活性维生素D治疗非增殖型糖尿病视网膜病变的疗效  

Effect of calcitriol in patients with proliferative diabetic retinopathy

作　　者：朱燕妮[1] 卢娟[1] 陈静[1] 朱炎华[1] 

机构地区：[1]长江大学附属第一人民医院眼科,中国湖北省荆州市434002

出　　处：《国际眼科杂志》2013年第1期104-106,共3页International Eye Science

摘　　要：目的:探讨活性维生素D(骨化三醇)治疗非增殖型糖尿病视网膜病变的临床疗效。方法:选取本院眼科门诊及内分泌科病房诊断明确的2型糖尿病视网膜病变患者96例,患者按随机数字表法随机均分为对照组(C组)和观察组(T组)各48例,C组给予二甲双胍降糖治疗,T组患者在对照组的基础上给予骨化三醇0.25μg/d治疗。另选取本院体检中心健康体检者20例作为正常组(N组),观察各组患者治疗前后血清钙、磷、25-(OH)D3、1,25-(OH)2D3及甲状旁腺激素(PTH)水平,并观察两组患者治疗后眼底病变减轻的有效率。结果:与N组相比,C组、T组患者治疗前均存在血清25-(OH)D3和1,25-(OH)2D3水平低下,甲状旁腺素上升;给予骨化三醇治疗后,T组患者维生素D及甲状旁腺素水平有改善,同时视力及眼底出血渗出均改善,有效率明显高于C组,两组比较差异均有统计学意义(P<0.05)。以上三组患者治疗前后血清钙、磷水平差异无统计学意义。结论:DR患者存在血清维生素D代谢紊乱,给予维生素D治疗可以改善其代谢紊乱,同时可以明显改善患者视力及眼底病变。AIM：To investigate the effect of calcitriol in patients with proliferative diabetic retinopathy（PDR）.METHODS：Totally 96 patients with PDR were chosen.All patients were divided into two groups randomly.Patients in group T（29 males and 19 females） were given calcitriol（0.25μg/day） and routine drugs,while patients in group C（31 males and 17 females） received routine drugs only.Other twenty normal adults were selected as healthy group（group N） and took no drugs.The serum Ca,P,25-（OH）D3,1,25-（OH）2D3 and parathyroid hormone（PTH） were measured at the experiment onset and 12 weeks later.RESULTS：Compared to group N,the serum 25-（OH）D3,1,25-（OH）2D3 level was both obviously decreased,and serum PTH level was increased both in Group C and Group T（P0.05）.After calcitriol treatment for 12 weeks,the serum 25-（OH）D3,1,25-（OH）2D3 level in group T was all obviously increased（P0.05）,and serum PTH level was obviously decreased（P0.05）.Simultaneously ocular fundus changes were improved,the efficiency ratio of group T was higher than that of group C（89.6% vs 60.4%,P0.05）.There was no significant difference in serum Ca,P among the three groups at any time.CONCLUSION：There is lower serum 25-（OH）D3,1,25-（OH）2D3 level in the patients with PDR,and calcitriol can improve the disorder and is effective in treating PDR.

关 键 词：糖尿病 视网膜病变 维生素D 

分 类 号：R587.2[医药卫生—内分泌] R774.1[医药卫生—内科学]