普罗布考对血糖控制欠佳的非增殖型糖尿病视网膜病变患者的临床疗效观察
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湖南省卫生厅课题(C2008-011);;湖南省科技计划项目(2009FJ3033);;诺美国际基金资助项目


Clinical Observation of Blood Sugar Uncontrolled Non-Proliferative Diabetic Retinopathy Patients Treated by Probucol
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    目的研究普罗布考对血糖控制欠佳的2型糖尿病非增殖型糖尿病视网膜病变患者血脂、氧化应激指标、视功能及眼底形态的影响,为血糖控制欠佳的非增殖型糖尿病视网膜病变患者探寻治疗方法。方法纳入47例患有非增殖型糖尿病视网膜病变且早期血糖控制欠佳的2型糖尿病患者91眼,随机分为对照组和治疗组:对照组进行强化降血糖、血压治疗,治疗组在强化治疗基础上加用普罗布考0.375 g,每天2次,口服,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、超氧化物歧化酶、丙二醛、视力、眼底及眼底荧光血管造影检查。结果所有47例91眼完成研究,普罗布考显著降低了患者总胆固醇、甘油三酯、低密度脂蛋白胆固醇水平,显著提高患者血清总抗氧化能力、超氧化物歧化酶,降低丙二醛,显著提高患者视力(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。结论普罗布考对于血糖控制欠佳的非增殖型糖尿病视网膜病变患者除了降脂作用外,还可提高患者抗氧化应激能力,改善患者视功能,降低患者视网膜的微血管病变及降低患者黄斑水肿发生率,提示对于血糖控制欠佳的非增殖型糖尿病视网膜病变患者可应用普罗布考进行治疗。

    Abstract:

    Aim To study the influence of probucol on the blood sugar uncontrolled type 2 diabetic mellitus patients with non-proliferative diabetic non-proliferative diabetic retinopathy(NPDR) about blood lipids,oxidative stress indicators,visual function and retinal morphology,so as to search treatment method for these patients.Methods 47 type 2 diabetes patients with 91 NPDR eyes and poor glycemic control at early stage were included.Patients were randomly divided into control and treatment groups:the control group 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,both groups of the patients had their blood lipids,serum level of the total antioxidant capacity(TAOC),superoxide dismutase(SOD),malondialdehyde(MDA),visual acuity,fundus,and fundus fluorescein angiography been checked.Results All 47 cases,91 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 SOD were improved significantly in the probucol group,while MDA decreased and the visual acuity improved significantly(P<0.01).The retinal capillary hemangioma,fundus bleeding and exudation,and macular edema were decreased significantly 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.Conclusions Probucol can not only regulate serum lipids of the poor glycemic controlled patients,but also has 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 blood sugar uncontrolled NDPR patients.

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陈忠平,刘江华,姜德咏,张入铭,蒋苏平.普罗布考对血糖控制欠佳的非增殖型糖尿病视网膜病变患者的临床疗效观察[J].中国动脉硬化杂志,2011,19(9):751~755.

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  • 收稿日期:2011-04-14
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