非诺贝特治疗糖尿病视网膜病变合并肾病的临床研究

发布时间：2018-06-01 18:16

本文选题：非诺贝特 + 视力　；参考：《眼科新进展》2014年12期

【摘要】：目的观察非诺贝特治疗糖尿病视网膜病变合并肾病的临床疗效。方法 28例(56眼)2型糖尿病患者并发糖尿病视网膜病及肾病在控制血糖基础上随机分为A、B两组。A组(对照组,14例28眼)口服安慰剂Vit C片0.1 g;B组(试验组,14例28眼)口服非诺贝特片0.2 g;均为每天3次,饭前0.5 h口服,连续用42 d,观察两组治疗前后视力、眼底的变化、血压、肾功能、24 h尿蛋白、尿转铁蛋白、血浆基质金属蛋白酶2(metalloproteinase 2,MMP2)和组织型基质金属蛋白酶抑制剂1(tissue inlaibitor of metalloproteinases 1,TIMP-1)水平。结果治疗前两组患者一般情况比较差异均无统计学意义(均为P0.05)。治疗42 d后,视力提高32眼,其中A组6眼(占18.7%),B组26眼(占81.3%),两组视力较治疗前改善的眼数比较差异有统计学意义(χ2=12.619,P0.05);A组患者较治疗前各项指标差异均无统计学意义(t24 h尿蛋白=1.254、tCr=1.302、tBUN=0.539、t尿β=0.926、t4、t2微球蛋白FA=1.026、tFib=0.95ET-1=1.124、tMMP2/TIMP1=0.982,均为P0.05);B组24 h尿蛋白、肾功能(Cr、BUN、尿β2微球蛋白)、FA、Fib、ET-1和MMP2/TIMP1水平均比治疗前明显降低(t24 h尿蛋白=6.739、tCr=8.378、tBUN=6.264、t尿β2MG=5.542、tFA=7.092、tFib=5.428、tET-1=6.554、tMMP2/TIMP1=8.922,均为P0.05)。治疗后两组患者各项指标比较差异均有统计学意义水平(t24 h尿蛋白=4.432、t尿β=8.821、t2微球蛋白=5.428、tFA=5.616、tCrBUN=6.482、tFib=5.904、tET-1=9.162、tMMP2/TIMP1=5.342,均为P0.05)。结论非诺贝特治疗临床期糖尿病视网膜病变及肾病,可提高患者视力,能更有效改善视网膜微循环和肾血流动力学,保护眼底和肾功能。
[Abstract]:Objective to observe the clinical effect of fenofibrate on diabetic retinopathy with nephropathy. Methods Twenty-eight patients with type 2 diabetes mellitus complicated with diabetic retinopathy and nephropathy were randomly divided into two groups: group A (control group, n = 14, n = 28) and group A (n = 14, n = 28): placebo group (n = 14, n = 14) and placebo group (n = 14, n = 28). To take fenofibrate 0.2 g, 3 times a day, The changes of visual acuity, fundus, blood pressure, renal function 24 h urine protein, urinary transferrin were observed before and after treatment for 42 days. Plasma levels of matrix metalloproteinase (2(metalloproteinase 2) and tissue inhibitor of matrix metalloproteinase (1(tissue inlaibitor of metalloproteinases 1, TIMP 1). Results there was no significant difference between the two groups before treatment (P 0.05). After 42 days treatment, the visual acuity was improved in 32 eyes. In group A, there were 6 eyes (accounting for 18.7 eyes) and 26 eyes (81.3 eyes) in group B (81.3%). There was a significant difference in the number of eyes improved between the two groups (蠂 212.619U P0.05A group). There was no significant difference in all the indexes of urine protein 1.254tCr1.302tBun 0.539t urine 尾 0.926t4t4t 2 in group A (蠂 212.619). White FAA 1.026 t Fibn 0.95ET-1 + 1.124t MMP2 / TIMP1 0.982were all 24 h urine protein in P0.05B group. The levels of urinary 尾 2 microglobulin (尾 2 microglobulin), FibT-1 and MMP2/TIMP1 in renal function were significantly lower than those before treatment. The urinary protein levels were significantly lower than those before treatment. The urinary protein level was 6.733 9 t BUN6.264 t urinary 尾 2MGN 5.542t FAA 7.092t Fib 5.428t ET-1 / 6.554tMMP2TIMP18.922, respectively. There were significant differences in the indexes between the two groups after treatment. There was significant difference between the two groups. The urinary protein levels were 4.432t / 4.432t / ml / t 尾 -821 / t / t 尾 -5428tFAA 5.616tCrBUNT 5.904tET-1 / 9.162tMMP2 / TIMP1342respectively, all of which were P0.05a. Conclusion fenofibrate can improve the visual acuity of patients with diabetic retinopathy and nephropathy, improve retinal microcirculation and renal hemodynamics, and protect fundus and renal function.
【作者单位】：北京大学深圳医院肾内科;南昌大学第一附属医院;南方医科大学附属南昌第三医院;
【基金】：国家自然科学基金资助(编号:81160118、81400372、81060063、81170823、81100648、81100649) 全国临床医药研究专项基金(编号:L2012052) 江西省科技平台建设项目(编号:2013116) 江西省青年科学基金(编号:20114BAB215036) 江西省科技支撑计划项目(编号:20111BBG70026-2) 江西省卫生厅科技计划面上项目(编号:Z20091069) 江西省卫生厅中医药科研项目(编号:2012A087) 江西省教育厅科技计划项目(编号:GJJ11354、GJJ14170) 南昌市指导性科技计划项目(编号:2013-210-48)~~
【分类号】：R587.2;R774.1;R692

【参考文献】