathy(DR).Methods Fifty patients with type 2 DR were randomly divided into control group and treatment group, with 25 cases in each group. Patients in both groups were given routine diet control and exercise therapy supplemented with intensive insulin therapy. The blood glucose control was up to standard before this test was initiated. The treatment group was supplemented with pentoxifylline sustained-release tablets. After 2-month treatment,the clinical efficacy and their influence on platelet parameters were observed and compared between the two groups.Results After treatment the levels of PLT, MPV, PDW and PCT in both groups were significantly lower than those before treatment(P<0.05),moreover,which in treatment group were significantly lower than those in control group(P<0.05). Before treatment there was no significant difference in fundus staging between the two groups(P>0.05). After treatment the numbers of patients in stage Ⅰ in treatment group were significantly more than those in control group, however, the numbers of patients in stage Ⅲ in treatment group were significantly less than those in control group(P<0.05). The numbers of patients in stage Ⅱ in treatment group were lower than those in control group, but the difference was not statistically significant(P>0.05).Before treatment there were no significant differences in fundus manifestations between the two groups(P>0.05). After treatment, the proportion of patients without microangioma, hemorrhage and exudation in treatment group was significantly higher than that before treatment and that in control group after treatment(P<0.05). Moreover the effective rate and total effective rate in treatment group were significantly higher than those in control group(P<0.05).Conclusion Intensive insulin therapy combined with pentoxifylline can significantly improve the clinical symptoms of patients with type 2 DR, and can significantly reduce the level of platelet parameters, which is of great significance for the prevention and treatment of type 2 DR.