羟苯磺酸钙联合复方血栓通胶囊治疗老年糖尿病视网膜病变的疗效及对血液流变学的影响

目的探讨羟苯磺酸钙联合复方血栓通胶囊治疗老年糖尿病视网膜病变患者的疗效及对血液流变学的影响。方法选取老年糖尿病视网膜病变患者86例。按随机数字表法,将患者分为对照组(羟苯磺酸钙治疗,n=42)与观察组(羟苯磺酸钙联合复方血栓通胶囊治疗,n=44)。治疗5个月后对所有患者临床疗效及不良反应进行评价,观察两组出血斑面积、黄斑厚度、血管瘤体积及视野灰度值的变化情况,比较两组血浆黏度、全血高切黏度、纤维蛋白原及全血低切黏度。结果观察组总有效率(86.36%)明显高于对照组(66.67%,P<0.05)。治疗后,两组出血斑面积、黄斑厚度、血管瘤体积及视野灰度值均明显低于治疗前,且观察组明显低于对照组(P<0.05)。两组血浆黏度、全血高切黏度、纤维蛋白原及全血低切黏度均明显低于治疗前,且观察组明显低于对照组(P<0.05)。观察组不良反应发生率(6.82%)与对照组(9.52%)比较差异无统计学意义(P>0.05)。结论羟苯磺酸钙联合复方血栓通胶囊可明显改善老年糖尿病视网膜病变患者临床症状及血液流变学水平,且安全有效。     

羟苯磺酸钙的临床应用进展

本文综述羟苯磺酸钙的临床应用进展。新近的研究除肯定其对糖尿病视网膜病变的防治作用外，还发现共对急性心肌梗塞有显著疗效，并适用于慢性静脉功能不全的治疗。     

羟苯磺酸钙胶囊治疗周围神经病变观察

将56例DPND患者随机分成2组,各28例,对照组采用常规治疗方法,治疗组加用羟苯硫酸钙胶囊1#Tid po.结果：治疗8周后,羟苯磺酸钙胶囊对改善临床症状的总有效率为75%。较对照组53.6%有显著性差异（P〈0.01）;对神经传导速度改善率为53.6%,较对照组21.4%有显著性差异（P〈0.01）。结论：羟苯磺酸钙胶囊对改善DPNP患者的临床症状有显著疗效,且可以改善神经传导速度。     

羟苯磺酸钙胶囊治疗周围神经病变观察

将56例DPND患者随机分成2组,各28例,对照组采用常规治疗方法.治疗组加用羟苯硫酸钙胶囊1#Tid po.结果治疗8周后,羟苯磺酸钙胶囊对改善临床症状的总有效率为75%.较对照组53.6%有显著性差异(P＜0.01);对神经传导速度改善率为53.6%,较对照组21.4%有显著性差异(P＜0.01).结论羟苯磺酸钙胶囊对改善DPNP患者的临床症状有显著疗效,且可以改善神经传导速度.     

羟苯磺酸钙联合利拉鲁肽治疗糖尿病性视网膜病变的临床效果

目的 研究糖尿病视网膜病变(DR)患者予羟苯磺酸钙联合利拉鲁肽(GLP-1受体激动剂)治疗的临床疗效。方法 选取2020年1—12月于靖江市人民医院内分泌及眼科门诊进行治疗的72例DR患者作为研究对象,以单盲形式将研究对象,分为对照组、研究组,各36例,对照组使用羟苯磺酸钙治疗糖尿病视网膜病变,研究组在对照组的基础上,加用皮下注射利拉鲁肽治疗,对比两组患者治疗效果。结果 研究组治疗的总有效率为94.44%,高于对照组,差异有统计学意义(χ²=6.400,P<0.05);治疗后,研究组空腹血糖为(5.63±0.93)mmol/L、餐后2 h血糖为(8.33±0.75)mmol/L、视力水平为(0.56±0.28)、黄斑厚度为(175.26±15.65)μm,优于对照组,差异有统计学意义(t=2.359、6.489、2.814、5.091,P<0.05)。结论 应用羟苯磺酸钙联合利拉鲁肽方式对糖尿病性视网膜病变患者施以治疗,可以有效控制患者血糖水平,改善患者视力,值得在临床推广。     

