[关键词]
[摘要]
目的 探讨长春胺缓释胶囊联合羟苯磺酸钙分散片治疗非增殖期糖尿病视网膜病变的临床效果。方法 选取2015年3月—2018年12月辽宁省人民医院治疗的200例非增殖期糖尿病视网膜病变患者(共383只患眼)作为研究对象,采用随机数字表法将患者其随机分成观察组(n=100例,195眼)与对照组(n=100例,188眼)。对照组患者口服羟苯磺酸钙分散片,2片/次,3次/d。观察组在对照组基础上口服长春胺缓释胶囊,1粒/次,2次/d。两组均治疗3个月。观察两组临床疗效,比较两组治疗前后的最佳矫正中心视力(BCVA)、眼底检查相关指标、血流变学指标、视网膜中央动脉血流动力学参数及不良反应发生情况。结果 治疗后,观察组总有效率为94.9%,显著高于对照组的87.2%(P<0.05)。两组治疗后BCVA较治疗前均显著提高,黄斑中心凹视网膜厚度(CMT)均显著减小,微血管瘤数则均显著减少,而视网膜血管渗漏(VL)、毛细血管无灌注区(CNP)面积均显著缩小,视网膜平均循环时间(MCT)均显著缩短(P<0.05);且观察组治疗后BCVA和眼底检查相关参数的改善效果均更显著(P<0.05)。与治疗前相比,两组治疗后红细胞聚集指数(RCAI)、血浆黏度(PV)均显著下降,而红细胞变形指数(RDI)均显著升高(P<0.05);且治疗后,观察组RCAI、PV均显著低于对照组同期,RDI则显著更高(P<0.05)。两组治疗后患眼视网膜中央动脉收缩期峰值(PSV)、舒张末期血流速度(EDV)较治疗前均显著增高,阻力指数(RI)则均显著降低(P<0.05);治疗后,观察组患眼视网膜中央动脉各项血流动力学参数的改善效果均更显著(P<0.05)。治疗期间,观察组不良反应发生率为5.0%,与对照组的3.0%比较,差异无统计学意义。结论 长春胺缓释胶囊联合羟苯磺酸钙分散片治疗非增殖期糖尿病视网膜病变的整体疗效良好,有助于提高患者视力,改善眼底病变,纠正体内血流变学异常,改善视网膜血流动力学,且安全可靠,值得临床推广应用。
[Key word]
[Abstract]
Objective To investigate the clinical effect of Vincamine Sustained Release Capsules combined with Calcium Dobesilate Dispersible Tablets in treatment of non-proliferative diabetic retinopathy. Methods A total of 200 patients with non-proliferative diabetic retinopathy (383 eyes) admitted to The People's Hospital of Liaoning Province from March 2015 to December 2018 were selected, and randomly divided into observation group (n=100 cases, 195 eyes) and control group (n=100 cases, 188 eyes) by random number table method. The control group was treated with Calcium Dobesilate Dispersible Tablets, 2 tablets/time, three times daily. Patients in observation group was po administered with Vincamine Sustained Release Capsules on the basis of control group, 1 grains/time, twice daily. All patients were treated for 3 months. After treatment, the clinical effects in two groups were observed, and the BCVA, fundus examination related indexes, hemorheological indexes, PV, central retinal artery hemodynamic parameters, and adverse reaction before and after treatment were compared. Results After treatment, the total effective rate in the observation group was 94.9%, which was significantly higher than 87.2% in the control group (P < 0.05). After treatment, BCVA in two groups were significantly increased, CMT were significantly decreased, the number of microangiomas was significantly decreased, while the VL, CNP area were significantly reduced, and the MCT were significantly shortened (P < 0.05). And the improvement effect of BCVA and fundus examination related parameters in the observation group after treatment was more significant (P < 0.05). Compared with treatment before, RCAI and PV in two groups were decreased significantly, but the RDI were increased (P < 0.05). After treatment, the RCAI and PV in the observation group were significantly lower than those in the control group, while RDI was significantly higher than those in the control group (P < 0.05). After treatment, PSV and EDV of central retinal artery in two groups were significantly higher than those before treatment, while RI were significantly decreased (P < 0.05). After treatment, the improvement effect of various hemodynamic parameters of the central retinal artery in the observation group was more significant (P < 0.05). During the treatment, the adverse reaction rate in the observation group was 5.0%, which was not significantly different between 3.0% in the control group. Conclusion Vincamine Sustained Release Capsules combined with Calcium Dobesilate Dispersible Tablets has a good effect in treatment of non-proliferative diabetic retinopathy, which is conducive to improving patients' vision, improving fundus lesions, correcting hemorheology anomalies in vivo, and retinal hemodynamics. It is safe and reliable, and worthy of clinical promotion and application.
[中图分类号]
R988.1
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