目的 探讨阿托伐他汀联合前列地尔注射液治疗糖尿病视网膜病变的临床疗效。方法 选取河北医科大学第三医院2018年6月-2019年1月收治的糖尿病视网膜病变患者72例，随机分为对照组（36例）和治疗组（36例）。对照组静脉滴注前列地尔注射液，10 μg加入100 mL生理盐水，1次/d。治疗组患者在对照组的基础上口服阿托伐他汀钙片，初始剂量1片/次，1次/d，后续逐渐增加至4片/次，1次/d。两组患者均连续治疗1个月。观察两组患者临床疗效，同时比较治疗前后两组患者血清细胞间黏附分子-1（ICAM-1）、肿瘤坏死因子-α（TNF-α）、超敏C反应蛋白（hs-CRP）、白细胞介素-10（IL-10）、总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-C）和高密度脂蛋白胆固醇（HDL-C）水平以及眼底微动脉瘤数目。结果 治疗后，对照组临床有效率为72.22%，显著低于治疗组的91.67%，两组比较差异有统计学意义（P<0.05）。治疗后，两组患者眼底微动脉瘤数目均明显降低（P<0.05），且治疗组降低更明显（P<0.05）。治疗后，两组患者血清ICAM-1、TNF-α、hs-CRP、TC、TG、LDL-C水平明显降低（P<0.05），而IL-10和HDL-C水平明显升高（P<0.05），且治疗组比对照组改善更明显（P<0.05）。结论 阿托伐他汀联合前列地尔注射液治疗糖尿病视网膜病变临床疗效显著，可有效改善血清炎症因子和血脂水平，且安全性高，具有一定的临床推广应用价值。

Objective To investigate the clinical efficacy of atorvastatin combined with alprostadil in treatment of diabetic retinopathy. Methods Patients (72 cases) with diabetic retinopathy in the Third Hospital of Hebei Medical University from June 2018 to January 2019 were randomly divided into control (36 cases) and treatment (36 cases) groups. Patients in the control group were iv administered with Alprostadil Injection, 10 μg added into normal saline 100 mL, once daily. Patients in the treatment group were po administered with Atorvastatin Calcium Tablets on the basis of the control group, the initial dose was 1 tablet/time, once daily, and gradually increased to 4 tablets/time, once daily. Patients in two groups were treated for 1 month. After treatment, the clinical efficacy was evaluated, and the serum levels of ICAM-1, TNF-α, hs-CRP, IL-10, TC, TG, LDL-C and HDL-C, and the number of fundus microaneurysms in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control group was 72.22%, which was significantly lower than 91.67% in the treatment group, and there were differences between two groups (P<0.05). After treatment, the number of fundus microaneurysms in two groups was significantly decreased (P<0.05), and which in the treatment group was significantly less than that in the control group (P<0.05). After treatment, the serum levels of ICAM-1, TNF-α, hs-CRP, TC, TG, LDL-C in two groups was significantly decreased (P<0.05), but the levels of IL-10 and HDL-C were significantly increased (P<0.05), and these indexes in the treatment group were significantly better than those in the control group (P<0.05). Conclusion Atorvastatin combined with alprostadil has a significant clinical effect in treatment of diabetic retinopathy, which can effectively improve serum inflammatory factors and blood lipid levels with high safety, which has a certain clinical application value.

R977

河北省卫生厅指令性项目（20160149）