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目的分析瑞舒伐他汀联合非诺贝特治疗老年糖尿病视网膜病变患者时,对血清单核细胞趋化因子-1(MCP-1)、基质金属蛋白酶-9(MMP-9)、血管内皮生长因子(VEGF)水平的影响。方法选择糖尿病视网膜病变患者140例,按入院先后顺序,以随机数字表法将患者分为瑞舒伐他汀组(单药组)和瑞舒伐他汀与非诺贝特联合治疗组(联合组)各70例。二组患者性别、年龄、体质量、血脂、血压及糖化血红蛋白水平差异无统计学意义(P>0.05)。单药组给予瑞舒伐他汀钙10 mg/d,联合组在单药组基础上给予非诺贝特胶囊100 mg/次,3次/d,观察时间为3个月。治疗前与治疗后晨空腹抽取肘静脉血,酶联免疫吸附法检测血清单核细胞趋化因子-1(MCP-1)、基质金属蛋白酶-9(MMP-9)及血管内皮生长因子(VEGF)水平的变化。结果单药组患者治疗后与治疗前比较,M CP-1[(2.59±0.38)比(3.23±0.61)μg/L,t=2.697]、M M P-9[(47.47±5.13)比(69.38±6.28)ng/L,t=2.868]、VEGF[(125.48±8.27)比(198.47±12.63)ng/L,t=2.846];联合组患者治疗后与治疗前比较,M CP-1[1.14±0.29)比(3.17±0.53)μg/L,t=3.217]、MMP-9[(34.18±4.29)比(71.05±7.36)ng/L,t=3.163]、VEGF[(87.39±10.27)比(195.28±11.49)ng/L,t=3.352],二组患者上述指标治疗后明显减少,差异有统计学意义(P<0.05)。其中,治疗后联合组MCP-1、MMP-9、VEGF水平较单纯组减少更为显著,差异有统计学意义(P<0.05)。结论瑞舒伐他汀钙与非诺贝特联合治疗有助于维持老年糖尿病视网膜病变患者血管内皮细胞功能稳定。
Objective To investigate the effect of rosuvastatin combined with fenofibrate on the progression of diabetic retinopathy in elderly patients with acute diabetic retinopathy. The levels of monocyte chemoattractant protein-1 (MCP-1), matrix metalloproteinase-9 (MMP-9), vascular endothelial growth factor (VEGF) levels. Methods 140 patients with diabetic retinopathy were randomly divided into two groups: rosuvastatin group (single drug group) and rosuvastatin and fenofibrate combination group (combination group) 70 cases in each. There were no significant differences in sex, age, body weight, blood lipid, blood pressure and HbA1c level between the two groups (P> 0.05). The single drug group was given rosuvastatin calcium 10 mg / d, the combination group was given fenofibrate capsule 100 mg / time on the basis of single drug group, 3 times / d, the observation time was 3 months. The elbow venous blood was collected from the antepartum before and after treatment, and the levels of MCP-1, MMP-9 and VEGF were measured by enzyme linked immunosorbent assay (ELISA) Change in level. Results Compared with those before treatment, M CP-1 [(2.59 ± 0.38) vs (3.23 ± 0.61) μg / L, t = 2.697] and MM P-9 (47.47 ± 5.13) (P <0.05), and the difference was statistically significant (P <0.05) .Conclusion: M CP-1 [1.14 ± 6.28) ng / L, t = 2.868 and VEGF 125.48 ± 8.27 (198.47 ± 12.63) ng / L, t = 2.846] (34.18 ± 4.29) vs (71.05 ± 7.36) ng / L, t = 3.163] and VEGF [(87.39 ± 10.27) ± 0.29 vs (3.17 ± 0.53) μg / L, (195.28 ± 11.49) ng / L, t = 3.352]. The above indexes of the two groups were significantly decreased after treatment, the difference was statistically significant (P <0.05). Among them, the levels of MCP-1, MMP-9 and VEGF in the combination group after treatment were significantly lower than those in the simple group, with significant difference (P <0.05). Conclusion The combination of rosuvastatin calcium and fenofibrate helps to maintain the function of vascular endothelial cells in elderly patients with diabetic retinopathy.