高级检索
中华实验眼科杂志
期刊首页
过刊列表
高级检索
稿件发表
• 临床研究 •
ENGLISH ABSTRACT
递法明片对糖尿病视网膜病变全视网膜光凝后视网膜功能恢复的促进作用
张茉莉
魏文斌
田蓓
作者及单位信息
·
DOI： 10.3760/cma.j.cn115989-20210325-00205
Promoting effects of Difrarel ® on retinal function following panretinal photocoagulation in diabetic retinopathy
Zhang Moli
Wei Wenbin
Tian Bei
Authors Info & Affiliations
Zhang Moli
Department of Ophthalmology, Beijing Daxing District People's Hospital, Beijing 102600, China
Wei Wenbin
Beijing Tongren Eye Center, Beijing Key Laboratory of Intraocular Tumor Diagnosis and Treatment, Beijing Ophthalmology & Visual Sciences Key Lab, Medical Artificial Intelligence Research and Verification Key Laboratory of the Ministry of Industry and Information Technology, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
Tian Bei
Beijing Tongren Eye Center, Beijing Key Laboratory of Intraocular Tumor Diagnosis and Treatment, Beijing Ophthalmology & Visual Sciences Key Lab, Medical Artificial Intelligence Research and Verification Key Laboratory of the Ministry of Industry and Information Technology, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
·
DOI： 10.3760/cma.j.cn115989-20210325-00205
790
63
0
0
5
0
PDF下载
APP内阅读
摘要

目的评估递法明片对全视网膜光凝(PRP)术后视网膜功能损伤修复的促进作用。

方法采用非随机对照研究方法，于2014年12月至2020年2月在北京同仁眼科中心和北京市大兴区人民医院纳入非增生性糖尿病视网膜病变(NPDR)患者108例108眼。根据患者自愿原则将患者分为2个组，其中PRP+递法明组患者56例56眼，于PRP后口服递法明片；PRP组患者52例52眼，未服用递法明片。于PRP治疗前及治疗后1 d及1、3、6、12个月对患者进行随访，采用国际视力表检查患眼视力；采用Humphrey视野计检查30°~60°环形视野并采用RETLscan系统记录多焦视网膜电图；采用光相干断层扫描仪检测黄斑中心凹厚度(CMT)；分别于PRP后6个月、12个月采用荧光素眼底血管造影观察眼底新生血管情况。

结果PRP+递法明组末次随访时视力治疗有效率为57.14%(32/56)，明显高于PRP组的32.69%(17/52)，差异有统计学意义( χ 2＝3.56， P<0.05)。2个组治疗前后各时间点视野平均阈值敏感度总体比较差异均有统计学意义( F 分组＝4.77， P<0.05； F 时间＝6.51， P<0.05)，2个组治疗后视野平均阈值敏感度均较治疗前降低，差异均有统计学意义(均 P<0.05)；PRP+递法明组治疗后3、6、12个月视野平均阈值敏感度值均高于PRP组，差异均有统计学意义(均 P<0.05)。PRP+递法明组第3、4、5环的P1波振幅密度高于PRP组，差异均有统计学意义(均 P<0.05)。2个组治疗前后不同时间点CMT总体比较差异均无统计学意义( F 分组＝3.57， P>0.05； F 时间＝1.23， P>0.05)。治疗后12个月，所有患眼均未出现视网膜新生血管及无灌注区。

结论口服递法明片可促进NPDR患眼PRP术后视网膜功能的恢复。

糖尿病视网膜病变/治疗;激光光凝术;术后并发症;视网膜/生理功能;花青素
ABSTRACT

ObjectiveTo investigate the promoting effect of Difrarel ® on retinal function following panretinal photocoagulation (PRP) in the eyes with diabetic retinopathy.

MethodsA non-randomized controlled study was performed.A total of 108 eyes of 108 patients with non-proliferative diabetic retinopathy (NPDR) were enrolled in Tongren Ophthalmology Center and Beijing Daxing District People's Hospital from December 2014 to February 2020.The patients were divided into PRP group and PRP+ Difrarel ® group according to different therapies under patients' selection.Difrarel ® was orally administered after PRP in 56 patients of PRP+ Difrarel ® group, and only PRP was given in 52 patients of PRP group.The visual acuity, 30°~60° circular visual field and multifocal electroretinogram were examined before and 1 day, 1 month, 3 months, 6 months, 12 months after PRP.The central macular thickness (CMT) was measured by optical coherence tomography, and fundus neovascularization was observed by fluorescein fundus angiography at 6 and 12 months after PRP.The study protocol was approved by an Ethics Committee of Beijing Daxing District People's Hospital (No.2021-F4).

ResultsVisual improvement rate was 57.14% (32/56) and 32.69% (17/52) in PRP+ Difrarel ® group and PRP group at the end of following-up, respectively, showing a significant difference between two groups ( χ 2=3.56, P<0.05). The visual field mean sensitivity was significantly different at different time points in two groups ( F group=4.77, P<0.05; F time=6.51, P<0.05), and was lower after PRP than those before treatment in both groups (both at P<0.05), and was significantly higher in PRP+ Difrarel ® group than PRP group at 3, 6, 12 months after PRP (all at P<0.05). The P1 amplitude density in 3 to 5 rings in PRP+ Difrarel ® group were higher than those in PRP group, and the differences were statistically significant (all at P<0.05). There was no significant difference in CMT between the two groups at different time points ( F group=3.57, P>0.05; F time=1.23, P>0.05). No new blood vessels and non-perfusion area were found in both groups.

