普罗布考对早期糖尿病视网膜病变患者氧化应激水平及黄斑水肿作用观察

目的 研究普罗布考对非增殖型糖尿病变视网膜病变（NPDR）患者血脂、血清总抗氧化能力（TAOC）、丙二醛（MDA）浓度、超氧化物歧化酶（SOD）水平及黄斑水肿的影响,为普罗布考防治早期DR提供临床依据.方法 纳入66例伴NPDR的2型糖尿病患者127眼,随机分为对照组和治疗组：对照组进行强化降血糖、血压治疗,治疗组在强化治疗基础上加用普罗布考0.375 g,2次/d,口服,总疗程为12月.治疗前后两组患者均进行了血脂、氧化应激指标及眼底荧光血管造影检查.结果 共有62例120眼完成研究,普罗布考组患者总胆固醇（TC）[（3.6±0.58）mmol/L VS（4.71±0.61）mmol/L,t=7.65,P＜0.01]、甘油三酯（TG）[（1.07±0.35）mmol/L VS（1.23±0.43）mmol/L,t=2.02,P＜0.05]、低密度脂蛋白胆固醇（LDLC）[（2.0±0.47）mmol/LVS（2.55±0.56）mmol/L,t=4.18,P＜0.01]及丙二醛（MDA）[（10.35±2.97）nmol/L VS（14.83±2.75）nmol/L,t=6.18,P＜0.01]水平降低,患者总抗氧化能力（TAOC）[（19.25±4.11）u/ml VS（16.63±3.27）u/ml,t=3.57,P＜0.01]及超氧化物歧化酶（SOD）[（94.52±10.28）u/ml VS（75.37±9.87）u/ml,t=8.62,P＜0.01]水平显著提高,且患者眼底黄斑水肿有明显减轻（Х^2=4.219,P＜0.05）.结论 普罗布考对于NDPR患者除了降脂作用外,还具有明显的抗氧化作用,显著降低患者黄斑水肿发生率,提示普罗布考对NDPR患者具有一定的治疗作用.

Observation of oxidative stress condition and macular edema in patients of early diabetic retinopathy treated by probucol

Objective To study the influence of probucol on the diabetic mellitus patients with non-proliferative diabetic retinopathy (NPDR) about blood lipids,serum level of the total antioxidant capacity (TAOC),malondialdehyde (MDA),superoxide dismutase (SOD) and macular edema,so as to provide clinical basis for the prevention and treatment of early DR by probucol.Methods 66 type 2 diabetes patients with 127 NPDR eyes were included.Patients were random divided into control and treatment groups,the control group was treated by intensive therapy of blood glucose and blood pressure control,and the treatment group was treated with the intensive therapy and probucol 0.375g,2 times a day for 12 months.Before and after treatment,the blood lipids,oxidative stress indicators and fundus fluorescein angiography in both groups had been determined.Results 62 cases with 120 eyes were enrolled in this study.Probucol obviously decreased levels of total cholesterol (TC) [ (3.6 ± 0.58) mmol/L VS (4.71 ± 0.61)mmol/L,t = 7.65,P ＜ 0.01 ],triglyceride (TG) [ (1.07 ± 0.35) mmol/L VS (1.23 ± 0.43) mmol/L,t = 2.02,P ＜ 0.05 ],low density lipoprotein cholesterol (LDLC) [ (2.0 ± 0.47) mmol/L VS (2.55 ±0.56)mmol/L,t =4.18,P ＜0.01] and MDA[ (10.35 ±2.97)nmol/L VS (14.83 ±2.75)nmol/L,t =6.18,P ＜0.01] in plasma of the patients.Levels of TAOC [(19.25±4.11)u/ml VS (16.63 ±3.27)u/ml,t =3.57,P ＜0.01 ]and SOD[ (94.52 ± 10.28)u/ml VS (75.37 ± 9.87) u/ml,t =8.62,P ＜0.01]were significantly improved in the probucol group,and the macular edema was significantly reduced in patients of the probucol group(x2 =4.219,P ＜0.05).Conclusion Probucol regulated serum lipids,and it had the apparent action of antioxidant,and it decreased the incidence of macular edema.Probucol had a therapeutic effect in patients with NDPR.