二甲双胍联合激光对2型糖尿病视网膜病变患者血管内皮功能和生活质量的影响

发布时间：2018-11-22 19:48

【摘要】：目的探讨二甲双胍联合激光对2型糖尿病视网膜病变患者血管内皮功能和生活质量的影响。方法选取本院就诊的240例糖尿病视网膜病变患者,按照治疗方法的不同均分为两组,每组120例,其中单独治疗组接受视网膜激光光凝治疗,而联合治疗组在此基础上使用二甲双胍控制血糖,测定两组患者治疗前后的视力变化,对比分析两组患者的空腹血糖(FBG)、糖化血红蛋白(Hb A1c)、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白(LDL-C)、高密度脂蛋白(HDL-C)、血浆内皮素-1(ET-1)和可溶性细胞间黏附分子-1(ICAM-1)水平;同时记录两组患者治疗前后的生活质量和并发症发生情况。结果治疗后,两组患者的生活质量均明显提高,且联合治疗组提高得更为显著(P0.05);联合治疗组视力提高者明显多于单独治疗组(P0.05);治疗后,两组患者的FBG、Hb A1c、TG、TC、LDL-C、ET-1和ICAM-1水平均有所降低,而HDL-C水平均有所升高,并且联合治疗组改善得更显著;与单独治疗组相比,联合治疗组的FMD上升得更为显著(P0.05)。结论二甲双胍联合激光治疗能够明显改善2型糖尿病视网膜病变患者的血管内皮细胞功能,最大程度地减轻糖尿病视网膜病变导致的视力损害,改善预后,提高生活质量,在临床上值得推广应用。
[Abstract]:Objective to investigate the effects of metformin combined with laser on vascular endothelial function and quality of life in patients with type 2 diabetic retinopathy. Methods 240 patients with diabetic retinopathy were divided into two groups, 120 cases in each group. On this basis, the combined treatment group used metformin to control blood glucose, and measured the changes of visual acuity before and after treatment. The fasting blood glucose (FBG), A1c and triglyceride (TG), were compared and analyzed. Total cholesterol (TC), low density lipoprotein (LDL-C), high density lipoprotein (HDL-C), plasma endothelin-1 (ET-1) and soluble intercellular adhesion molecule-1 (ICAM-1); Quality of life and complications were recorded before and after treatment. Results after treatment, the quality of life of the two groups were significantly improved, and that of the combined treatment group was more significant (P0.05), the visual acuity of the combined treatment group was significantly higher than that of the single treatment group (P0.05). After treatment, the levels of FBG,Hb A1cTGN TGN LDL-CfET-1 and ICAM-1 in both groups were decreased, while the HDL-C level was increased, and the improvement was more significant in the combined treatment group. Compared with the single treatment group, the FMD in the combined treatment group increased significantly (P0.05). Conclusion Metformin combined with laser therapy can significantly improve the function of vascular endothelial cells in patients with type 2 diabetic retinopathy, minimize the visual impairment caused by diabetic retinopathy, improve the prognosis and improve the quality of life. It is worth popularizing in clinic.
【作者单位】：重庆市璧山区人民医院眼科;重庆市璧山区人民医院内科四病区;
【基金】：重庆市璧山区科技计划项目(编号:201325)
【分类号】：R587.2;R774.1

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