达格列净对2型糖尿病非增殖期视网膜病变的影响  

Effect of Dapagliflozin on Non-proliferative Diabetic Retinopathy in Type 2 Diabetes Mellitus

作　　者：李青[1] 周国艳[1] 瞿子春 阳丽辉 LI Qing;ZHOU Guoyan;QU Zichun;YANG Lihui(Xiangdong Hospital Affiliated to Hunan Normal University,Liling 412200,China;不详)

机构地区：[1]湖南师范大学附属湘东医院,湖南醴陵412200

出　　处：《中外医学研究》2024年第16期26-30,共5页CHINESE AND FOREIGN MEDICAL RESEARCH

基　　金：2021年度湖南省教育厅科学研究项目(21C0025)。

摘　　要：目的:探讨达格列净对2型糖尿病非增殖期视网膜病变(non-proliferative diabetic retinopathy,NPDR)的影响。方法:选取2021年10月—2023年6月湖南师范大学附属湘东医院收治的88例2型糖尿病NPDR患者。随机将其分为观察组及对照组,各44例。两组均给予常规降糖治疗,观察组加用达格列净治疗。比较两组治疗前后血糖指标及相关指标。分析血管内皮生长因子(vascular endothelial growth factor,VEGF)与血糖波动指标的相关性。结果:治疗后,两组空腹血糖(fasting blood glucose,FBG)、餐后2 h血糖(2 h postprandial blood glucose,2 h PBG)、糖化血红蛋白(glycosylated hemoglobin,HbA1c)、血糖水平标准差(standard deviation of blood glucose,SDBG)、餐后血糖波动幅度(postprandial glucose excursion,PPGE)、最大血糖波动幅度(large amplitude glycemic excursion,LAGE)均下降,观察组SDBG、PPGE、LAGE均低于对照组,差异有统计学意义(P<0.05)。治疗后,两组VEGF、黄斑中心凹厚度均下降,最佳矫正视力(best-corrected visual acuity,BCVA)升高,观察组VEGF、黄斑中心凹厚度均低于对照组,BCVA高于对照组,差异有统计学意义(P<0.05)。Pearson相关性分析结果显示:VEGF与SDBG、PPGE、LAGE均呈正相关(P<0.05)。结论:达格列净能够改善血糖波动,降低VEGF水平,对2型糖尿病NPDR有保护作用。Objective:To investigate the effect of Dapagliflozin on non-proliferative diabetic retinopathy(NPDR)in type 2 diabetes mellitus.Method:A total of 88 NPDR patients in type 2 diabetes mellitus treated in Xiangdong Hospital Affiliated to Hunan Normal University from October 2021 to June 2023 were selected.They were randomly divided into observation group and control group,44 cases in each group.Both groups were given routine hypoglycemic treatment,and observation group was given Dapagliflozin treatment.Blood glucose indexes and related indexes were compared between the two groups before and after treatment.The correlation between vascular endothelial growth factor(VEGF)and blood glucose fluctuation index was analyzed.Result:After treatment,fasting blood glucose(FBG),2 h postprandial blood glucose(2 h PBG),glycosylated hemoglobin(HbA1c),standard deviation of blood glucose(SDBG),postprandial glucose excursion(PPGE)and large amplitude glycemic excursion(LAGE)all decreased,SDBG,PPGE and LAGE in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).After treatment,VEGF and macular fovea thickness decreased,and the best-corrected visual acuity(BCVA)increased in both groups,VEGF and macular fovea thickness in observation group were lower than those in control group,and BCVA was higher than that in control group,the differences were statistically significant(P<0.05).Pearson correlation analysis showed that VEGF was positively correlated with SDBG,PPGE and LAGE(P<0.05).Conclusion:Dapagliflozin can improve blood glucose fluctuation,reduce VEGF level,and has a protective effect on NPDR in type 2 diabetes.

关 键 词：钠-葡萄糖协同转运蛋白2抑制剂 达格列净 2型糖尿病非增殖期视网膜病变 血糖波动 血管内皮生长因子 

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