胰岛素强化治疗对2型糖尿病合并原发性开角型青光眼患者的视野保护研究

摘目的胰岛素强化治疗对2型糖尿病合并原发性开角型患者的视野保护作用。方法将80例（80眼）2型糖尿病合并原发性开角型患者随机分为观察组（n=40）和对照组（n=40），观察组患者采用胰岛素强化治疗，对照组采用常规治疗治疗，然后分析两组患者的疗效。结果观察组患者治疗后视野平均缺损为（12．02±4．82）dB，治疗后视野平均光敏感度为（17．14±5．54）dB，治疗后视力为0．77±0．02，治疗后眼压为（17．24±6．19）mmHg，治疗后空腹血糖为（6．53±3．13）mmol.L^-1，治疗后早餐后2h血糖为（7．47±2．17）mmol·L^-1，治疗后糖化血红蛋白为（7．03±1．02）％，治疗后体重指数为（24．72±5．41）kg.m^-1。对照组患者治疗后视野平均缺损为（12．11±4．32）dB，治疗后视野平均光敏感度为（14．16土6．47）dB，治疗后视力为0．68±0．01，治疗后眼压为（18．39±6．13）mmHg，治疗后空腹血糖为（7．41±2．53）mmol·L^-1，治疗后早餐后2h血糖为（7．82±3．14）mmol·L^-1，治疗后糖化血红蛋白为（7．75±1．22）％，治疗后体重指数为（26．26±3．43）kg·m^-1。观察组患者的视野平均缺损、视野平均光敏感、视力、眼压、空腹血糖、早餐后2h血糖、糖化血红蛋白和体重指数都明显地优于对照组（P〈0．05）。结论胰岛素强化治疗能改善2型糖尿病合并原发性开角型患者的视野和视力，值得临床推广应用。

Protective effect .of intensive insulin therapy on the visual field of patients with type 2 diabetes mellitus and primary open angle glaucoma

Objective To observe the protective effect of intensive insulin therapy on the visual field of patients with type 2 diabetes mel litus and primary open angle glaucoma. Methods Eighty patients with type 2 diabetes mellitus and primary open angle glaucoma in our hospital from July 2009 to july 2012 were randomly divided into observation group （n = 40） and control group （n = g0）. Observation group was given intensive insulin therapy,and control group was given conventional treatment. Then the effects of two groups were ana lyzed. Results The visual fields mean defect was （ 12.02 ± 4.82） dB, vision average light sensibility was （ 17.14 ± 5.54） dB, vision was 0.77 - 0.02, intraocular pressure was （ 17.24 ± 6.19 ） mmHg, fasting blood glucose was （ 6.53 ± 3.13 ） mmol/L, blood glucose 2h after breakfast was（7.47 ±2.17）mmol . L^-1 ,glycosylated hemoglobin was（7.03 - 1.02）% ,body mass index was（24.72 ± 5.41 ）kg . m^-2 in the observation group after treatment. The visual fields mean defect was （ 12.11 ± 4.32） dB, vision average light sensibility was（ 14.16 - 6.47） dB, vision was 0.68 ± 0.01, intraocular pressure was （ 18.39 ± 6.13 ） mmHg, fasting blood glucose was （ 7.41 ± 2.53 ） mmol . L^-1, blood glucose 2 h after breakfast was （7.82 - 3.14） mmol . L^- 1, glycosylated hemoglobin was （ 7.75 - 1.22 ） %, body mass index was （26.26 ± 3.43 ）kg . m^-2 in the control group after treatment. The visual fields mean defect, vision average light sensibility, vision, in traocular pressure, fasting blood glucose, blood glucose 2 h after breakfast, glycosylated hemoglobin, body mass index in observation group were significantly better than those in control group （P 〈 0.05）. Conclusions Intensive insulin therapy can improve the visual field and vision of patients with type 2 diabetes mellitus and primary open angle glaucoma,which is worthy to be popularized.