前列地尔联合胰激肽原酶对早期糖尿病视网膜病变患者疗效及血清CD73与MK表达的影响

Effect of alprostadil combined with kallikrein on serum efficacy CD73 and Midkine expression in patients with early diabetic retinopathy

目的探讨前列地尔联合胰激肽原酶对早期糖尿病视网膜病变(DR)患者的疗效及对血清胞外5′-核苷酸酶(CD73)与血清中期因子(MK)表达的影响。方法选取2016年3月至2019年3月该院收治的168例早期DR患者,并按照随机数字表法将其分为对照组和观察组,每组84例。两组患者均使用胰激肽原酶治疗,观察组在对照组基础上加用前列地尔注射液治疗,对比两组的临床疗效,以及两组患者治疗前及治疗后的血液流变学、氧化应激指标、炎性因子、血清CD73和MK的变化。结果观察组的总有效率为95.2%,显效率为70.2%,而对照组的总有效率为82.1%,显效率为52.4%,观察组的总有效率、显效率高于对照组,差异有统计学意义(P<0.05)。观察组的血液流变学指标、氧化应激指标、炎性因子的改善情况均显著优于对照组(P<0.05)。两组治疗后的血清CD73和MK水平均低于治疗前(P<0.05),且观察组治疗后血清CD73和MK水平降低幅度较对照组更明显(P<0.05)。结论前列地尔联合胰激肽原酶治疗能提高早期DR的临床疗效,改善血液流变学、缓解机体氧化反应和降低炎症因子水平,同时血清CD73和MK水平与DR疾病进展情况有一定相关性,可用于评估疗效情况。

Objective To investigate the effect of alprostadil combined with pancreatic kininogenase on early diabetic retinopathy(DR)and the expression of extracellular 5′-nucleotidase(CD73)and serum midkine(MK).Methods A total of 168 patients with early DR admitted to this hospital from March 2016 to March 2019 were enrolled in the control group and the observation group according to the random number table method,with 84 cases in each group.Both groups were treated with pancreatic kallidinogenase.The observation group was treated with alprostadil injection on the basis of the control group.The clinical efficacy of the two groups was compared,as well as the changes of hemorheology,oxidative stress indicators,inflammatory factors,serum CD73 and MK of the two groups before and after treatment.Results The total effective rate of the observation group was 95.2%and the marked rate was 70.2%,while the total effective rate of the control group was 82.1%,and the marked rate was 52.4%.The total effective rate and the marked rate of the observation group were higher than those of the control group,the differences were statistically significant(P<0.05).The improvement of hemorheology indexes,oxidative stress indexes,and inflammatory factors in the observation group were significantly better than those in the control group(P<0.05).The expression levels of serum CD73 and MK levels in the two groups were lower than those before treatment(P<0.05),and the serum CD73 and MK levels in the observation group were significantly lower than those in the control group(P<0.05).Conclusion Alprostadil combined with pancreatic kininogenase can improve the clinical effect of early DR,improve hemorheology,alleviate body oxidation and reduce the levels of inflammatory factors.At the same time,the serum CD73 and MK levels are related to the progression of DR disease.which can be used to evaluate the efficacy.