羟苯磺酸钙胶囊治疗糖尿病周围神经病变60例观察

将60例糖尿病周围神经病变患者随机分成2组,各30例,对照组采用常规治疗方法,治疗组加用羟苯磺酸钙胶囊1#po Tid 结果:治疗8周后,羟苯磺酸钙胶囊对改善临床症状的总有效率为75%。较对照组54%有显著性差异(P0.01);对神经传导速度改善率为53.3%,较对照组16.6%有显著性差异(P0.01)。结论:羟苯磺酸钙胶囊对改善糖尿病周围神经病变患者的临床症状有显著疗效,且可以改善神经传导速度。     

羟苯磺酸钙治疗糖尿病微血管病变的疗效及对患者血糖水平的影响

目的 观察羟苯磺酸钙治疗糖尿病微血管病变的疗效及对患者血糖水平的影响分析。方法 选取2021年6—11月火箭军广州特勤疗养中心收治的糖尿病微血管病变患者100例,以随机数表法分成两组,各50例。对照组接受常规治疗,研究组对照组基础上联合羟苯磺酸钙治疗。比较两组患者治疗前后的血糖、血脂与凝血指标,评价治疗疗效。结果 治疗前,两组血糖、血脂比较,差异无统计学意义（P>0.05）;治疗后,各项血糖、血脂指标较治疗前均改善,且研究组血糖、血脂指标均优于对照组,差异有统计学意义（P<0.05）;治疗后,两组凝血酶原时间（PT）、凝血酶时间（TT）比较,差异无统计学意义（P>0.05）。结论 在糖尿病微血管病变治疗的药物选择上,羟苯磺酸钙治疗,相对于常规的治疗方式使患者的血糖指标水平与血脂水平显著降低,临床治疗的疗效显著提升,效果理想。     

大黄蜜虫丸对老年糖尿病视网膜病变患者血小板功能的影响

糖尿病视网膜病变(diabetic retinopathy，DRN)治疗较为困难，预后不良。大黄zhe虫丸治疗老年DRN有较好疗效，并对病人血小板活化有抑制作用。     

羟苯磺酸钙联合复方血栓通胶囊治疗早期糖尿病性视网膜病变的疗效及对血清IGF-1和VEGF水平的影响

目的探讨羟苯磺酸钙联合复方血栓通胶囊治疗早期糖尿病性视网膜病变(DR)患者的疗效及对血清中胰岛素样生长因子(IGF)-1和血管内皮细胞生长因子(VEGF)水平的影响。方法 DR患者68例,按照随机数字表法分为对照组和研究组各34例,对照组给予羟苯磺酸钙治疗,研究组给予羟苯磺酸钙联合复方血栓通胶囊治疗,两组均治疗3个月。对比两组治疗3个月后的临床总有效率,对比治疗前、治疗3个月后两组出血斑点面积、黄斑厚度、视野灰度值、微血管瘤数量、VEGF、IGF-1、舒张末期血流速度(EDV)及收缩期峰值血流速度(PSV)。结果治疗3个月后研究组临床总有效率显著高于对照组(P<0.05)。治疗3个月后两组出血斑点面积、黄斑厚度、视野灰度值、微血管瘤数量、VEGF和IGF-1较治疗前均显著降低,且研究组低于对照组,EDV和PSV显著升高,且研究组高于对照组(均P<0.05)。结论与单用羟苯磺酸钙治疗早期DR相比,羟苯磺酸钙联合复方血栓通胶囊治疗具有更好的临床疗效,可以更明显地降低患者出血斑点面积、黄斑厚度、视野灰度值、微血管瘤数量及VEGF、IGF-1水平,并提高EDV和PSV。     

老年糖尿病性视网膜病变患者血小板功能及其颗粒膜蛋白的变化

观察了２９例糖尿病无视网膜病变者和５２例糖尿病性视网膜病变者血小板聚集功能、血小板颗粒膜蛋白１４０（ＧＭＰ－１４０）及电游率（ＥＰＭ）的变化，并与健康老年人对照。结果表明，无视网膜病变者ＥＰＭ低于健康人组（Ｐ＜０．０１），而血小板集率及ＧＭＰ－１４０水平无明显变化。视网膜病变组血小板聚集率和ＧＭＰ－１４０明显高于健康人组（Ｐ＜０．０５），ＥＰＭ呈显著性降低（Ｐ＜０．０１），与无视网膜病变组比较，视网膜病变组血小板聚集率和ＧＭＰ－１４０水平升高（Ｐ＜０．０５，Ｐ＝０．０５），而ＥＰＭ水平低下（Ｐ＜０．０１）．提示老年人糖尿性视网膜病变者血小板聚集释放功能亢进，这可能是视网膜病变者视网膜微循环内微血栓形成的病理生理基础。     

