硫辛酸联合利拉鲁肽对糖尿病肾病合并视网膜病变患者视力的影响

Effect of lipoic acid combined with liraglutide on visual acuity in diabetic nephropathy patients with retinopathy

目的 观察硫辛酸联合利拉鲁肽对糖尿病肾病合并视网膜病变患者视力的影响。方法 选取2020年8月—2022年8月厦门弘爱医院收治的糖尿病肾病合并视网膜病变患者120例,根据随机数字表法分为观察组(n=60)和对照组(n=60)。对照组应用利拉鲁肽治疗,观察组在对照组基础上应用硫辛酸治疗,2组均治疗42 d。比较2组治疗前后氧化应激指标、中医证候积分、血糖指标,以及视网膜病变和视力改善情况。结果 治疗42 d后,2组血清丙二醛、空腹血糖、餐后2 h血糖水平及糖化血红蛋白、中医证候积分均低于治疗前,血清超氧化物歧化酶水平及总抗氧化能力高于治疗前,且观察组降低/升高幅度大于对照组(P<0.01);观察组视网膜病变改善有效率为90.00%,高于对照组的53.33%(χ^(2)=19.863,P<0.001);观察组视力提高率为85.00%,高于对照组的41.67%(χ^(2)=24.258,P<0.001)。结论 硫辛酸联合利拉鲁肽治疗糖尿病肾病合并视网膜病变临床效果确切,可改善患者氧化应激反应,减轻视网膜病变程度,提高视力。

Objective To observe the effect of lipoic acid combined with liraglutide on visual acuity in diabetic nephropathy patients with retinopathy.Methods A total of 120 patients with diabetic nephropathy complicated with retinopathy admitted to Xiamen Hongai Hospital from August 2020 to August 2022 were selected and divided into observation group(n=60) and control group(n=60) according to random number table method.The control group was treated with liraglutide,and the observation group was treated with lipoic acid on the basis of the control group.Both groups were treated for 42 days.Oxidative stress indexes,TCM syndrome score,blood glucose indexes before and after treatment,retinopathy improvement and visual acuity were compared between the two groups.Results After 42 days of treatment,serum malondialdehyde,fasting blood glucose,2 h postprandial blood glucose levels,glycated hemoglobin and TCM syndrome scores in the two groups were lower than before treatment,serum superoxide dismutase level and total antioxidant capacity were higher than before treatment,and the decrease/increase in observation group were greater than those in control group(P<0.01).The improvement rate of retinopathy in observation group was 90.00%,which was higher than 53.33% in control group(χ^(2)=19.863,P<0.001).The visual acuity improvement rate in the observation group was 85.00%,which was higher than 41.67% in the control group(χ^(2)=24.258,P<0.001).Conclusion Lipoic acid combined with liraglutide has definite clinical effect in the treatment of diabetic nephropathy complicated with retinopathy,which can improve the oxidative stress,reduce the degree of retinopathy and improve visual acuity.