普罗布考治疗非增殖型糖尿病视网膜病变临床观察

目的 研究普罗布考对2型糖尿病非增殖型糖尿病视网膜病变患者血脂、抗氧化能力、视功能及眼底形态的影响,为普罗布考防治早期糖尿病视网膜病变提供临床依据.方法 纳入66例伴非增殖型糖尿病视网膜病变的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和降血压治疗,治疗组在强化治疗基础上口服普罗布考0.375 g,每天2次,总疗程为12个月.治疗前后两组患者均进行了血脂、血清总抗氧化能力、视力、眼底及眼底荧光血管造影检查.结果 共有62例120眼完成研究,普罗布考显著降低了患者总胆固醇、甘油三酯和低密度脂蛋白胆固醇水平,显著提高患者总抗氧化能力和视力(P<0.01),明显改善患者眼底微血管瘤、出血及渗出,且显著降低患者眼底黄斑水肿(P<0.05),对于减少毛细血管无灌注区也有一定作用.结论 普罗布考对于非增殖型糖尿病视网膜病变患者除了降脂作用外,还可提高患者总抗氧化能力,改善患者视功能,降低患者视网膜微血管病变及降低患者黄斑水肿发生率,提示普罗布考对非增殖型糖尿病视网膜病变患者具有一定的治疗作用.

Effection of Probucol on the Treatment of Non-Proliferative Diabetic Retinopathy

Aim To study the influence of probucol on the type 2 diabetic mellitus patients with non-proliferative diabetic retinopathy(NPDR) about blood lipids,antioxidant capacity,visual function and retinal morphology,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 randomly divided into control and treatment groups: the control group were treated by intensive therapy of blood glucose and blood pressure control,the treatment group were treated with the intensive therapy and probucol 0.375 g,2 times a day for 12 months.Before and after treatment,the their blood lipids,serum level of the total antioxidant capacity(TAOC),visual acuity,fundus,and fundus fluorescein angiography in both group were checked. Results There were 62 cases 120 eyes completed the study.Probucol obviously decreased levels of total cholesterol(TC),triglyceride(TG) and low density lipoprotein cholesterol(LDLC) in plasma of the patients.Levels of TAOC and the visual acuity was significantly improved in the probucol group(P><0.01) than that of control group,and the retinal capillary hemangioma,fundus bleeding and exudation,and macular edema were significantly decreased in patients of the probucol group(P><0.05).Probucol also has a role in reduction of capillary non-perfusion areas in the diabetic retina. Conclusion Probucol can not only regulate serum lipids,but also have the action of improving antioxidant capacity.It can improve the visual function,ameliorate retinal''s microangiopathy,and decrease the incidence of macular edema.It means that probucol has a therapeutic effect in patients with NDPR.