The value of calcium dobesilate in the treatment of diabetic retinopathy

Summary The effect of calcium dobesilate on capillary resistance and background retinopathy was compared with placebo in a double-blind cross-over trial on 18 diabetics. Each treatment lasted 8 months. The trial produced no evidence in favour of a significant beneficial effect of calcium dobesilate on the capillary resistance in diabetics or on the course of the diabetic retinopathy.     

老年2型糖尿病视网膜病变患者骨密度变化的研究

目的探讨老年2型糖尿病(T2DM)合并视网膜病变患者骨密度(BMD)变化的特点。方法测定56例老年T2DM合并糖尿病视网膜病变患者(DR组)、60例无糖尿病视网膜病变T2DM患者(NDR组)和58例健康老年人(健康对照组)股骨颈、大转子、Ward's三角区(ward's)及前后位腰椎BMD,并检测血清骨钙素(BGP)、血钙(Ca)、血磷(P)、甲状旁腺激素(PTH)及Ⅰ型胶原降解产物(Crosslaps)/尿肌酐(Cr)水平。结果DR组的股骨颈的BMD低于健康对照组及NDR组〔分别为(0.66±0.15)、(0.76±0.15)、(0.81±0.18)g/cm2〕,差异有统计学意义(P<0.05及P<0.01);前后位腰椎各部位BMD在DR组BMD均高于健康对照组及NDR组(P<0.05)。DR组血清BGP显著低于健康对照组(P<0.01),与NDR组比较,差异无统计学意义(P>0.05);DR组血清PTH、P显著高于NDR组及健康对照组(P<0.05及P<0.01)。结论老年T2DM合并视网膜病变者的股骨近端BMD显著低于无视网膜病变糖尿病患者和健康人群,而腰椎各部位BMD水平则与之相反。     

Serum vaspin levels are positively associated with diabetic retinopathy in patients with type 2 diabetes mellitus

Aims/IntroductionVaspin is linked to obesity and its metabolic abnormalities. However, the role of vaspin serum levels in diabetic retinopathy (DR) is unknown. In the present study, we investigated the association between serum levels of vaspin and both DR and vision‐threatening DR.Materials and MethodsThis was a cross‐sectional single‐center observational study from December 2018 to September 2019. We evaluated circulating serum levels of vaspin in 372 participants with type 2 diabetes. DR was screened through detailed ocular examination. DR patients were also divided two groups: vision‐threatening DR and non‐vision‐threatening DR. The relationship between vaspin and DR was investigated by univariate and multivariate logistic regression analyses, and the results are shown as odds ratios with 95% confidence intervals.ResultsThe vaspin serum levels of 372 patients were obtained, with a median value of 1.50 ng/mL (interquartile range 0.94–2.18 ng/mL). The median age of those patients was 53 years (interquartile range 44–62 years), and 44.4% were women. Patients with DR and VDTR had significantly increased vaspin serum levels (P < 0.001 andP < 0.001). A multivariable regression model found that patients with high levels of vaspin were approximately 1.85‐fold (odds ratio for per unit increase 1.85, 95% confidence interval 1.43–2.55; P < 0.001) more likely to experience DR, and 3.76‐fold (odds ratio for per unit increase 3.76, 95% confidence interval 2.05–6.55; P < 0.001) more likely to experience VTDR. The predictive value of vaspin was stronger in women than in men.ConclusionHigher vaspin serum levels were associated with an increased risk of DR and VDTR in patients with type 2 diabetes, which showed that vaspin is an important indicator factor for DR.     

