罗格列酮钠对非增生性糖尿病视网膜病变的作用

目的探讨针对早期糖尿病视网膜病变的治疗药物和敏感的监测方法。方法选择40～70岁的2型糖尿病合并非增生性糖尿病视网膜病变的患者,共82例,分为罗格列酮钠组和二甲双胍组,各41例。均强化控制血糖治疗,随访1年。研究前及6个月、12个月检测体质量指数、血压、临床生化指标、糖化血红蛋白、眼底荧光造影检查及多焦视网膜电图检查。每月访视1次,监测血压、血糖;3个月检测1次糖化血红蛋白。结果多焦视网膜电图检查P1波振幅12个月时2组各环均明显改善,与基线值比较差异有统计学意义(P<0.01),且罗格列酮钠组优于二甲双胍组,差异具有统计学意义(P<0.05)。眼底荧光造影检查,观察前后及组间对照差异无统计学意义(P>0.05)。结论罗格列酮钠对非增生性糖尿病视网膜病变具有独特的治疗作用,多焦视网膜电图检查对早期糖尿病视网膜病变检测更敏感。

Effect of Rosiglitazone Sodium on Nonproliferative Diabetic Retinopathy in patients with Type 2 Diabetes

Objective To evaluate the effect of rosiglitazone on non-proliferative diabetic retinopathy and the sensitivity of multifocal electroretinogram(mf-ERG) in detecting and monitoring early diabetic retinopathy. Methods Eighty-two patients who were 40 to 70 years old with type 2 diabetes mellitus and non-proliferative diabetic retinopathy who had no severe heart, brain hepatic, or renal diseases were enrolled in this study. These patients were randomized to receive either rosiglitazone sodium(rosiglitazone group) or metformin(metformin group) for intensified blood glucose control. All the participants were followed up for 1 year. BMI, blood pressure, HbA1c, biochemical characteristics, fundus inspection and multifocal electroretinogram(mf-ERG) and fluorescence fundus angiography(FFA) were performed before, during and after the treatment in the two groups. Results The mf-ERG showed that oscillatory potentials amplitude of P1 in rosiglitazone group were higher than that in metformin group at 12th months of follow up, the difference was significant. FFA status of rosiglitazone group and metformin group had no significant difference after 6 and 12 months follow-up. Conclusion Rosiglitazone sodium has a special therapeutic effect for the patients with non-proliferative diabetic retinopathy, and mf-ERG is more sensitive than other methods to detect early diabetic retinopathy.