目的 探討辛伐他汀聯(lián)合羥苯磺酸鈣治療高血脂非增殖期糖尿病視網(wǎng)膜病變的臨床療效。方法 選取2012年1月—2015年1月就診于天津市河西區(qū)康復醫(yī)院并進行治療的高血脂非增生型糖尿病視網(wǎng)膜病變患者120例,隨機分為對照組60例和治療組60例。對照組患者口服羥苯磺酸鈣分散片,0.5 g/次,3次/d。治療組患者在對照組治療基礎(chǔ)上口服辛伐他汀片,10 mg/次,1次/d。兩組患者均連續(xù)治療2個月。觀察兩組的臨床療效,比較兩組患者治療前后總膽固醇(TC)、三酰甘油(TG)、高密度脂蛋白膽固醇(HDL-C)變化情況,以及血液流變學指標,同時觀察藥物的不良反應(yīng)情況。結(jié)果 對照組總有效率73.33%,治療組總有效率86.67%,兩組總有效率比較差異具有統(tǒng)計學意義(P< 0.05)。治療后治療組患者TG、TC均低于對照組患者,HDL-C明顯高于對照組患者,差異具有統(tǒng)計學意義(P< 0.05);治療組患者血流變學指標較對照組有明顯改善,全血低切黏度、全血高切黏度、血漿黏度、血小板黏附率、血小板聚集率均顯著下降(P< 0.05)。兩組間不良反應(yīng)發(fā)生比較差異無統(tǒng)計學意義。結(jié)論 辛伐他汀聯(lián)合羥苯磺酸鈣能夠有效改善糖尿病視網(wǎng)膜病變患者的臨床癥狀和血脂水平,不良反應(yīng)發(fā)生率低,具有一定的臨床推廣應(yīng)用價值。

Objective To investigate the clinical curative effect of simvastatin combined with calcium dobesilate in the treatment of diabetic retinopathy in high blood lipid and non proliferative phase. Methods Patients (120 cases) with diabetic retinopathy in high blood lipid and non proliferative phase in Rehabilitation Hospital of Hexi District in Tianjin City from January 2012 to January 2015 were randomly divided into control and treatment groups, and each group had 60 cases. The patients in the control group were po administered with Calcium Dobesilate Dispersible Tablets, 0.5 mg/time, three times daily. The patients in the treatment group were po administered with Simvastatin Tablets on the basis of control group, 10 mg/time, once daily. Two groups were treated for 2 months. After treatment, the total efficacy was evaluated, and the changes of TC, TG, HDL-C, and blood rheology index in two groups were compared. And adverse events were observed. Results After treatment, the efficacies in the control and treatment groups were 73.33% and 86.67%, respectively, and there was difference between two groups (P < 0.05). After treatment, TG and TC in treatment group were lower than those in control group, but HDL-C was higher than that in control group, and there were differences between two groups (P < 0.05). Blood rheology index in treatment group improved better than those in the control group, low blood viscosity, whole blood viscosity, plasma viscosity, platelet adhesion rate, and platelet aggregation rate were obviously decreased with significant differences between two groups (P < 0.05). There was no obvious difference of adverse events between two groups. Conclusion Simvastatin combined with calcium dobesilate can effectively improve the clinical symptoms and blood lipid level in patients with diabetic retinopathy, and can also reduce adverse events, which has a certain clinical application value.