电话教育对糖尿病视网膜病变筛查的影响

目的 研究电话教育和邮寄教育材料对糖尿病患者完成视网膜病变筛查的影响.方法 300例既往未进行过糖尿病视网膜病变筛查的门诊2型糖尿病患者采用计算机完全随机法分为对照组、邮寄组和电话组,每组各100例.对照组患者进行常规诊疗,邮寄组与电话组患者除常规诊疗外,分别予邮寄糖尿病教育材料1次、电话进行糖尿病教育1次,比较3组患者在纳入研究后6个月内完成糖尿病视网膜病变筛查的情况.所有入组对象均完成人口与社会学资料登记并且记录在整个研究过程中的平均空腹血糖、餐后血糖及糖化血红蛋白情况.结果 3组患者性别、年龄、常住地、受教育程度、经济收入、就诊难易程度、自身对血糖控制的满意程度、对糖尿病视网膜病变的知晓情况、体重指数、糖尿病病程、空腹血糖、餐后血糖、糖化血红蛋白、慢性并发症情况均无统计学差异（P＞0.05）.3组患者视网膜病变筛查的完成率分别为26.0％（25/96）、16.2％（16/99）、45.7％（43/94）,差异具有统计学意义（x2=21.105,P＜0.05）.与对照组相比,电话组视网膜病变筛查完成率提高了75.8％（P＜0.01）,邮寄组的完成率较低,尚未达统计学差异（P＞0.05）.女性、受教育程度较高、糖尿病病程较长的患者更可能完成视网膜病变筛查.结论 电话教育是一种有效的促进糖尿病患者完成视网膜病变筛查的方法.     

老年糖尿病患者糖尿病视网膜病变的危险因素分析

目的探讨老年2型糖尿病患者糖尿病视网膜病变的患病率及相关危险因素。方法测定190例60岁及以上2型糖尿病患者糖化血红蛋白、胰岛素、C肽等各生化指标并检测眼底,根据眼底病变程度将患者分为糖尿病无视网膜病变(无病变组)、无增殖期视网膜病变(无增殖期组)及增殖期视网膜病变(增殖期组)3组,比较各组糖尿病病程及糖化血红蛋白等检测指标。结果无病变组103例,无增殖期组59例,增殖期组28例。3组糖尿病病程分别为(121.1±93.3)(、149.6±112.1)及(182.2±83.6)个月,差异有统计学意义(P<0.05);糖化血红蛋白分别为(8.7±2.3)、(9.7±2.1)及(9.5±1.8)%,差异有统计学意义(P<0.05);尿白蛋白(56.0±185.6)、(234.2±535.1)及(229.9±513.9)mg/L,(P<0.01)。Logistic回归结果显示糖尿病病程、尿白蛋白和糖化血红蛋白是糖尿病视网膜病变的独立危险因素(OR值分别为1.004、1.002和1.143)。结论在老年2型糖尿病视网膜病变患者中,糖尿病病程、尿白蛋白和糖化血红蛋白是3个独立的危险因素。     

The effect of calcium dobesilate on venous function following saphenectomy in coronary artery bypass grafting

BACKGROUND: The aim of this study was to determine whether prophylactic use of calcium dobesilate (CD) can improve venous function after saphenous vein harvest in coronary artery bypass graft (CABG). MATERIALS AND METHODS: A total of 100 patients who underwent elective CABG were divided into four equal groups. In Group A, the greater saphenous vein (GSV) was harvested below the knee and, in Group B, through the knee till the groin. These patients remained untreated. Group C received CD in a dosage of 1500 mg po daily after the GSV was harvested below the knee. Group D received same dosage of CD after the GSV was harvested through the knee till the groin. Venous function of ipsilateral leg was evaluated clinically and by Doppler ultrasonography in the postoperative first week and second month. RESULTS: Clinical findings of venous insufficiency were observed with a similar rate between groups at both early and late periods. In Groups A and B, after 2 months, flow velocities decreased and reflux periods increased significantly. In groups C and D, treatment with CD for 2 months after saphenectomy resulted in a significant increase in flow velocities and a significant decrease in reflux periods. Patients in Groups B and D have significantly more impaired venous functions. CONCLUSION: Saphenectomy results in ipsilateral leg venous dysfunction, which seems to be unrelated to leg swelling and to be more prominent in patients with high-level saphenectomy. In addition, to be careful about the restriction of the saphenectomy procedure into the most appropriate level, prophylactic use of CD can prevent this deterioration when it was added to varice socks.     

