[1]肖红波,吕金雷,邵毅,等.非诺贝特治疗糖尿病视网膜病变合并肾病的临床研究[J].眼科新进展,2014,34(12):1132-1136.[doi:10.13389/j.cnki.rao.2014.0314]
　XIAO Hong-Bo,LV Jin-Lei.SHAO Yi,YU Yao,et al.Fenofibrate for diabetic retinopathy combined with diabetic nephropathy[J].Recent Advances in Ophthalmology,2014,34(12):1132-1136.[doi:10.13389/j.cnki.rao.2014.0314]
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非诺贝特治疗糖尿病视网膜病变合并肾病的临床研究
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《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:
34卷
期数:
2014年12期
页码:
1132-1136
栏目:
应用研究
出版日期:
2014-12-05

文章信息/Info

Title:
Fenofibrate for diabetic retinopathy combined with diabetic nephropathy
作者:
肖红波; 吕金雷; 邵毅; 余瑶; 陈素芳; 裴重刚; 涂萍; 黄歆; 胡佩宏; 彭萌
518036　广东省深圳市，北京大学深圳医院肾内科
Author(s):
XIAO Hong-Bo ;  LV Jin-Lei.SHAO Yi ;  YU Yao ;  CHEN Su-Fang;  PEI Chong-Gang;  TU Ping;  HUANG Xin;  HU Pei-Hong; PENG Meng
Department of Kidney, Shenzhen Hospital of Peking University,Shenzhen 518036, Guangdong Province, China
关键词:
非诺贝特; 视力; 糖尿病视网膜病变; 糖尿病肾病; 肾功能
Keywords:
fenofibrate ;  vision;  diabetic retinopathy ;  diabetic nephropathy ;  renal function
DOI:
10.13389/j.cnki.rao.2014.0314
文献标志码:
A
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ＶｉｔＣ片０．１ｇ；Ｂ组（试验组，１４例２８眼）口服非诺贝特片０．２ｇ；均为每天３次，饭前０．５ｈ口服，连续用４２ｄ，观察两组治疗前后视力、眼底的变化、血压、肾功能、２４ｈ尿蛋白、尿转铁蛋白、血浆基质金属蛋白酶２（ｍｅｔａｌｌｏｐｒｏｔｅｉｎａｓｅ２，ＭＭＰ２）和组织型基质金属蛋白酶抑制剂１（ｔｉｓ-ｓｕｅｉｎｌａｉｂｉｔｏｒｏｆｍｅｔａｌｌｏｐｒｏｔｅｉｎａｓｅｓ１，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Ｐ＞０. ０５）。治疗４２ｄ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，Ｐ＜０．０５）；Ａ组患者较治疗前各项指标差异均无统计学意义（ｔ２４ｈ尿蛋白＝１．２５４、ｔＣｒ＝１．３０２、ｔＢＵＮ ＝０．５３９、ｔ尿β２微球蛋白＝０．９２６、ｔＦＡ ＝１．０２６、ｔＦｉｂ＝０．９５４、ｔＥＴ-１＝１．１２４、ｔＭＭＰ２／ＴＩＭＰ１＝０．９８２，均为Ｐ＞０．０５）；Ｂ组２４ｈ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（ｔ２４ｈ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Ｐ＜０．０５）。治疗后两组患者各项指标比较差异均有统计学意义水平（ｔ２４ｈ尿蛋白＝４．４３２、ｔ尿β２微球蛋白＝５．４２８、ｔＦＡ ＝５．６１６、ｔＣｒ＝８．８２１、ｔＢＵＮ ＝６．４８２、ｔＦｉｂ＝５．９０４、ｔＥＴ-１＝９．１６２、ｔＭＭＰ２／ＴＩＭＰ１＝５．３４２，均为Ｐ＜０．０５）。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 effects of fenofibrate on diabetic retinopathy combined with diabetic nephyopathy. Methods Totally 28 patients ( 56 eyes) with diabetic retinopathy and diabetic nephyopathy were randomly divided into two groups: Group A with placebo vitanun C(O. I g,once per day) and group B with Fenofibrate ( 0. 5 g , once per day , taking before meals half an hour ) for 42 days , 14 cases in each group. The changed of vision . ocular fundus , blood pressure , renal function , 24 hours urine protein , urine β2 microglobulin, serum matrix metalloproteinase 2 ( MMP2 ) and tissue inhibitor of metalloproteinase I ( TIMPI ) and endothelin I ( ET-I ) were observed. Resrilts There was no significant difference in general information before therapy between two groups ( all P > 0. 05 ) . After therapy for 42 days, the visual acuity in 32 eyes were increased. including 6 eyes ( 18. 7% ) in group A,26 eyes ( 81. 3% ) in group B, there was statistically significance between group A and B (X2 = 12. 619,P < 0. 05 ) . Compared with before therapy , the above items after therapy in group A had no obvious change ( t24 hours urine protein = 1. 254 , tC.r = 1. 302 , tBUN = 0. 539 ,tp2-MG = 0. 926 , tFA = 1. 026 , tFib = 0. 954 , tEr-, = 1. 124 , tMMl.2rnMP, = 0. 982, all P > 0. 05 ) . which in group B obviously decrased ( t24 hours urine protein = 6. 739 , tCr = 8. 378 , tBIJh, = 6. 264 , tp2-MG = 5. 542 , tF.A = 7. 092 , tFib = 5. 428 , tEr-, = 6. 554 , tMMP2rnMP, = 8. 922 . all P < 0. 05 ) . and there were statistical differences between two groups ( t24 hours urine protein = 4. 432, tV2-MG = 5. 428, tF.A = 5. 616, tCr = 8. 821, tBUN = 6. 482, tFm = 5. 904 , tEl--, = 9. 162 , tMMPZfiUMP, = 5. 342 , all P < 0. 05 ) . Conclusion Fenfibrate for patients with diabetic retinopathy combined with diabetic nephropathy can obviously improve the vision, retinal microcirculation and renal hemodynamics to protect the ocular fundus and renal function.

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备注/Memo

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更新日期/Last Update: 2014-12-04