目的 探讨辛伐他汀联合羟苯磺酸钙治疗高血脂非增殖期糖尿病视网膜病变的临床疗效。方法 选取2012年1月—2015年1月就诊于天津市河西区康复医院并进行治疗的高血脂非增生型糖尿病视网膜病变患者120例,随机分为对照组60例和治疗组60例。对照组患者口服羟苯磺酸钙分散片,0.5 g/次,3次/d。治疗组患者在对照组治疗基础上口服辛伐他汀片,10 mg/次,1次/d。两组患者均连续治疗2个月。观察两组的临床疗效,比较两组患者治疗前后总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)变化情况,以及血液流变学指标,同时观察药物的不良反应情况。结果 对照组总有效率73.33%,治疗组总有效率86.67%,两组总有效率比较差异具有统计学意义(P< 0.05)。治疗后治疗组患者TG、TC均低于对照组患者,HDL-C明显高于对照组患者,差异具有统计学意义(P< 0.05);治疗组患者血流变学指标较对照组有明显改善,全血低切黏度、全血高切黏度、血浆黏度、血小板黏附率、血小板聚集率均显著下降(P< 0.05)。两组间不良反应发生比较差异无统计学意义。结论 辛伐他汀联合羟苯磺酸钙能够有效改善糖尿病视网膜病变患者的临床症状和血脂水平,不良反应发生率低,具有一定的临床推广应用价值。

Objective To investigate the clinical curative effect of simvastatin combined with calcium dobesilate in the treatment of diabetic retinopathy in high blood lipid and non proliferative phase. Methods Patients (120 cases) with diabetic retinopathy in high blood lipid and non proliferative phase in Rehabilitation Hospital of Hexi District in Tianjin City from January 2012 to January 2015 were randomly divided into control and treatment groups, and each group had 60 cases. The patients in the control group were po administered with Calcium Dobesilate Dispersible Tablets, 0.5 mg/time, three times daily. The patients in the treatment group were po administered with Simvastatin Tablets on the basis of control group, 10 mg/time, once daily. Two groups were treated for 2 months. After treatment, the total efficacy was evaluated, and the changes of TC, TG, HDL-C, and blood rheology index in two groups were compared. And adverse events were observed. Results After treatment, the efficacies in the control and treatment groups were 73.33% and 86.67%, respectively, and there was difference between two groups (P < 0.05). After treatment, TG and TC in treatment group were lower than those in control group, but HDL-C was higher than that in control group, and there were differences between two groups (P < 0.05). Blood rheology index in treatment group improved better than those in the control group, low blood viscosity, whole blood viscosity, plasma viscosity, platelet adhesion rate, and platelet aggregation rate were obviously decreased with significant differences between two groups (P < 0.05). There was no obvious difference of adverse events between two groups. Conclusion Simvastatin combined with calcium dobesilate can effectively improve the clinical symptoms and blood lipid level in patients with diabetic retinopathy, and can also reduce adverse events, which has a certain clinical application value.