两种不同的治疗方案对早期糖尿病视网膜病变患者眼底微血管及血液流变学的影响

Effects of two Different Treatment Regimens on Fundus Microvessels and Hemorheology in Patients with Early Diabetic Retinopathy

目的:比较不同的治疗方案对早期糖尿病视网膜病变患者的眼底微血管及血液流变学指标的影响。方法:选取2021年1-10月上海交通大学医学院附属瑞金医院收治的152例糖尿病视网膜病变患者,按随机数字表法将其分为常规组(n=76,口服羟苯磺酸钙)与试验组(n=76,口服羟苯磺酸钙+复方血栓通胶囊)。比较两组临床疗效、眼底微血管检查指标、血液流变学相关指标及不良反应发生情况。结果:试验组治疗总有效率为93.42%高于常规组的76.32%(P<0.05)。治疗后,试验组视力(0.56±0.03)、黄斑厚度(303.29±4.40)μm、出血斑面积(1.83±0.08)mm^(2)、血管瘤体积(8.97±1.25)μm^(3)均优于对照组(0.41±0.07)、(0.41±0.07)μm、(2.10±0.15)mm^(2)、(11.53±1.06)μm^(3)(P<0.05)。治疗后,试验组血浆黏度(1.78±0.25)mPa·s、全血高切黏度(4.42±0.31)mPa·s、全血低切黏度(9.11±0.67)mPa·s、纤维蛋白原(2.18±0.31)g/L均优于对照组(2.63±0.28)、(5.93±0.24)、(10.57±0.59)mPa·s、纤维蛋白原(3.25±0.47)g/L(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:羟苯磺酸钙与复方血栓通胶囊联用治疗糖尿病所致早期视网膜病变效果优于单纯口服羟苯磺酸钙,可有效改善患者眼底微血管状态,调整患者的血液流变学指标,且不增加不良反应,具有较高的推广价值。

Objective:To compare the effects of different treatment methods on the fundus microvessels and hemorheological indexes in patients with early diabetic retinopathy.Method:A total of 152 patients with diabetic retinopathy who were admitted to Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine from January 2021 to October 2021 were selected.They were divided into conventional group(n=76,oral Calcium Dobesilate)and experimental group(n=76,oral Calcium Dobesilate+Fufang Xueshuantong Capsules)according to random number table method.The clinical efficacy,fundus microvascular examination indicators,hemorheological indicators and the incidence of adverse reactions were compared between the two groups.Result:The total effective rate in experimental group was 93.42%,which was higher than 76.32% in conventional group(P<0.05).After treatment,visual acuity(0.56±0.03),macular thickness(303.29±4.40)μm,bleeding macular area(1.83±0.08)mm^(2),hemangioma volume(8.97±1.25)μm^(3) in experimental group were better than those in control group(0.41±0.07),(0.41±0.07)μm,(2.10±0.15)mm^(2),(11.53±1.06)μm^(3)(P<0.05).After treatment,plasma viscosity(1.78±0.25)mPa·s,whole blood high shear viscosity(4.42±0.31)mPa·s,whole blood low shear viscosity(9.11±0.67)mPa·s,fibrinogen(2.18±0.31)g/L in experimental group were better than those in control group(2.63±0.28),(5.93±0.24),(10.57±0.59)mPa·s,fibrinogen(3.25±0.47)g/L(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:The effect of Calcium Dobesilate combined with Fufang Xueshuantong Capsules in the treatment of early diabetic retinopathy is better than that of oral Calcium Dobesilate,which can effectively improve the state of fundus microvessels and adjust the hemorheological indicators of patients,without increasing the adverse reactions,and has high promotion value.