Application of Lutein and Zeaxanthin in nonproliferative diabetic retinopathy

AIM: To compare serum Lutein and Zeaxanthin (L/Z) concentrations between patients with nonproliferative diabetic retinopathy (NDR) and normal subjects,and to explore the effect of L/Z supplementation on serum L/Z level and visual function in NDR patients METHODS: Subjects were divided into three groups: 30 NDR patients supplied with Lutein 6mg/d and Zeaxanthin 0.5mg/d for three months (DR Group),30 NDR patients without L/Z supplementation (DR Control Group) and 30 normal subjects (Control Group).Serum L/Z concentrations were measured by liquid high-resolution chromatography (HPLC).Visual acuity was recorded at baseline,1 month,2 months and 3 months post initial supplementation.Serum L/Z concentration were measured at baseline,1 month and 2 months post initial supplementation.Contrast sensitivity (CS) and fovea thickness were recorded at baseline and 3 months post initial supplementation.RESULTS: Mean serum lutein concentrations in DR group were 0.0686±0.0296μg/mL and zeaxanthin concentration was 0.0137±0.0059μg/mL.The L/Z level of DR group was significantly lower compared to the control group( lutein: 0.2302±0.1308μg/mL,zeaxanthin: 0.0456±0.0266μg/m,P = 0.000).The concentration of lutein and zeaxanthin in the DR control group at base line was 0.0714±0.0357μg/mL and 0.0119±0.0072μg/mL,respectively.There was no significant change of L/Z concentration in the DR control group during the study.Serum L/Z concentrations of DR group increased significantly after supplementation(F=109.124,P=0.000;F=219.207,P=0.000).Visual acuity improved significantly after medication.Compared with pre-medication,the average CS values of 1.5cpd,3cpd and 6cpd after three months increased significantly (P =0.030,0.013,0.008) and the foveal thickness decreased.(P =0.05) CONCLUSION: Serum L/Z concentrations in DR patients are significantly lower than those in normal subjects,and L/Z intake can improve the visual acuity,CS and macular edema in DR patients,suggesting that L/Z supplementation might be targeted as potential potential therapeutic agents in treating NDR.

Efficacy of intravitreal conbercept combined with panretinal photocoagulation for severe nonproliferative diabetic retinopathy without macular edema

AIM: To assess efficacy of intravitreal conbercept(IVC) injection in combination with panretinal photocoagulation(PRP) vs PRP alone in patients with severe nonproliferative diabetic retinopathy(SNPDR) without macular edema(ME).METHODS: Forty-eight patients with SNPDR without ME(56 eyes) were divided into the PRP group and IVC+PRP group(the pulse group) in this retrospective clinical study. Conbercept was intravitreally administered to patients in the pulse group 1 wk before treatment with PRP and followed up for 1, 3, and 6 mo. The best-corrected visual acuity(BCVA, log MAR), center foveal thickness(CFT), visual acuity(VA) improvement, and adverse reactions were compared between groups.RESULTS: In the PRP group, the BCVA reduced at 1 and 3 mo before improving at 6 mo. In the pulse group, baseline BCVA decreased continuously at 1 mo, increased at 3 and 6 mo. BCVA in the pulse group was better than that in the PRP group at 1, 3, and 6 mo. There was an increase in CFT in the PRP group during follow-up compared with baseline. In the pulse group, CFT was increased at 1 mo relative to baseline, steadily decreased to the baseline level at 3 and 6 mo. There was a more significant reduction in CFT in the pulse group during follow-up compared with the PRP group. The effective rates of VA in the PRP and the pulse groups were 81.48% and 100%, respectively. CONCLUSION: As PRP pretreatment, a single dose of IVC administration has beneficial effects for preventing PRPinduced foveal thickening and increasing VA in patients with SNPDR without ME.

