玻璃体腔注射抗-VEGF联合阿托伐他汀治疗高血脂合并糖尿病黄斑性水肿的临床效果
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摘要
目的:探究和分析玻璃体腔注射抗-VEGF联合阿托伐他汀治疗高血脂合并糖尿病黄斑性水肿的临床效果。方法:选取本院2016年2月至2018年3月接收治疗的86例高血脂糖尿病黄斑水肿患者,根据随机数字表法分为实验组和对照组各43例,对照组患者应用玻璃体腔内注射康柏西普进行治疗,实验组在对照组的基础上服用阿托伐他汀治疗,治疗4个月之后,对比观察两组临床疗效,治疗前后黄斑区渗漏情况、视力、黄斑厚度、眼压以及血脂变化情况。结果:实验组治疗的总有效率明显高于对照组,具有显著的统计学差异(P<0.05)。治疗前两组患者三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白-胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)差异无统计学意义(P>0.05);治疗后实验组患者LDL-C、TC、TG水平明显低于对照组(P<0.05),HDL-C水平明显高于对照组(P<0.05),实验组黄斑区发生荧光渗漏比例低于对照组(P<0.05),两组患者在治疗后眼压都呈下降趋势,但实验组比对照组下降明显(P<0.05);实验组黄斑中心凹厚度改善情况较优于对照组(P<0.05),实验组最佳矫正视力高于对照组(P<0.05)。结论:玻璃体腔注射抗-VEGF联合阿托伐他汀能够显著改善患者的视网膜渗漏及黄斑水肿情况,有效降低血脂,促进患者康复,安全性高,值得临床推广应用。
Objective: To explore and analyze the clinical effect of anti-VEGF combined with atorvastatin in the treatment of hyperlipidemia with diabetic macular edema. Methods: From February 2016 to March 2018,86 patients with diabetic macular edema with hyperlipidemia were divided into experimental group( n = 43) and control group( n = 43),the patients in the control group were treated with intravitreal injection of Compactopril,the experimental group was treated with Atto vastatin on the basis of the control group.After4 months of treatment,the clinical efficacy,macular leakage,visual acuity,macular thickness,intraocular pressure and changes of blood lipid were compared between the two groups. Results: The total effective rate of the experimental group was significantly higher than that of the control group,with significant statistical difference( P < 0. 05). There was no significant difference in triglyceride( TG),total cholesterol( TC),low density lipoprotein cholesterol( LDL-C) and high density lipoprotein cholesterol( HDL-C) between the two groups before treatment( P>0.05).After treatment,the levels of LDL-C,TC,TG and HDL-C in the experimental group were significantly lower than those in the control group( P<0.05),and the level of HDL-C in the experimental group was significantly higher than that in the control group( P<0.05).the percentage of fluorescent leakage in the macular area of the experimental group was lower than that in the control group( P<0.05).After treatment,intraocular pressure of both groups showed a downward trend,but the experimental group was significantly lower than the control group( P<0.05).The improvement of macular fovea thickness in the experimental group was better than that in the control group( P<0.05).The best corrected visual acuity in the experimental group was higher than that in the control group( P< 0.05). Conclusion: Intra-vitreous injection of anti-VEGF combined with atorvastatin can significantly improve the retinal leakage and macular edema,effectively reduce blood lipids,and promote the recovery of patients with high safety,worthy of clinical application.
Objective: To explore and analyze the clinical effect of anti-VEGF combined with atorvastatin in the treatment of hyperlipidemia with diabetic macular edema. Methods: From February 2016 to March 2018,86 patients with diabetic macular edema with hyperlipidemia were divided into experimental group( n = 43) and control group( n = 43),the patients in the control group were treated with intravitreal injection of Compactopril,the experimental group was treated with Atto vastatin on the basis of the control group.After4 months of treatment,the clinical efficacy,macular leakage,visual acuity,macular thickness,intraocular pressure and changes of blood lipid were compared between the two groups. Results: The total effective rate of the experimental group was significantly higher than that of the control group,with significant statistical difference( P < 0. 05). There was no significant difference in triglyceride( TG),total cholesterol( TC),low density lipoprotein cholesterol( LDL-C) and high density lipoprotein cholesterol( HDL-C) between the two groups before treatment( P>0.05).After treatment,the levels of LDL-C,TC,TG and HDL-C in the experimental group were significantly lower than those in the control group( P<0.05),and the level of HDL-C in the experimental group was significantly higher than that in the control group( P<0.05).the percentage of fluorescent leakage in the macular area of the experimental group was lower than that in the control group( P<0.05).After treatment,intraocular pressure of both groups showed a downward trend,but the experimental group was significantly lower than the control group( P<0.05).The improvement of macular fovea thickness in the experimental group was better than that in the control group( P<0.05).The best corrected visual acuity in the experimental group was higher than that in the control group( P< 0.05). Conclusion: Intra-vitreous injection of anti-VEGF combined with atorvastatin can significantly improve the retinal leakage and macular edema,effectively reduce blood lipids,and promote the recovery of patients with high safety,worthy of clinical application.
引文
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[7]王伟民.阿托伐他汀钙联合缬沙坦对原发性高血压血清炎性因子水平及血管内皮功能的影响[J].中西医结合心脑血管病杂志,2017,15(18):2287-2289.
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[2]陈静,赖铭莹,罗恒,等.抗VEGF药物联合激光光凝治疗糖尿病性黄斑水肿观察研究[J].中国实用眼科杂志,2014,32(6):693-697.
[3]曹靓,刘静霞.年龄相关性黄斑变性的分子免疫研究[J].黑龙江医学,2016,40(02):190-192.
[4]孙清磊,罗媛嫒,宋颖,等.糖尿病性黄斑水肿的发病机制与治疗进展[J].中华老年多器官疾病杂志,2015,14(1):33-38.
[5]丁伟红.不同剂量阿托伐他汀联合氨氯地平对高血压患者脂代谢改善及肾功能保护的作用分析[J].黑龙江医药,2017,30(06):1241-1244.
[6]陈丽华,莫纯坚.抗VEGF药物治疗糖尿病黄斑水肿的临床应用[J].东南国防医药,2015,17(4):414-417.
[7]王伟民.阿托伐他汀钙联合缬沙坦对原发性高血压血清炎性因子水平及血管内皮功能的影响[J].中西医结合心脑血管病杂志,2017,15(18):2287-2289.
[8]张伟.不同剂量阿托伐他汀降脂治疗对冠心病稳定性心绞痛疗效、血脂相关指标和氧化应激的影响研究[J].陕西医学杂志,2018,47(03):395-397.