阿托伐他汀联合前列地尔治疗糖尿病视网膜病变的临床研究  

Clinical study on atorvastatin combined with alprostadil in treatment of diabetic retinopathy

作　　者：张晓娟[1] 张洁 许寅聪 秦静 娄萍萍[1] 周亚茹[1] ZHANG Xiao-juan;ZHANG Jie;XU Yin-cong;QIN Jing;LOU Ping-ping;ZHOU Ya-ru(NO.1Department of Endocrine,the Third Hospital of Hebei Medical University,Shijiazhuang 050051,China;Department of Ophthalmology,980 Hospital of Joint Logistics Support Force of PLA,Shijiazhuang 050051,China)

机构地区：[1]河北医科大学第三医院内分泌一科,河北石家庄050051 [2]解放军联勤保障部队第980医院眼科,河北石家庄050051

出　　处：《现代药物与临床》2021年第1期106-110,共5页Drugs & Clinic

基　　金：河北省卫生厅指令性项目(20160149)。

摘　　要：目的探讨阿托伐他汀联合前列地尔注射液治疗糖尿病视网膜病变的临床疗效。方法选取河北医科大学第三医院2018年6月—2019年1月收治的糖尿病视网膜病变患者72例,随机分为对照组(36例)和治疗组(36例)。对照组静脉滴注前列地尔注射液,10μg加入100 mL生理盐水,1次/d。治疗组患者在对照组的基础上口服阿托伐他汀钙片,初始剂量1片/次,1次/d,后续逐渐增加至4片/次,1次/d。两组患者均连续治疗1个月。观察两组患者临床疗效,同时比较治疗前后两组患者血清细胞间黏附分子-1(ICAM-1)、肿瘤坏死因子-α(TNF-α)、超敏C反应蛋白(hs-CRP)、白细胞介素-10(IL-10)、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)和高密度脂蛋白胆固醇(HDL-C)水平以及眼底微动脉瘤数目。结果治疗后,对照组临床有效率为72.22%,显著低于治疗组的91.67%,两组比较差异有统计学意义(P<0.05)。治疗后,两组患者眼底微动脉瘤数目均明显降低(P<0.05),且治疗组降低更明显(P<0.05)。治疗后,两组患者血清ICAM-1、TNF-α、hs-CRP、TC、TG、LDL-C水平明显降低(P<0.05),而IL-10和HDL-C水平明显升高(P<0.05),且治疗组比对照组改善更明显(P<0.05)。结论阿托伐他汀联合前列地尔注射液治疗糖尿病视网膜病变临床疗效显著,可有效改善血清炎症因子和血脂水平,且安全性高,具有一定的临床推广应用价值。Objective To investigate the clinical efficacy of atorvastatin combined with alprostadil in treatment of diabetic retinopathy. Methods Patients(72 cases) with diabetic retinopathy in the Third Hospital of Hebei Medical University from June 2018 to January 2019 were randomly divided into control(36 cases) and treatment(36 cases) groups. Patients in the control group were iv administered with Alprostadil Injection, 10 μg added into normal saline 100 mL, once daily. Patients in the treatment group were po administered with Atorvastatin Calcium Tablets on the basis of the control group, the initial dose was 1 tablet/time, once daily, and gradually increased to 4 tablets/time, once daily. Patients in two groups were treated for 1 month. After treatment, the clinical efficacy was evaluated, and the serum levels of ICAM-1, TNF-α, hs-CRP, IL-10, TC, TG, LDL-C and HDL-C, and the number of fundus microaneurysms in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control group was 72.22%, which was significantly lower than 91.67% in the treatment group, and there were differences between two groups(P < 0.05). After treatment, the number of fundus microaneurysms in two groups was significantly decreased(P < 0.05), and which in the treatment group was significantly less than that in the control group(P < 0.05). After treatment, the serum levels of ICAM-1, TNF-α, hs-CRP, TC, TG, LDL-C in two groups was significantly decreased(P < 0.05), but the levels of IL-10 and HDL-C were significantly increased(P < 0.05), and these indexes in the treatment group were significantly better than those in the control group(P < 0.05). Conclusion Atorvastatin combined with alprostadil has a significant clinical effect in treatment of diabetic retinopathy, which can effectively improve serum inflammatory factors and blood lipid levels with high safety, which has a certain clinical application value.

关 键 词：阿托伐他汀钙片 前列地尔注射液 糖尿病 视网膜病变 细胞间黏附分子-1 超敏C反应蛋白 低密度脂蛋白胆固醇 

分 类 号：R977[医药卫生—药品]