Meta analysis and data mining of the method of yishenhuoxue in the treatment of nonproliferative diabetic retinopathy

Objective:To evaluate the efficacy and safety of the method of Yishen Huoxue in the intervention of nonproliferative diabetic retinopathy(NPDR)by Meta analysis and explore the medication regularity of Chinese Medicine(TCM)based on data mining.Methods:The related literature of TCM in the treatment of NPDR published in CNKI,VIP,WF,PubMed,the Cochrane Library,SinoMed,Embase were collected.The quality of the included literature was evaluated with reference to the Cochrane System Evaluators'Handbook,and statistical analysis was performed by applying Revman 5.4.1 software.After normalization of the Chinese medicine names,association rule analysis was performed by using SPSS Modeler 18,and then Cytoscape was used to produce complex network diagrams.Results:20 RCTs were included.Meta-analysis results showed that the method of Yishen Huoxue or Yishen Huoxue combined with western medicine were better than the control group in improving the total clinical efficiency[RR=1.21,95%CI(1.16,1.27),P<0.00001],TCM symptom efficacy[RR=1.28,95%CI(1.18,1.39),P<0.00001],and visual acuity[MD=0.11,95%CI(0.05,0.17),P=0.0001],HDL-C[MD=0.14,95%CI(0.03,0.25),P=0.02];reducing the number of fundus hemangiomas[MD=-3.51,95%CI(-5.73,-1.28),P=0.002],hemorrhagic spot area[MD=-0.70,95%CI(-0.95,-0.46),P<0.00001],CMT[MD=-35.31,95%CI(-55.47,-15.14),P=0.0006],FBG[MD=-0.39,95%CI(-0.72,-0.05),P=0.02],LDL-C[MD=-0.36,95%CI(-0.64,-0.08),P=0.01],whole high blood viscosity[MD=-0.43,95%CI(-0.75,-0.12),P=0.006],plasma viscosity[MD=-0.36,95%CI(-0.67,-0.06),P=0.02]and fibrinogen[MD=-0.50,95%CI(-0.81,-0.19),P=0.002].The differences were statistically significant.The 20 recipes entered involved a total of 70 herbal medicines.It is analyzed that the high-frequency drugs and the core drugsare gou qi,san qi,dan shen,haung qi,sheng di huang,et al.The association rule analysis summarizes the commonly used pairs including:sheng di huang-san qi,sheng di huang-gou qi,et al.Conclusions:Compared with western medicine treatment alone,the method of Yishen Huoxue or Yishen Huoxue combined with western medicine produce better effects,but it still needs to be verified by higher quality clinical studies.

Prevalence of diabetic retinopathy, proliferative diabetic retinopathy and non-proliferative diabetic retinopathy in Asian T2DM patients: a systematic review and Metaanalysis

AIM: To investigate the pooled prevalence of diabetic retinopathy(DR), proliferative DR(PDR) and nonproliferative DR(NPDR) in Asian type 2 diabetes mellitus(T2 DM) patients. METHODS: We performed a systematic search online search using PubMed, EMBASE, Web of Science, the Cochrane Library, and China WeiPu Library to identify eligible studies that reported the prevalence of DR, PDR and NPDR in Asian T2 DM patients. Effect size(ES) with 95% confidence interval(CI) was used to evaluate the prevalence of DR, PDR and NPDR in Asian T2 DM patients, respectively. RESULTS: There were 41 references and 48 995 T2 DM patients involved in this study. The prevalence of DR, PDR, and NPDR was 28%, 6%, and 27% in T2 DM patients, respectively; while the prevalence of PDR and NPDR in DR patients was 17% and 83%, respectively. Subgroup analysis showed that prevalence of DR in T2 DM patients from Singaporean, Indian, South Korean, Malaysian, Asian, and Chinese was 33%, 42%, 16%, 35%, 21% and 25%, respectively. In T2 DM patients with NPDR from Indian, South Korean, Malaysian, Asian, Chinese, higher prevalence was found than that in PDR patients(45% vs 17%, 13% vs 3%, 30% vs 5%, 23% vs 2% and 22% vs 3%), as well as in DR patients(74% vs 26%, 81% vs 19%, 86% vs 14%, 92% vs 8% and 85% vs 15%). The prevalence of PDR in T2 DM from India was higher than patients fromother locations of Asia, and the same results were also observed in NPDR patients. CONCLUSION: In either T2 DM Asian patients or DR patients, NPDR is more common than PDR. Based on our results, we should pay more attention to NPDR screening and management in T2 DM patients, and we also recommend suitable interventions to prevent its progression.

