二甲双胍治疗早期糖尿病性视网膜病变临床研究  

Clinical Study of Metformin in the Treatment of Early Diabetic Retinopathy

作　　者：刘会华 陈敏 杨瑾 LIU Huihua;CHEN Min;YANG Jin(Yingcheng People's Hospital,Xiaogan,Hubei,China 432400;Wuhan Central Hospital,Wuhan,Hubei,China 430014)

机构地区：[1]湖北省应城市人民医院,湖北孝感432400 [2]湖北省武汉市中心医院,湖北武汉430014

出　　处：《中国药业》2021年第13期93-95,共3页China Pharmaceuticals

基　　金：湖北省自然科学基金[2018CFB296]。

摘　　要：目的探讨二甲双胍治疗早期糖尿病性视网膜病变(DR)的疗效,以及对患者血清肿瘤坏死因子-α(TNF-α)、超敏C反应蛋白(hs-CRP)、细胞间黏附分子1(ICAM-1)水平的影响。方法选取湖北省应城市人民医院2019年2月至12月收治的早期DR患者100例,按随机数字表法分为对照组和观察组,各50例。两组患者均予阿卡波糖治疗,观察组患者加用二甲双胍治疗,均持续治疗3个月。结果观察组视力改善、眼底改变的总有效率分别为84.00%和86.00%,显著高于对照组的62.00%和60.00%(P<0.05);治疗后,两组患者微动脉瘤、眼底出血、黄斑水肿的发生率均较治疗前显著下降,且观察组上述3种视网膜病变发生率均显著低于对照组(P<0.05);治疗后,两组患者血清TNF-α,hs-CRP,ICAM-1水平均较治疗前显著下降,且观察组上述3种血清学指标水平均显著低于对照组(P<0.05);两组患者不良反应发生率无显著差异(P>0.05)。结论二甲双胍治疗早期DR疗效良好,可有效降低患者的血清TNF-α,hs-CRP,ICAM-1水平,且安全性较好。Objective To investigate the efficacy of metformin in the treatment of early diabetic retinopathy(DR)and its effect on the levels of serum tumor necrosis factor-α(TNF-α),high sensitivity C-reactive protein(hs-CRP)and intercellular adhesion molecule-1(ICAM-1).Methods A total of 100 patients with early DR admitted to the Yingcheng People’s Hospital from February to December2019 were selected and randomly divided into the control group and the observation group according to the random number table method,50 cases in each group.The patients in the two groups were treated with Acarbose Tablets,on this basis,the patients in the observation group were treated with Metformin Hydrochloride Enteric-Coated Tablets.Both groups were continuously treated for three months.Results The total effective rates of visual acuity improvement and fundus change in the observation group were 84.00% and 86.00%,respectively,which were significantly higher than 62.00% and 60.00% in the control group(P<0.05).After treatment,the incidences of microaneurysm,fundus hemorrhage and macular edema in the two groups were significantly lower than those before treatment,and the those in the observation group were significantly lower than those in the control group(P<0.05).After treatment,the levels of serum TNF-α,hs-CRP and ICAM-1 in the two groups were significantly lower than those before treatment,and those in the observation group were significantly lower than those in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Metformin is effective and safe in the treatment of patients with early DR,which can effectively reduce the levels of serum TNF-α,hs-CRP and ICAM-1.

关 键 词：二甲双胍 早期糖尿病性视网膜病变 疗效 肿瘤坏死因子-Α 超敏C反应蛋白 细胞间黏附分子1 

分 类 号：R969.4[医药卫生—药理学] R977.15[医药卫生—药学]