递法明片辅助阿柏西普与激光治疗对DR患者血清Copeptin、VEGF水平的影响  

Effects of Difamin tablets assisted aflibercept and laser therapy on serum Copeptin and VEGF levels in patients with DR

作　　者：武圣洁 王晋峰[2] 王斗 WU Sheng-jie;WANG Jin-feng;WANG Dou(Department of Ophthalmology,Shanxi Integrated Traditional Chinese and Western Medicine Hospital,Taiyuan Shanxi 030001,China;Department of Ophthalmology,The First Hospital of Shanxi Medical University,Taiyuan Shanxi 030001,China)

机构地区：[1]山西省中西医结合医院眼科,山西太原030001 [2]山西医科大学第一医院眼科,山西太原030001

出　　处：《临床和实验医学杂志》2022年第22期2441-2445,共5页Journal of Clinical and Experimental Medicine

基　　金：山西省科技厅重点研发计划项目(编号:201803D31095)。

摘　　要：目的观察递法明片辅助阿柏西普与激光治疗对糖尿病视网膜病变(DR)患者血清和肽素(Copeptin)、血管内皮生长因子(VEGF)水平的影响。方法前瞻性将2020年4月至2022年4月在山西省中西医结合医院眼科接受治疗的100例重度非增殖期DR伴有黄斑水肿的患者作为对象,采用简单随机法分为两组。所有患者均给予全视网膜光凝治疗,对照组采用阿柏西普治疗,观察组采用递法明片联合阿柏西普治疗,连续治疗3个月。比较两组临床疗效、暗适应功能、视网膜血流动力学[阻力指数(RI)、收缩期血流峰值(PSV)、舒张末期血流速度(EDV)、平均血流速度(Vm)]及Copeptin、VEGF、丙二醛、单核细胞趋化蛋白-1(MCP-1)、肿瘤坏死因子-α(TNF-α)、超氧化物歧化酶(SOD)等相关因子以及不良反应的差异。结果观察组总有效率为94.00%(47/50),高于对照组的82.00%(41/50),但差异无统计学意义(P>0.05)。治疗后,两组患者的暗视视杆反应bT值、bA值较治疗前升高,而观察组暗视视杆反应bT值、bA值均高于对照组,差异均有统计学意义(P<0.05)。治疗后,两组患者的RI较治疗前下降,PSV、EDV、Vm较治疗前升高,而观察组患者的RI低于对照组,PSV、EDV、Vm均高于对照组,差异均有统计学意义(P<0.05)。两组患者的血清Copeptin、VEGF、丙二醛、MCP-1、TNF-α较治疗前下降,血清SOD则较治疗前升高,观察组患者的血清Copeptin、VEGF、MDA、MCP-1、TNF-α均低于对照组,SOD高于对照组,差异均有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论递法明片辅助阿柏西普与激光治疗DR可保护患者暗适应功能,改善视力和视网膜血流动力学,调节血清Copeptin、VEGF相关因子的表达。Objective To observe the effects of Difamin tablets assisted aflibercept and laser therapy on serum levels of Copeptin and vascular endothelial growth factor(VEGF)in patients with diabetic retinopathy(DR).Methods From April 2020 to April 2022,100 patients with DR accompanied with macular edema who were treated in the Department of Ophthalmology,Shanxi Integrated Hospital of Traditional Chinese and Western Medicine from April 2020 to April 2022 were prospectively divided into two groups by simple random method.All 100 patients were treated with panretinal photocoagulation.The control group was treated with arboxipril,and the observation group was treated with Difrarel combined with arboxipril for 3 months.The differences in curative effect,dark adaptation function,retinal hemodynamics[resistance index(RI),peak systolic velocity(PSV),end diastolic velocity(EDV),mean blood flow velocity(Vm)]and related factors such as Copeptin,VEGF,malondialdehyde,monocyte chemoattractant protein-1(MCP-1),tumor necrosis factor-α(TNF-α)and superoxide dismutase(SOD)were compared between the two groups.Results The total effective rate of the observation group was 94.00%(47/50),which was higher than that of the control group's 82.00%(41/50),but the difference was not statistically significant(P>0.05).After treatment,the bT and bA values of scotopic rod reaction in the two groups were higher than those before treatment,and the bT and bA values of scotopic rod reaction in the observation group were higher than those in the control group after treatment,the differences were statistically significant(P<0.05).After treatment,RI in the two groups decreased and PSV,EDV and Vm increased compared with that before treatment,while RI in the observation group was lower than that in the control group,and PSV,EDV and Vm were higher than those in the control group,the differences were statistically significant(P<0.05).After treatment,serum Copeptin,VEGF,MDA,MCP-1 and TNF-αin the two groups decreased compared with those before treatment,SOD were inc

关 键 词：糖尿病视网膜病变 递法明片 阿柏西普 激光 暗适应功能 视网膜血流动力学 

分 类 号：R587.2[医药卫生—内分泌] R774.1[医药卫生—内科学]