摘要
目的观察缬沙坦联合己酮可可碱(pentoxifylline,PTX)治疗临床期糖尿病肾病及视网膜病变的疗效。方法 32例(64眼)2型糖尿病并发糖尿病性视网膜病及肾病患者随机分为A(对照组)、B(治疗组),每组各16例,在控制血糖基础上A组用缬沙坦每天80mg口服,B组缬沙坦加PTX(200mg,每天两次)口服,观察两组治疗前后眼底的变化、血压、肾功能、24h尿蛋白、血浆果糖胺(FA)、纤维蛋白原(Fib)、内皮素水平(ET)、血浆基质金属蛋白酶2(matrix metalloproteinase-2,MMP2)和1型组织基质金属蛋白酶抑制剂(matrix metallopro-teinaseinhibitor1,TIMP-1)水平。结果两组治疗前各项指标相比差异均无统计学意义(均为P>0.05)。治疗21d后,对照组眼底病变治疗有效率为68.8%(22眼),治疗组则高达93.8%(30眼),两组有效率比较差异有统计学意义(χ2=4.236,P<0.05)。治疗21d后,A组肾功能(Scr、Ccr、BUN、尿β2微球蛋白)、FA、Fib、ET和MMP2/TIMP1水平无明显变化(均为P>0.05);而B组各指标均有明显改善(均为P<0.05);两组患者血压、肾功能(24h尿蛋白、Scr、Ccr、BUN、尿β2微球蛋白)、FA、Fib、ET和MMP2/TIMP1水平相比,差异均有统计学意义(均为P<0.05)。结论缬沙坦联合PTX治疗临床期糖尿病肾病及视网膜病变具有协同作用,优于单用缬沙坦治疗,能更有效改善视网膜微循环、肾血流动力学,保护眼底和肾功能。
Objective To evaluate the curative effects of valsartan combined with pentoxifylline （PTX） for diabetic retinopathy and diabetic nephropathy.Methods Totally thirty-two patients （64 eyes） with diabetic retinopathy and diabetic nephropathy were randomly divided into control group and treated group.The patients in control group were treated with valsartan （80 mg per day）,treated group were treated with valsartan and PTX （400 mg per day）.The changes of fundus,blood pressure,renal function,24 hours urine protein,plasma fructosamine,fibrinogen,endothelin,matrix metalloproteinase 2 （MMP2） and matrix metalloproteinase inhibitor 1 （TIMP1） were observed before and after treatment of two groups.Results There was no statistical difference in general data between two groups（all P0.05）.After treated for 21 days,the effective rate for fundus disease in control group and treated group were 68.8% （22 eyes） and 93.8% （30 eyes）,respectively,there was statistical difference（χ2=4.236,P0.05）;The renal function （Scr,Ccr,BUN,β2 microglobulin）, plasma fructosamine,fibrinogen,endothelin,and MMP2/TIMP1 in control group had no obvious changes（all P0.05）,which in treated group obviously changed （all P0.05）,and there were statistical differences between two groups（all P0.05）.Conclusion Valsartan combined with pentoxifylline （PTX） for diabetic retinopathy and diabetic nephropathy have the synergistic effects,which are better than the single valsartan treatment,can obviously improve the retinal microcirculation and renal hemodynamics to protect the fundus and renal function.
出处
《眼科新进展》
CAS
北大核心
2012年第10期945-948,共4页
Recent Advances in Ophthalmology
基金
国家自然科学基金项目(编号:81060063
81160118)
江西省科技支撑计划项目(编号:20111BBG70026-2)
江西省自然科学基金(编号:20114BAB215029)
江西省卫生厅科技计划面上项目(编号:20061045
20121026)
江西省教育厅(青年)科学基金项目(编号:GJJ11354
JJJ12158)~~