Review of the management of sight-threatening diabetic retinopathy during pregnancy

Diabetes mellitus(DM)is a noncommunicable disease reaching epidemic proportions around the world.It affects younger individuals,including women of childbearing age.Diabetes can cause diabetic retinopathy(DR),which is potentially sight threatening when severe nonproliferative DR(NPDR),proliferative DR(PDR),or sight-threatening diabetic macular oedema(STDME)develops.Pregnancy is an independent risk factor for the progression of DR.Baseline DR at the onset of pregnancy is an important indicator of progression,with up to 10% of women with baseline NPDR progressing to PDR.Progression to sight-threatening DR(STDR)during pregnancy causes distress to the patient and often necessitates ocular treatment,which may have a systemic effect.Management includes prepregnancy counselling and,when possible,conventional treatment prior to pregnancy.During pregnancy,closer follow-up is required for those with a long duration of DM,poor baseline control of blood sugar and blood pressure,and worse DR,as these are risk factors for progression to STDR.Conventional treatment with anti-vascular endothelial growth factor agents for STDME can potentially lead to foetal loss.Treatment with laser photocoagulation may be preferred,and surgery under general anaesthesia should be avoided.This review provides a management plan for STDR from the perspective of practising ophthalmologists.A review of strategies for maintaining the eyesight of diabetic women with STDR with emphasis on prepregnancy counselling and planning,monitoring and safe treatment during pregnancy,and management of complications is presented.

Detection and Classification of Diabetic Retinopathy Using DCNN and BSN Models

Diabetes is associated with many complications that could lead to death.Diabetic retinopathy,a complication of diabetes,is difficult to diagnose and may lead to vision loss.Visual identification of micro features in fundus images for the diagnosis of DR is a complex and challenging task for clinicians.Because clinical testing involves complex procedures and is timeconsuming,an automated system would help ophthalmologists to detect DR and administer treatment in a timelymanner so that blindness can be avoided.Previous research works have focused on image processing algorithms,or neural networks,or signal processing techniques alone to detect diabetic retinopathy.Therefore,we aimed to develop a novel integrated approach to increase the accuracy of detection.This approach utilized both convolutional neural networks and signal processing techniques.In this proposed method,the biological electro retinogram(ERG)sensor network(BSN)and deep convolution neural network(DCNN)were developed to detect and classify DR.In the BSN system,electrodes were used to record ERGsignal,which was preprocessed to be noise-free.Processing was performed in the frequency domain by the application of fast Fourier transform(FFT)and mel frequency cepstral coefficients(MFCCs)were extracted.Artificial neural network(ANN)classifier was used to classify the signals of eyes with DR and normal eye.Additionally,fundus images were captured using a fundus camera,and these were used as the input for DCNN-based analysis.The DCNN consisted of many layers to facilitate the extraction of features and classification of fundus images into normal images,non-proliferative DR(NPDR)or earlystage DR images,and proliferative DR(PDR)or advanced-stage DR images.Furthermore,it classifiedNPDRaccording tomicroaneurysms,hemorrhages,cotton wool spots,and exudates,and the presence of new blood vessels indicated PDR.The accuracy,sensitivity,and specificity of the ANNclassifier were found to be 94%,95%,and 93%,respectively.Both the accuracy rate and sensitivity rate of theDCNNclassifierwas 96.5%for the images acquired from various hospitals as well as databases.A comparison between the accuracy rates of BSN andDCNN approaches showed thatDCNNwith fundus images decreased the error rate to 4%.

复方血栓通胶囊和胰激肽酶原治疗NPDR的研究

目的:研究探讨复方血栓通胶囊、胰激肽酶原以及两者联合应用在非增殖期糖尿病视网膜病变中的疗效。方法:按照随机、对照的原则,把90例早期糖尿病视网膜病变患者分为3组,第一组服用复方血栓通胶囊;第二组服用胰激肽酶原;第三组同时服用复方血栓通胶囊和胰激肽酶原。疗程为3mo,观察患者治疗前及治疗后的视力、视网膜的变化。对比治疗前后的变化,将观察指标结果量化,利用SAS简明统计软件处理,得出其疗效有无差异性。结果:在本研究中,应用复方血栓通胶囊治疗患者30例60眼,有效43眼,有效率71.6%;应用胰激肽酶原患者30例60眼,有效46眼,有效率76.6%;两者联合应用30例60眼,有效55眼,有效率91.6%。经统计学分析,应用复方血栓通胶囊、胰激肽酶原治疗期非增殖期糖尿病视网膜病变均有效,两组比较无差异性。两者联合应用与单纯应用相比较,统计学分析有差异性。结论:在非增殖期糖尿病视网膜病变的治疗中,复方血栓通胶囊以及胰激肽酶原对其治疗均有效,两者联合应用,疗效更佳。我们得出:中西医结合治疗非增殖期糖尿病视网膜病变是一种疗效较好的方法。

