胰高血糖素样肽-1治疗早期糖尿病视网膜病变的临床研究  

Glucagon-like peptide-1(GLP-1) analogues for the treatment of early diabetic retinopathy

作　　者：雷雨 郑宏华 陈小红 梅雪 陈梅珠 LEI Yu;ZHENG Hong-Hua;CHEN Xiao-Hong;MEI Xue;CHEN Mei-Zhu(Fuzhou General Hospital,Dongfang Hospital Affiliated to Xiamen University,Clinical Medical College of Fujian Medical University,Fuzhou 350025,Fujian Province,China)

机构地区：[1]福州总医院、厦门大学附属东方医院、福建医科大学福总临床医学院,福建省福州市350025

出　　处：《眼科新进展》2018年第7期656-659,共4页Recent Advances in Ophthalmology

基　　金：福建省科技重点项目基金资助(编号:2016Y0067)。

摘　　要：目的观察胰高血糖素样肽-1(glucagon-like peptide-1,GLP-1)的类似物(利拉鲁肽)治疗轻、中度非增生期糖尿病视网膜病变(non-proliferative diabetic retinopathy,NPDR)的临床疗效。方法收集我院内分泌科治疗的2型糖尿病合并轻、中度NPDR的患者60例。随机分为试验组和对照组,试验组患者采用二甲双胍+胰岛素联合利拉鲁肽强化控制血糖,对照组使用二甲双胍+胰岛素降低血糖。比较治疗前和治疗后3个月所有患者视网膜病变分期、黄斑区视网膜厚度和视网膜电图(electroretinogram,ERG)的振荡电位(oscillatory potentials,OPs)总波幅值。结果治疗后3个月2组患者糖尿病视网膜病变(diabetic retinopathy DR)临床分期差异无统计学意义(P>0.05);试验组治疗前及治疗后黄斑区视网膜厚度分别是(284.98±28.54)μm、(278.84±27.98)μm,差异有统计学意义(P<0.01),对照组治疗前后及2组患者治疗后黄斑区视网膜厚度对比差异均无统计学意义(均为P>0.05)。试验组OPs总波幅治疗前后分别是(140.99±38.34)μV、(157.18±40.33)μV,差异有统计学意义(P=0.000);对照组OPs总波幅治疗前后分别是(140.80±38.60)μV、(133.76±43.29)μV,差异有统计学意义(P=0.015);治疗后试验组OPs总波幅较对照组高,差异有统计学意义(P=0.006)。结论 GLP-1类似物可以延缓轻、中度NPDR的进展,对其预后有着积极的作用。Objective To investigate the clinical effect of glucagon-like peptide-1(GLP-1)analogues(liraglutide)on mild and moderate nonproliferative diabetic retinopathy(NPDR).Methods Sixty patients with type 2 diabetes mellitus and mild to moderate nonproliferative diabetic retinopathy(NPDR)were collected and randomly divided into experimental group and control group.And patients in the experimental group were treated with metformin plus insulin combined with liraglutide to control blood glucose,while metformin plus insulin for the patients in the control group.Then the staging of retinopathy,macular retinal thickness and total oscillatory potentials(OPs)of the full-field electroretinogram(F-ERG)of all patients before and at 3 months after treatment were compared and analyzed.Results There was no significant difference in the clinical staging of diabetic retinopathy(DR)between the two groups 3 months after treatment(P>0.05).The macular retinal thickness in the experimental group was(284.98±28.54)μm before treatment and(278.84±27.98)μm after treatment,and the difference was statistically significant(P<0.01).There was no significant difference in macular retinal thickness before and after treatment between the control group and the two groups after the treatment(all P>0.05).The total amplitude of Ops in the experimental group was(140.99±38.34)μV before treatment and(157.18+40.33)μV after treatment,and the difference was statistically significant(P<0.01).The total Ops amplitude of the control group before and after treatment was(140.80±38.60)μV and(133.76±43.29)μV,and the difference was statistically significant(P=0.015).The total amplitude of Ops in the experimental group after treatment was higher than that in the control group(P=0.006).Conclusion GLP-1 analogues can delay the progression of mild and moderate NPDR and have a positive effect on its prognosis.

关 键 词：GLP-1类似物 黄斑区视网膜厚度 振荡电位 糖尿病视网膜病变 

分 类 号：R774[医药卫生—眼科]