高压氧联合胰激肽原酶对老年糖尿病伴视网膜病变患者的相关性影响  

Intervention analysis of hyperbaric oxygen combined with pancreatic kininogenase on retinal blood flow and VEGF in elderly diabetic retinopathy patients

作　　者：李婧[1] 任卫东[1] 王敏敏[1] 张丽茜[1] 崔婧[2] LI Jing;REN Weidong;WANG Minmin;ZHANG Liqian;CUI Jing(Department of Endocrinology,The First Affiliated Hospital of Hebei North University,Zhangjiakou 075000,Shijiazhuang,China;Department of Severe Medicine,The First Affiliated Hospital of Hebei North University,Zhangjiakou 075000,Shijiazhuang,China)

机构地区：[1]河北北方学院附属第一医院内分泌科,河北张家口075000 [2]河北北方学院附属第一医院重症医学科,河北张家口075000

出　　处：《西部医学》2018年第10期1462-1466,1470,共6页Medical Journal of West China

基　　金：国家自然科学基金资助项目(81571383)

摘　　要：目的探讨高压氧联合胰激肽原酶对老年糖尿病伴视网膜病变(DR)患者视网膜血流、血管内皮生长因子(VEGF)的影响。方法选取我院收治的老年DR患者146例,按随机数字表法分为对照组和研究组,每组各73例(146眼),对照组予以安慰剂治疗,研究组予以高压氧联合胰激肽原酶治疗,比较两组间视网膜血流动力学指标、血清VEGF、胰岛素样生长因子(IGF-1)、碱性成纤维细胞生长因子(bFGF)水平、血清炎性细胞因子水平、临床疗效及不良反应发生率。结果对照组有效率低于研究组,差异有统计学意义(P<0.05);与对照组比较,研究组治疗后视网膜中央动脉VPS、VED水平较高,RI水平较低,治疗后血清VEGF、IGF-1、bFGF水平较低,治疗后血清超敏C反应蛋白(hs-CRP)、白细胞介素(IL-6)水平较低,差异有统计学意义(P<0.05);治疗中出现的不良反应为胃部不适、头晕、耳鸣、倦怠,两组不良反应发生率差异无统计学意义(P>0.05)。结论高压氧联合胰激肽原酶能有效改善老年DR患者视网膜血流动力学指标,降低血清VEGF、IGF-1、bFGF及炎性细胞因子水平,抑制血管增殖和炎症反应,临床疗效和安全性较好。Objective To investigate the effect of hyperbaric oxygen combined with pancreatic kininogenase on retinal blood flow and vascular endothelial growth factor（VEGF）in elderly diabetic retinopathy（DR）patients.Methods 146 elderly patients with DR in our hospital were selected and divided into 2 groups.73 cases were in the control group treated with pancreatic kininogenase.73 cases were in the experiment group treated with hyperbaric oxygen on the basis of control group.The retinal hemodynamic parameters,serum VEGF,insulin-like growth factor（IGF-1）,basic fibroblast growth factor（bFGF）levels,and serum levels of inflammatory cytokines,clinical efficacy and incidence of adverse reaction were compared.Results The effective rate in the control group（67.81%）was lower than that in the experiment group（78.77%）,and the difference was statistically significant（P〈0.05）.Compared with the control group,the levels of VPS and VED in the central retinal artery were higher.The level of RI was lower after treatment in the experiment group.The levels of serum VEGF,IGF-1 and bFGF were lower after treatment.The levels of serum hypersensitivity C reactive protein（hs-CRP）,interleukin-6（IL-6）were lower after treatment,with significant difference（P〈0.05）.The adverse reactions included Stomach upset,dizziness,ringing in the ears and tiredness,and there was no significant difference in the incidence of adverse reactions between the two groups（P〉0.05）.Conclusion Hyperbaric oxygen combined with pancreatic kininogenase can effectively improve the retinal hemodynamic indexes in elderly patients with DR,reduce serum VEGF,IGF-1,bFGF and inflammatory cytokine levels,inhibit the proliferation of blood vessels and inflammatory response,and the clinical efficacy and safety are good.

关 键 词：高压氧 胰激肽原酶 糖尿病伴视网膜病变 视网膜血流 VEGF 

分 类 号：R587.2[医药卫生—内分泌]