瑞舒伐他汀联合非诺贝特对老年糖尿病视网膜病变患者血管内皮功能的影响

目的 分析瑞舒伐他汀联合非诺贝特治疗老年糖尿病视网膜病变患者时,对血清单核细胞趋化因子-1(MCP-1)、基质金属蛋白酶-9(MMP-9)、血管内皮生长因子(VEGF)水平的影响。方法 选择糖尿病视网膜病变患者140例,按入院先后顺序,以随机数字表法将患者分为瑞舒伐他汀组(单药组)和瑞舒伐他汀与非诺贝特联合治疗组(联合组)各70例。二组患者性别、年龄、体质量、血脂、血压及糖化血红蛋白水平差异无统计学意义(P>0.05)。单药组给予瑞舒伐他汀钙10 mg/d,联合组在单药组基础上给予非诺贝特胶囊100 mg/次,3次/d,观察时间为3个月。治疗前与治疗后晨空腹抽取肘静脉血,酶联免疫吸附法检测血清单核细胞趋化因子-1(MCP-1)、基质金属蛋白酶-9(MMP-9)及血管内皮生长因子(VEGF)水平的变化。结果 单药组患者治疗后与治疗前比较, MCP-1[(2.59±0.38)比(3.23±0.61)μg/L,t=2.697]、MMP-9[(47.47±5.13)比(69.38±6.28)ng/L,t=2.868]、VEGF[(125.48±8.27)比(198.47±12.63)ng/L,t=2.846];联合组患者治疗后与治疗前比较, MCP-1[1.14±0.29)比(3.17±0.53)μg/L,t=3.217]、MMP-9[(34.18±4.29)比(71.05±7.36)ng/L,t=3.163]、VEGF[(87.39±10.27)比(195.28±11.49)ng/L,t=3.352],二组患者上述指标治疗后明显减少,差异有统计学意义(P<0.05)。其中,治疗后联合组MCP-1、MMP-9、VEGF水平较单纯组减少更为显著,差异有统计学意义(P<0.05)。结论 瑞舒伐他汀钙与非诺贝特联合治疗有助于维持老年糖尿病视网膜病变患者血管内皮细胞功能稳定。

Effects of rosuvastatin combined with fenofibrate therapy on vascular endothelial function retinopathy diabetic retinopathy patients

Objective To investigate the effects of rosuvastatin combined with fenofibrate therapy on monocyte chemotactic factor-1 (MCP-1), matrix metalloproteinase-9 (MMP-9), and vascular endothelial growth factor (VEGF) in elderly diabetic patients with retinopathy. Methods A total of 140 cases with diabetic retinopathy admitted during Oct. 2012 and Oct. 2014 were randomly divided into rosuvastatin group (single drug group, n=70), and rosuvastatin and fenofibrate treatment group (combined group, n=70). The single drug group received rosuvastatin calcium 10 mg/d, while the combined group were given rosuvastatin calcium 10mg/d, and Fenofibrate Capsules 100 mg once for 3 times each day. The clinical baseline levels of sex, age, body weight index, blood lipid, blood pressure and andglycated hemoglobin in the two groups had no significant differences (P<0.05). The changes of MCP-1, MMP-9 and VEGF before and after treatment were compared. Results The levels of MCP-1, MMP-9 and VEGF in the single drug group were [(2.59±0.38) vs (3.23±0.61) μg/L,t=2.697], [(47.47±5.13) vs (69.38±6.28) ng/L, t=2.868], [(125.48±8.27) vs (198.47±12.63) ng/L, t=2.846], while the levels of MCP-1, MMP-9 and VEGF in the combined group were [(1.14±0.29) vs (3.17±0.53) μg/L, t=3.217], [(34.18±4.29) vs (71.05±7.36) ng/L, t=3.163], [(87.39±10.27) vs (195.28±11.49) ng/L, t=3.352], before and after treatment, respectively. The indexes in the two groups significantly reduced after treatment. The levels of MCP-1, MMP-9 and VEGF in combined group reduced more significantly than in the single drug group, and the difference was statistically significant (P<0.05). Conclusion Rosuvastatin calcium and fenofibrate treatment contributes to the stable endothelial function in elderly diabetic retinopathy patients.