胰激肽原酶治疗早期糖尿病性视网膜病变的初步研究

目的：探讨早期糖尿病性视网膜病变（diabetic retinopathy,DR)对视盘及黄斑部视网膜血流的影响及与吲哚青绿血管造影（indocyanine green angiography,ICGA)中黄斑部脉络膜血管充盈时间（choriocapillaris filling phase,CFP)、黄斑中心凹无血管区（foveal avascular zone,FAZ)的关系，评价胰激肽原酶肠溶片（pancreatic kiniogenase tablets，商品名：怡开）对视盘及黄斑部视网膜血流动力学的影响。方法：对30例（60只眼）早期DR及49例（98只眼）正常对照组进行ICGA与荧光素血管同步造影及共焦扫描激光多普勒视网膜血流分析仪(heilberg retina flowmeter,HRF)检查。结果：早期DR组的视盘及黄斑部视网膜的血流量、流速及红细胞移动速率均低于正常对照组，二者差异有非常显著性意义（P＜0．01）；经怡开治疗后视盘及黄斑部视网膜的血流量、流速及红细胞移动速率均较治疗前有显著或非显著性意义（P＜0．01或P＜0．05）；CFP与黄斑视网膜的血流量、流速及红细胞移动速率呈负显著相关（P＜0．05）。结论：早期DR视盘及黄斑部视网膜毛细血管血流已发生改变，怡开可能改善DR患者的微循环障碍，HRF可评价其治疗效果。

Primary study of Pancreatic Kininogenase Tablets treating primary diabetic retinopathy

Objective To study that primary diabetic retinopathy(DR)affect blood flow of optic and macular retina,and in relation to choriocapillaris filling phase(CFP),foveal avascular zone(FAZ)in indocyanine green angiography(ICGA).To evaluate change of blood flow of optic and macular retina after Pancreatic Kininogenase Tablets treating.Methods 30 patients(60 eyes)of DR and 49 control subjects(98 eyes) undertook ICGA,FFA and Heidelberg Retina Flowmeter(HRF).Results The blood flow volume(VOL),blood flow velocity(FLW)and the erythrocyte flow velocity(VEL)of optic and macular retina of DR were lower those of control subject(P<0.01).VOL,FLW and VEL of optic and macular retina after treating have obvious difference to compare with those before treating(P<0.01 or P<0.05).CFP was negative relation with VOL,FLW adn VEL of optic and macular retina (P<0.05).Conclusion The blood flow of optic and macular retina already change in primary DR.PKT maybe improve microcirculation disturbance.HRF can evaluate curative effect.