普罗布考辅助治疗增殖前期及增殖早期糖尿病视网膜病变  

Probucol in treatment of pre-stage and early stage of proliferative diabetic retinopathy

作　　者：段毅琴[1,2] 林丁[1,2] 陈忠平[1,2] 王启常[1,2] 

机构地区：[1]长沙爱尔眼科医院 [2]中南大学爱尔眼科学院,湖南省长沙市410005

出　　处：《眼科新进展》2015年第10期945-948,共4页Recent Advances in Ophthalmology

基　　金：爱尔眼科集团项目(编号:AF141Z01);长沙市科技计划项目(编号:K2013037-31);湖南省卫生厅课题(编号:C2015-69)~~

摘　　要：目的观察半导体激光光凝联合普罗布考治疗增殖前期及增殖早期糖尿病视网膜病变患者视力、眼底改变以及血清8-羟基脱氧鸟苷(8-hydroxy-2’-deoxyguanosine,8-0Hd G)浓度的变化,以评估其临床治疗效果。方法选取增殖前期及增殖早期糖尿病视网膜病变需行眼底激光治疗的患者60例(60眼)纳入研究,按治疗方法不同分成A、B、C 3组,A组行眼底激光光凝加安慰剂治疗,B组行眼底激光光凝加Vit C口服,C组行眼底激光光凝加普罗布考口服,口服药连续服用3个月。用眼底荧光血管造影检查判断眼底病变及黄斑水肿改善情况,用光学相干断层扫描法检查患者黄斑区视网膜厚度的改变,患者空腹抽取静脉血送检,采用酶联免疫吸附试验(ELISA)测定血清8-0Hd G含量。治疗前及治疗后1个月、3个月、6个月、12个月所有患者均复查眼底荧光血管造影、OCT及测定血清8-0Hd G浓度。治疗后随访12个月。结果治疗后1个月、3个月、6个月,C组血清8-0Hd G浓度逐渐降低,与治疗前相比差异均有统计学意义(均为P<0.05);但治疗后12个月与6个月时相比,血清8-0Hd G浓度差异无统计学意义;治疗后3个月、6个月、12个月,C组血清8-0Hd G与A组、B组相比均显著下降,差异均有统计学意义(均为P<0.05)。C组末次随访时黄斑中心凹视网膜厚度为(214±15)μm,与B组的(245±19)μm及A组的(258±24)μm相比,差异均有统计学意义(均为P<0.05),C组、B组和A组对糖尿病视网膜病变患者眼底改善的总有效率分别为65%、35%及30%,C组与B组、A组眼底改善有效率相比差异均有统计学意义(均为P<0.05)。结论血清8-0Hd G浓度是反映糖尿病视网膜病变预后的一个较为敏感的指标,普罗布考对增殖前期及增殖早期糖尿病视网膜病变具有辅助治疗效果,对糖尿病视网膜病变激光术后视功能具有保护作用。Objective To observe visual acuity, fundus improvement and fluctua- tion of serμm 8-hydroxydeoxyguanosine（8-0HdG） in pre-stage and early stage of prolif- erative diabetic retinopathy after treatment with oral probucol and retinal laser photoco- agulation. Methods According to fluorescein fundus angiography （ FFA）, 60 cases of pre-stage and early stage of proliferative diabetic retinopathy were chosen in this study, then all patients were divided into three groups, named group A, group B and group C by randomized double-blindness,20 cases in each group. Group A was treated with oral placebo and retinal laser photocoagulation, group B with oral vitamin C and retinal laser photocoagulation, and group C with oral probucol and retinal laser photocoagulation. O- ral tablets were given to patients for 3 months. The improvement of fudus and macular edema were checked with fluorescein fundus angiography, and OCT was used to deter- mine the retinal thickness in macular zone. The serμm 8-0HdG was checked by enzymelinked immunosorbent assay（ELISA）. FFA, OCT and serμm 8-0HdG were checked re- peatediy before treatment and 1 month,3 months,5 months and 12 months after treat- ment. Results The serμm 8-0HdG in group C at 1 month,3 months and 5 months after treatment were decreased, there were statistical differences compared with pre-treatment（ all P 〈 0.05 ）, but no statistical difference was found between 12 months and 5 months. Compared with group A and B, the serμm 8-0HdG in group C at 3 months, 5 months and 12 months after treatment were decreased obviously（ all P 〈 0.05 ）. The cen- tral macular retinal thickness of group C was （ 214 ± 15 ）μm, compared with group B （245 ± 19）μm and group A（ 258 ± 24 ）μm, the differences were statistically significant （ all P 〈 0.05 ）. The total effective ratio of fimdus improvement in group C, B and A were 55% ,35% and 30% , respectively, the difference was statistically significant between group C and group A, B （all P 〈 0.05 ）. Con

关 键 词：糖尿病视网膜病变 普罗布考 8-羟基脱氧鸟苷 

分 类 号：R774.1[医药卫生—眼科]