骨化三醇联合二甲双胍治疗非增殖型糖尿病视网膜病变的临床疗效

目的 探讨骨化三醇联合二甲双胍治疗非增殖型糖尿病视网膜病变的临床疗效.方法 将2008年1月至2012年5月收治的非增殖型糖尿病视网膜病变患者156例随机分为两组,对照组78例,使用二甲双胍控制血糖,观察组78例,在对照组的基础上联用骨化三醇,根据血清钙的浓度调整骨化三醇剂量,肾性骨营养不良者最初剂量为0.25 μg/日,1次/日,连服2～4周;血清钙浓度正常或偏低的患者为0.25 μg/次,每2日1次,连续治疗2个月后比较两组视力情况及治疗期间眼部并发症发生率.结果 治疗后观察组的视力显著高于对照组（P＜0.01）.治疗期间观察组的眼底出血、黄斑水肿及失明等并发症发生率显著低于对照组（P＜0.01）.结论 对于非增殖型糖尿病视网膜病变在使用二甲双胍控制血糖后联合应用骨化三醇能有效地提高患者维生素D水平,提高临床治疗效果.

Clinical efficacy of calcitriol combined with metformin in the treatment of non-proliferative diabetic retinopathy

Objective To investigate the clinical efficacy of calcitriol combined with metformin in the treatment of non-proliferative diabetic retinopathy.Methods 156 cases with non-proliferative diabetic retinopathy,admitted into hospital form Jan, 2008 to May, 2012, were randomly divided into two groups,with 78 cases in each group.The control group were given metformin to control blood sugar. The observation group were given calcitriol as well as metformin. The dosage of calcitriol were adjusted according to the calcium concentration in serum. Patients with renal osteodys- trophy were initially given 0.25/zg calcitriol per day, with once a day for continuous 2~4 weeks.Patients with normal or low serum calcium levels were given 0.25 btg calcitriol each time with 2 times a day.After 2 months of continuous treatment, the eyesight condition and eye complications of both groups during the treatment were compared.Results After treatment, eyesight of the observation group were significantly better than that of the control group（ P ~0.01）. The incidence of complications including eyeground hemorrhage, macular edema and blindness in the observation group were significantly lower than those in the controll group （ P 〈0.01）.Conclusion For patients with non-proliferative diabetic retinopathy,calcitriol combined with metformin can effectively improve their vitamin D levels and improve the clinical effect.