Assessment of awareness of diabetic retinopathy and utilization of eye care services among Turkish diabetic patients

AimsRaising awareness of diabetic retinopathy (DR) was shown to be a key element for early diagnosis and treatment of this blinding disease. There is very limited data about the knowledge level, attitude, and behavior of diabetic patients regarding DR in Turkey. This study was planned to assess the awareness of DR and the utilization of eye care services among Turkish diabetic patients.MethodsDiabetic patients who were under the care of ophthalmologists, endocrinologists, and/or primary care physicians were administered a questionnaire in order to assess their awareness of diabetes and its ocular complications.ResultsA total of 437 patients (51.8% female and 48.2% male) with a mean age of 55.2 ± 11.9 were included in the study. Of the 437 patients, 31.8% had not been educated about diabetes, 88.1% were aware that diabetes can affect the eyes, and 39.8% thought that diabetics with good glycaemic control might suffer from DR. While 86.7% thought that early diagnosis was possible in DR, 77.3% previously had eye examinations, and 41.9% stated that annual eye examinations were necessary for diabetics. An educational level of middle school or higher, duration of DM longer than 5 years, previous DM education, and recruitment from the university (ophthalmology department and endocrinology department) were associated with better awareness of DR. The independent factors associated with visiting an ophthalmologist on a regular basis were DM education, DM duration, and site of recruitment.ConclusionAlthough most of the patients know that DM affects the eye, there is a lack of appropriate knowledge and behavior about the management of DR. The importance of better control of DM and regular eye examination in the prevention of DR should be emphasized.     

The fluorescence of serum proteins in diabetic patients with and without retinopathy

Non-enzymatic glycosylation of long-lived proteins results in a characteristic fluorescence, known as protein 'browning'. The degree of fluorescence of skin collagen correlates with retinopathy in diabetes. We have therefore measured the fluorescence of serum albumin and IgG by a sensitive HPLC technique in 69 diabetic patients, 38 with retinopathy and 31 without complications, and in 26 age-matched controls. The fluorescence of the IgG fraction, calculated as the ratio of fluorescence (excitation 360 nm, emission 454 nm) to optical density (280 nm), was elevated in diabetic patients with retinopathy (1.5 +/- 0.5) compared with those without retinopathy (1.1 +/- 0.2, p less than 0.005) and control subjects (1.1 +/- 0.2, p less than 0.005). The fluorescence ratio for the albumin fraction was increased in all diabetic patients (11.2 +/- 2.7) compared with control subjects (8.9 +/- 1.5, p less than 0.001). There was no significant difference in the fluorescence ratios of albumin in those with and without retinopathy. The fluorescence of serum albumin and IgG were not significantly correlated with serum protein glycosylation measured by the fructosamine method.     

Impact of diabetic retinopathy on prognosis of patients with heart failure with preserved ejection fraction

Background and aimsDiabetic retinopathy (DR) is one of the most common microvascular complications of diabetes mellitus (DM), and could increase the risks of adverse cardiovascular events among DM patients. Since heart failure with preserved ejection fraction (HFpEF) and DM often coexist, our present study aimed to explore the associations of DR with adverse outcomes in HFpEF patients.Methods and resultsWe conducted this study in a large, international population suffering from HFpEF (n = 3442) based on the Treatment of Preserved Cardiac Function Heart Failure With an Aldosterone Antagonist (TOPCAT) trial. The associations of baseline DR with clinical outcomes were expressed as adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) using the Cox proportional hazard regression models. The crude incidence rates of all the outcomes studied were significantly increased when DM patients with or without DR compared to those without DM (all P < 0.05), whereas there were no differences between DM patients without DR versus those with DR (all P > 0.05). In the multivariate cox regression analysis, DR was not significantly associated with increased risks of the primary composite outcome (HR, 1.178 [95% CI, 0.870–1.596]) and secondary outcomes including all-cause death, cardiovascular death, all-cause hospitalization, hospitalization for HF, myocardial infarction, and stroke (all P > 0.05).ConclusionsOur results of current study suggested that DM but not DR could be regarded as an independent risk factor for the prognosis of HFpEF.Clinical trial registrationURL: https://clinicaltrials.gov. Unique identifier: NCT00094302.