基于数据挖掘探讨中医药治疗NPDR用药规律

目的基于数据挖掘技术分析中医药治疗非增殖性糖尿病视网膜病变(NPDR的用药规律,为临床治疗NPDR提供用药参考。方法检索2010年1月—2020年12月中国知网、万方、维普、中国生物医学文献数据库中中医药治疗NPDR的临床研究类文献,将纳入文献的方药组成、中医证候录入Excel 2016建立数据库,采用古今医案云平台医案数据库进行中药的使用频次分析、药物属性、中医证候进行统计,并做关联分析、聚类分析和复杂网络分析。结果(1)一般情况:共纳入文献94篇。包含方剂94首,共涉及中药150味、中医证候15个。四气以微寒性药最多,共38味,占比25.33%。五味以甘味药最多,共67味,占比44.67%。归经以肝经最多,共40味,占比26.67%。(2)使用频次:使用频次≥20次的中药(高频中药)有15味,排名前5位的分别为生地黄(66次,64.08%)、黄芪(64次,62.14%)、丹参(41次,39.81%)、枸杞子(38次,36.89%)和山药(36次,34.95%)。(3)中医证候:排在前5位的分别为气阴两虚证(32次,34.04%)、瘀血阻络证(23次,24.47%)、肝肾阴虚证(10次,10.64%)、阴虚证(8次,8.51%)和气滞血瘀证(6次,6.38%)。(4)中药配伍关联分析:相关度排在前5位的药对分别是玄参-生地黄;丹参、生地黄-黄芪;丹参、黄芪-生地黄;黄芪-生地黄;生地黄-黄芪。(5)聚类分析:药对和方剂共5类,其功效分别是滋阴补气、凉血滋阴健脾、活血化瘀、补肝益肾养阴、清热凉血通络。(6)核心药物对应证候分析:权重排在前5位的分别是黄芪-气阴两虚证、生地黄-气阴两虚证、黄芪-瘀血阻络证、当归-气阴两虚证、麦冬-气阴两虚证。结论临床治疗NPDR所选用的中药药性多微寒,药味多甘,主入肝经,以气阴两虚证多见,临证时应注重组方配伍,活用核心药物。

红花黄色素氯化钠注射液联合复方樟柳碱注射液对NPDR患者的临床疗效

目的观察红花黄色素氯化钠注射液联合复方樟柳碱注射液对非增殖型糖尿病视网膜病变(NPDR)患者的临床疗效。方法 68例(102只眼)患者随机分为对照组(32例,48只眼)和观察组(36例,54只眼),对照组予以常规治疗,观察组在常规治疗基础上予以红花黄色素氯化钠注射液联合复方樟柳碱注射液,比较2组治疗前后视力、眼底出血、渗出、微血管瘤和黄斑中心厚度的变化。结果治疗后观察组视力恢复、眼底改善、黄斑中心厚度控制显著优于对照组(P<0.05,P<0.01)。结论红花黄色素氯化钠注射液联合复方樟柳碱注射液可有效改善NPDR患者的视力,延缓疾病进展。

无黄斑水肿的NPDR患者中心凹区mfERG与视网膜厚度的研究

目的:分析非增生性糖尿病视网膜病变(nonproliferative diabetic retinopathy,NPDR)无黄斑水肿的患者黄斑中心凹区视网膜功能及厚度间的关系。方法:选取NPDR患者20例35眼患眼为糖尿病视网膜病变(diabetic retinopathy,DR)组,行多焦视网膜电图(multifocal electronic retinography,mfERG)及Spectralis相干断层扫描(Spectralis optical coherence tomography,Spectralis OCT)检查。以15例20眼正常眼为OCT对照组,以19例20眼正常眼为mfERG对照组,OCT对照组做Spectralis OCT检查,mfERG对照组做mfERG检查。结果:与对照组相比,DR组黄斑中心凹mfERGi环的P1波反应密度减小,P1波及N1波隐含期改变无统计学意义;DR组无水肿的黄斑中心凹视网膜厚度、神经上皮层厚度仍有显著增加。结论:应用mfERG可以在视网膜无可见明显结构改变之前发现视网膜功能上的异常变化;Spectralis OCT可以测量视网膜各层厚度,反映视网膜精细结构变化,验证视网膜功能上的异常改变,二者联合应用为极早期发现糖尿病视网膜病变视功能改变提供有效的证据,并为及时治疗提供资料。

