非诺贝特对糖尿病视网膜病变患者血清脂蛋白相关磷脂酶A2水平及疗效的影响  

Influence of Fenofibrate on Level of Serum Lipoprotein Associated Phospholipase A2 and Treatment of Diabetic Retinopathy

作　　者：鞠海兵[1] 朱红云[2] 张福仙[1] 王爽[2] 宋洁[1] 崔涛[1] 李丽凤[1] 阮兆娟[1] 何慧梅[1] 

机构地区：[1]成都军区昆明总医院内分泌科,云南昆明650032 [2]昆明医科大学临床学院

出　　处：《华南国防医学杂志》2017年第3期170-173,共4页Military Medical Journal of South China

基　　金：云南省昆明市西山区科技计划项目(西科字15号)

摘　　要：目的通过观察非诺贝特治疗对糖尿病视网膜病变(diabetic retinopathy,DR)患者的血清脂蛋白相关磷脂酶A2(lipoprotein-associated phospholipase A2,Lp-PLA2)水平以及视力、眼底病变的影响,并探讨其在临床防治DR中的作用及机制。方法选取作者医院收治的非增殖期糖尿病视网膜病变(non-proliferative diabetic retinopathy,NPDR)患者67例(NPDR组,134只眼)和增殖期糖尿病视网膜病变(proliferative diabetic retinopathy,PDR)患者42例(PDR组,84只眼)纳入研究,2组随机均分为非诺贝特治疗组与对照组。对照组给予常规降糖治疗,治疗组在对照组的基础上口服非诺贝特160 mg,1次/d,治疗12周。比较治疗前后血清Lp-PLA2、血管内皮生长因子(vascular endothelial growth factor,VEGF)水平的变化情况及视力、眼底病变的检查结果。结果与NPDR对照组比较,NPDR治疗组患者血清Lp-PLA2(P<0.01)、VEGF(P<0.05)水平均明显下降,患者的视力治疗有效率和眼底病变治疗有效率均明显提高(P<0.05)。与PDR对照组比较,PDR治疗组患者血清Lp-PLA2、VEGF水平均明显下降,组间比较差异具有统计学意义(P<0.05)。结论非诺贝特治疗可以明显降低NPDR和PDR患者血清Lp-PLA2、VEGF水平,提高NPDR患者视力,改善眼底病变,有效延缓DR的进展。Objective To observe effect of fenofibrate on level of lipoprotein-associated phospholipase A2（Lp-PLA2）,visual function and retinal morphology in diabetic retinopathy（DR）patients,and explore the application value of fenofibrate in prevention and treatment of DR.Methods A total of 67 patients（134 eyes）with non-proliferative diabetic retinopathy（NPDR group）and 42 cases（84 eyes）with proliferative diabetic retinopathy（PDR group）were randomly divided into two subgroups：the treatment group and the control group.The cases of control group and treatment group were given routine drugs and routine drugs plus fenofibrate treatment for 12 weeks respectively.The vision,retinal morphology and changes in levels of serum Lp-PLA2 of two groups were compared before and after treatment.ResultsAfter 12 weeks of fenofibrate treatment,the levels of Lp-PLA2（P〈0.01）and vascular endothelial growth factor（VEGF）（P〈0.05）in NPDR patients were decreased,the levels of Lp-PLA2（P〈0.01）and VEGF（P〈0.05）in PDR patients were decreased.The effective rates of visual acuity and fundus lesions were improved in NPDR patients more than those in control group（P〈0.05）.Conclusion Fenofibrate treatment can significantly reduce levels of serum Lp-PLA2 and VEGF in patients with DR.Fenofibrate treatment of NPDR patients can significantly improve the visual acuity and fundus lesions,delay the progression of retinopathy.

关 键 词：糖尿病视网膜病变 非诺贝特 脂蛋白相关磷脂酶A2 血管内皮生长因子 

分 类 号：R587.2[医药卫生—内分泌]