益气化瘀、平肝滋肾方对高血压视网膜病变患者心肾损伤的修复作用及对循环活化血小板、动静脉管径比例改变和血清LMP-10、TXA2的影响

Repair Effects of Yiqi Huayu and Pinggan Zishen Decoction on Heart and Kidney Injury in Patients with Hypertensive Retinopathy and Its Influence on Circulating Activated Platelets,Arteriovenous Diameter Ratio,Serum LMP-10 and TXA2

目的:观察益气化瘀、平肝滋肾方对高血压视网膜病变患者心肾损伤的修复作用及对循环活化血小板、动静脉管径比例改变和血清低分子量多肽(LMP)10、血浆血栓素A2(TXA2)的影响。方法:选取2018年6月至2021年6月于唐山市爱尔眼科医院眼科、唐山市中医医院心内科及肾病科就诊的高血压视网膜病变患者260例,采用随机数字表法分为研究组和对照组。研究组130例患者采用益气化瘀、平肝滋肾方联合常规西医治疗,对照组130例患者采用常规西医治疗。治疗前后检测两组患者免疫蛋白酶体亚基LMP-10、TXA2、N-乙酰-β-D-氨基葡萄糖苷酶(NAG)、血小板α-颗粒膜糖蛋白(CD62P)、胱抑素C(Cys-C)、纤维蛋白原受体(FIB-R)、脑钠肽(BNP)、左心室射血分数(LVEF)、臂踝脉搏波传导速度(baPWV)、视网膜静脉充盈时间(VFT)和视网膜毛细血管交换时间(CET)等指标水平,检测两组患者视网膜静脉血管直径、动脉血管直径,并计算其比例,测量两组患者舒张压、最佳矫正视力(BCVA)和收缩压,比较两组患者的临床疗效。结果:治疗后,研究组患者的TXA2、FIB-R、CD62P和LMP-10水平低于对照组,Cys-C、NAG和BNP水平低于对照组,LVEF水平高于对照组,VFT、CET和baPWV水平低于对照组,视网膜动静脉血管直径、动静脉管径比例高于对照组,血压较对照组低,BCVA水平较对照组高,差异均有统计学意义(P<0.05)。研究组患者的总有效率为95.38%(124/130),高于对照组的86.92%(113/130),差异有统计学意义(P<0.05)。结论:益气化瘀、平肝滋肾方治疗高血压视网膜病变,可改善患者TXA2、FIB-R、CD62P和LMP-10水平,改善血流状态,调节视网膜病变、血压,促进心肾损伤修复,提高动静脉管径比例、视力和临床疗效。

OBJECTIVE:To observe the repair effects of Yiqi Huayu and Pinggan Zishen decoction on heart and kidney injury in patients with hypertensive retinopathy and its influence on circulating activated platelets,arteriovenous diameter ratio,serum serum low molecular weight polypeptide(LMP)10 and plasma thromboxane A2(TXA2).METHODS:A total of 260 patients with hypertensive retinopathy in the department of ophthalmology of Tangshan Aier Eye Hospital and department of cardiology and nephrology of Tangshan Hospital of Traditional Chinese Medicine from Jun.2018 to Jun.2021 were extracted to be divided into the research group and control group via the random number table method.Totally 130 cases in the research group were treated with Yiqi Huayu and Pinggan Zishen decoction combined with conventional western medicine,and 130 cases in the control group was given conventional western medicine.Before and after treatment,the immunoproteasome subunit LMP-10 and TXA2,N-acetyl-β-D-glucosaminidase(NAG),plateletα-granule membrane glycoprotein(CD62P),cystatin C(Cys-C),fibrinogen receptor(FIB-R),brain natriuretic peptide(BNP),left ventricular ejection fraction(LVEF),brachial-ankle pulse wave velocity(baPWV),retinal vein filling time(VFT),retinal capillary exchange time(CET)levels of two groups were detected.Blood vessel diameter and arterial blood vessel diameter were detected,and the proportions were calculated.Diastolic blood pressure,best corrected visual acuity(BCVA),and systolic blood pressure were measured in two groups,and the clinical efficacy of two groups were compared.RESULTS:After treatment,the levels of TXA2,FIB-R,CD62P and LMP-10 in the research group were lower than those in the control group,the levels of Cys-C,NAG and BNP in the research group were lower than those in the control group,and the level of LVEF in the research group was higher than that in the control group,the levels of VFT,CET and baPWV in the research group were lower than those in the control group,the retinal artery and vein diameter and arteriovenous diameter ratio ratio of artery and vein diameter were higher than those in the control group,the blood pressure was lower than that in the control group,the level of BCVA was higher than that in the control group,with statistically significant differences(P<0.05).The total effective rate of the research group was 95.38%(124/130),higher than 86.92%(113/130)of the control group,the difference was statistically significant(P<0.05).CONCLUSIONS:Yiqi Huayu and Pinggan Zishen decoction in the treatment of hypertensive retinopathy can improve the levels of TXA2,FIB-R,CD62P,LMP-10,improve blood flow,regulate retinopathy,blood pressure,and promote the repair of heart and kidney injury,and improve retinal artery and vein diameter and ratio of artery and vein diameter,visual acuity and clinical efficacy.