复方血栓通对NPDR激光光凝术后的视网膜血流动力学影响

目的:观察复方血栓通对非增生性糖尿病性视网膜病变(nonproliferative diabetic retinopathy,NPDR)激光光凝术后的视网膜血流动力学的影响。方法:选取已行激光光凝术后的NPDR患者41例72眼,给予复方血栓通治疗,于治疗前后,采用彩色多普勒血流检测仪检测视网膜血流动力学情况。结果:治疗后患眼视网膜血流灌注有明显改善,视网膜中央动脉的收缩期峰值血流速度(PSV)、舒张末期血流速度(EDV)和平均血流速度(Vm)均增高,而阻力指数(RI)降低,差异有统计学意义(P<0.05)。治疗后61眼视力改善,总有效率85%。治疗后视力提高值和患眼的PSV,Vm和RI的变化差值呈明显的相关性。结论:复方血栓通对NPDR激光光凝术后患者的视网膜血流灌注有明显改善,并且这种改善和患者视力预后的改善密切相关。

口服中成药联合羟苯磺酸钙治疗非增殖型糖尿病视网膜病变的网状meta分析

目的综合分析口服中成药联合羟苯磺酸钙(CD)治疗非增殖型糖尿病视网膜病变(NPDR)的效果和安全性。方法检索从建库至2023年3月26日中外数据库(中国知网、万方、维普、Sinomed、PubMed、Cochrane Library、Embase)中口服中成药治疗NPDR的随机对照试验。依据Cochrane Risk of Bias(ROB)1.0工具进行质量评价,使用ADDIS 1.16.8及Stata 15.0软件统计分析数据并绘制相关图形。结果网状meta分析结果显示临床总有效率疗效排序为:复方丹参滴丸联合CD>芪明颗粒联合CD>复方血栓通胶囊联合CD>双丹明目胶囊联合CD>单用CD;中成药联合CD的不良反应均比单独使用CD少。结论口服中成药联合CD治疗NPDR的临床疗效优于单用CD,且安全性更佳,但受到研究质量及数量限制,望日后得到更多高质量研究佐证。

羟苯磺酸钙联合氨碘肽滴眼液治疗非增殖期糖尿病视网膜病变的效果

目的:探讨羟苯磺酸钙联合氨碘肽滴眼液治疗非增殖期糖尿病视网膜病变(nonproliferative diabetic retinopathy,NPDR)的效果。方法:选取2022年5月—2023年8月浏阳市集里医院收治的180例NPDR患者。根据随机数表法将其分为基线组和试验组,各90例。基线组给予氨碘肽滴眼液,试验组在基线组基础上给予羟苯磺酸钙胶囊。比较两组治疗后临床疗效,治疗前后视野相关指标、眼动脉血流、血管内皮功能及不良反应。结果:试验组治疗总有效率高于对照组,差异有统计学意义(P<0.05)。治疗后,两组视野灰度值、黄斑厚度、血管瘤体积、出血斑面积均降低,试验组视野灰度值、黄斑厚度、血管瘤体积、出血斑面积均低于基线组,差异有统计学意义(P<0.05)。治疗后,两组收缩期峰值流速(peak systolic velocity,PSV)、舒张末期流速(end-diastolic velocity,EDV)均升高,阻力指数(resistance index,RI)降低,试验组PSV、EDV均高于基线组,RI低于基线组,差异有统计学意义(P<0.05)。治疗后,两组血管内皮生长因子(vascular endothelial growth factor,VEGF)、胰岛素样生长因子1(insulin-like growth factor 1,IGF-1)水平均降低,试验组VEGF、IGF-1水平均低于基线组,差异有统计学意义(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:羟苯磺酸钙和氨碘肽滴眼液共同治疗NPDR效果较好,可改善患者视野问题和眼底病变,改善眼部血流,能调节血管内皮功能,不良反应少。

抗血管内皮生长因子药物玻璃体腔注射联合激光光凝治疗重度非增殖性糖尿病视网膜病变伴黄斑水肿的临床研究

目的探究抗血管内皮生长因子药物玻璃体腔注射联合激光光凝治疗重度非增殖性糖尿病视网膜病变伴黄斑水肿的临床效果。方法前瞻性随机选取2020年3月—2023年3月因重度非增殖性糖尿病视网膜病变伴黄斑水肿在常熟市第一人民医院眼科门诊诊疗的80例患者进行研究,根据抛硬币法随机分为两组,各组40例,对照组予以全视网膜激光光凝治疗,观察组予以抗血管内皮生长因子药物玻璃体腔注射+全视网膜激光光凝治疗。比较整体临床疗效。结果观察组治疗总有效率高达95.00%,比对照组80.00%显著更高,差异有统计学意义(χ^(2)=4.114,P<0.05);观察组术后1、3、6个月的视力水平和黄斑中心视网膜厚度优于对照组,差异有统计学意义(P均<0.05);观察组术后并发症发生率12.50%和对照组20.00%比较,差异无统计学意义(P>0.05)。结论重度非增殖性糖尿病视网膜病变合并黄斑水肿患者采用玻璃体腔注射抗血管内皮生长因子+激光光凝治疗法,可发挥安全有效的治疗作用。

养目汤加味联合羟苯磺酸钙胶囊治疗非增殖期糖尿病视网膜病变肝肾亏虚、目络失养证临床研究

目的:观察养目汤加味联合羟苯磺酸钙胶囊治疗非增殖期糖尿病视网膜病变(NPDR)肝肾亏虚、目络失养证的临床疗效及对血清趋化因子样受体1(CMKLR1)、卵泡抑素样蛋白1(FSTL1)、C1q/肿瘤坏死因子相关蛋白9(CTRP9)水平的影响。方法:采用随机数字表法将82例NPDR肝肾亏虚、目络失养证患者分为治疗组与对照组各41例。对照组给予羟苯磺酸钙胶囊治疗,治疗组给予养目汤加味联合羟苯磺酸钙胶囊治疗,2组均连续治疗12周。比较2组治疗前后视力、眼压、眼底指标、中医证候评分及血清CMKLR1、FSTL1、CTRP9水平,并评估2组临床疗效及不良反应发生情况。结果:治疗组总有效率92.68%,高于对照组73.17%(P<0.05)。2组治疗后循环时间、血管渗漏面积、微血管瘤个数、毛细血管无灌注区面积较治疗前减少(P<0.05),中医证候评分、眼压及血清CMKLR1、FSTL1水平降低(P<0.05),且治疗组循环时间、血管渗漏面积、微血管瘤个数、毛细血管无灌注区面积少于对照组(P<0.05),中医证候评分、眼压及血清CMKLR1、FSTL1水平均低于对照组(P<0.05)。2组治疗后视力及血清CTRP9水平均较治疗前升高(P<0.05),且治疗组视力及血清CTRP9水平高于对照组(P<0.05)。2组未见明显不良反应。结论:养目汤加味联合羟苯磺酸钙胶囊治疗NPDR肝肾亏虚、目络失养证疗效确切,能够抑制机体炎症,保护患者视网膜屏障,提高视力,安全性较好。

口服羟苯磺酸钙联合和血明目片治疗非增殖性糖尿病视网膜病变临床观察

目的:研究口服羟苯磺酸钙联合和血明目片治疗非增殖性糖尿病视网膜病变(nonproliferative diabetic retinopathy,NPDR)的临床效果。方法:根据随机数表法将176例NPDR患者分为对照组和研究组,每组各88例。所有患者均接受降脂、降糖及降压等常规对症治疗,同时对照组患者加服羟苯磺酸钙治疗,研究组患者采用口服羟苯磺酸钙联合和血明目片治疗。比较两组患者治疗前后出血吸收时间、血糖水平及治疗效果。结果:研究组出血吸收时间少于对照组,差异有统计学意义(t=12.798,P=0.001);治疗后两组患者的空腹血糖(FBG)、糖化血红蛋白(HbA1C)水平均较治疗前降低,研究组患者低于对照组(P<0.05);研究组治疗总显效率为86.4%,高于对照组的65.9%,差异有统计学意义(P<0.05)。结论:口服羟苯磺酸钙联合和血明目片治疗NPDR效果显著,能有效调节血糖水平,控制病情进展,值得临床推广。

加味补阳还五汤对单纯型糖尿病视网膜病变患者血浆ET-1及NO的影响

目的:观察加味补阳还五汤治疗单纯型糖尿病视网膜病变(DR)的疗效及对患者血浆内皮素(ET-1)和一氧化氮(NO)的影响。方法:将70例患者随机分为两组各35例。两组均予以常规治疗,治疗组加服加味补阳还五汤,对照组口服多贝斯胶囊,疗程8周,观察两组治疗前后视力、眼底检查、眼底荧光血管造影及ET-1、NO等指标的变化。结果:治疗组总有效率优于对照组,有显著性差异(P<0.05)。治疗组治疗后ET-1明显下降、NO明显上升,与对照组比较,有显著性差异(P<0.05)。结论:加味补阳还五汤能有效改善患者血浆ET-1及NO水平,对单纯型DR具有较好的防治作用。

非增殖期糖尿病视网膜病变黄斑区硬性渗出的临床观察

目的观察非增殖期糖尿病视网膜病变黄斑区硬性渗出的特点。方法回顾性分析自2008年1月~2009年5月接受荧光血管造影检查（fundus fluorescein angiography,FFA）,并确诊为单眼或双眼非增殖期糖尿病视网膜病变者共261人,440只眼,观察黄斑区硬性渗出累及的范围、程度,并分析其与视力的关系。结果FFA检查诊断为背景型糖尿病视网膜病变（background diabeticretinopathy,BDR）Ⅱ期及Ⅲ期的440只眼中,黄斑区未见硬性渗出者152只眼（34.6%）,可辨认出硬性渗出者272只眼（61.8%）,16只眼因屈光间质不清而无法辨认（3.6%）。硬性渗出多累及黄斑区1~2个象限（约占40.4%）,以颞侧受累多见。中心凹500μm以内无硬性渗出者约为63.9%,其视力〉0.5者占50.6%,少量硬性渗出者约为27.6%,视力〉0.5者占42.6%,大量硬性渗出者约为4%,视力〉0.5者仅占22.9%（P=0.02）。在单眼发生了较严重的硬性渗出的患者中,88%的患者对侧眼硬性渗出程度较轻,双眼硬性渗出程度的差异有统计学意义（P〈0.0001）。结论硬性渗出是非增殖期糖尿病视网膜病变的常见眼底表现,具有中心凹颞侧多见,双眼严重程度不完全对称,严重硬性渗出发生率低等特点,其发生位置及严重程度与视力损害密切相关。

544例糖尿病患者视网膜病变临床分析

对7年来住院的544例糖尿病(DM)患者视网膜病变(DR)发生情况进行了调查分析,结果表明:视网膜病变总发生率为34％。其中非增殖性为29.8％,增殖性为4.2％。DR发生率与性别、糖尿病类型及血糖高低关系不显著,与糖尿病患者的年龄、血压及尿蛋白关系较密切。提出防止DM患者失明的关键是严格控制血糖、血压,必要时对有视网膜病变的患者进行激光光凝和/或玻璃体切割术可能会收到良好的效果。

羟苯磺酸钙联合复方樟柳碱治疗非增殖性糖尿病性视网膜病变临床研究

目的:探讨羟苯磺酸钙(CaD)联合复方樟柳碱治疗非增殖性糖尿病性视网膜病变(NPDR)的临床效果。方法:收集120例单眼NPDR患者,采用平行随机对照法分为对照组和观察组,各60例60眼。两组均给予控制血糖、饮食运动疗法等常规治疗处理,对照组患者常规口服羟苯磺酸钙胶囊治疗,观察组在对照组的基础上加用复方樟柳碱双颞侧皮下注射,两组均持续治疗3个月。对比两组治疗前后视力、眼底病变以及相关血清细胞因子血管内皮生长因子(VEGF)和内皮素-1(ET-1)的变化,综合评估并比较两组的治疗效果。结果:观察组总有效率高于对照组(P<0.05),视力较对照组有所提升,眼底微动脉瘤个数和出血、渗出面积较对照组减少,两组比较差异均具有统计学意义(P<0.05);经治疗后观察组血清VEGF、ET-1水平较对照组显著降低,两组比较差异均具有统计学意义(P<0.05)。结论:CaD联合复方樟柳碱治疗NPDR可有效改善患者视力,减轻眼底病变,降低VEGF和ET-1水平,临床治疗效果显著。