ConclusionsOral Difrarel ® can improve retinal function after PRP in the eyes with NPDR.

Diabetic retinopathy/therapy;Laser photocoagulation;Postoperative complications;Retina/physiological function;Anthocyanin
Wei Wenbin, Email: mocdef.3ab61rtnibnewiew
Copyright by Chinese Medical Association
No content published by the journals of Chinese Medical Association may be reproduced or abridged without authorization. Please do not use or copy the layout and design of the journals without permission.
All articles published represent the opinions of the authors, and do not reflect the official policy of the Chinese Medical Association or the Editorial Board, unless this is clearly specified.
引用本文

张茉莉,魏文斌,田蓓. 递法明片对糖尿病视网膜病变全视网膜光凝后视网膜功能恢复的促进作用[J]. 中华实验眼科杂志,2022,40(03)：247-252.

DOI:10.3760/cma.j.cn115989-20210325-00205

PERMISSIONS

Request permissions for this article from CCC.

评价本文
*以上评分为匿名评价

版权归中华医学会所有。

未经授权，不得转载、摘编本刊文章，不得使用本刊的版式设计。

除非特别声明，本刊刊出的所有文章不代表中华医学会和本刊编委会的观点。

递法明片的主要成分为花青素，其具有强大的抗氧化作用，能清除体内、体外多种氧自由基，包括超氧阴离子、羟自由基等，具有维护毛细血管正常的通透性、抑制醛糖还原酶、提高视紫红质的再生速率等药理作用，对视网膜微循环及淋巴系统有明确的灌注作用 [ 1 , 2 , 3 ]。递法明片被广泛用于改善糖尿病视网膜病变(diabetic retinopathy，DR)患者的视功能、青少年近视、视网膜色素变性、视网膜光损伤的修复等眼部疾病的临床治疗，并已取得良好的效果 [ 4 , 5 , 6 , 7 , 8 ]。DR是一种慢性进展性微血管病变，高血糖可导致视网膜色素上皮屏障损害、外层视网膜缺血和炎症反应，缺血、缺氧导致慢性视网膜炎症和血管内皮生长因子(vascular endothelial growth factor，VEGF)的高表达，促进DR的发生和发展。以新生血管为标志，可将DR分为非增生性糖尿病视网膜病变(nonproliferative diabetic retinopathy，NPDR)和增生性糖尿病视网膜病变(proliferative diabetic retinopathy，PDR)。PDR是糖尿病严重并发症之一，亦是主要致盲眼病之一，其主要治疗方法是玻璃体切割术，但术后视力的恢复非常有限。目前对于DR治疗的共识是在NPDR期进行积极治疗，预防PDR发生，全视网膜光凝(panretinal photocoagulation，PRP)是防止NPDR向PDR发展的主要方法，可有效减少缺血、缺氧诱导的血管生成因子的合成和释放，延缓疾病的发展，降低视力严重损害的风险 [ 9 , 10 ]。然而，PRP治疗的同时可引发黄斑水肿、脉络膜渗漏、视野缺损及暗适应下降等并发症 [ 11 ]。本研究拟观察递法明片对视网膜激光光凝所致视网膜损伤的影响，以期建立减少PRP不良反应的治疗方案。
试读结束，您可以通过登录机构账户或个人账户后获取全文阅读权限。
参考文献
[1]
Nabavi SF ， Habtemariam S ， Daglia M ，et al. Anthocyanins as a potential therapy for diabetic retinopathy[J]．Curr Med Chem， 2015，22(1)∶51-58. DOI： 10.2174/0929867321666140815123852 .
返回引文位置Google Scholar
百度学术
万方数据
[2]
Huang WY ， Wu H ， Li DJ ，et al. Protective effects of blueberry anthocyanins against H 2 O 2 -induced oxidative injuries in human retinal pigment epithelial cells [J]．J Agric Food Chem， 2018，66(7)∶1638-1648. DOI： 10.1021/acs.jafc.7b06135 .
返回引文位置Google Scholar
百度学术
万方数据
[3]
Huang W ， Zhu Y ， Li C ，et al. Effect of blueberry anthocyanins malvidin and glycosides on the antioxidant properties in endothelial cells[J/OL]．Oxid Med Cell Longev， 2016，2016∶1591803[2021-04-18]．http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4789434. DOI： 10.1155/2016/1591803 .
返回引文位置Google Scholar
百度学术
万方数据
[4]
郭浩轶，李玉军，董应丽，等．高危增生型糖尿病视网膜病变玻璃体切割手术后递法明强化治疗疗效观察[J]．中华眼底病杂志， 2014，30(2)∶196-197. DOI： 10.3760/cma.j.issn.1005-1015.2014.02.019 .
返回引文位置Google Scholar
百度学术
万方数据
[5]
邓宏伟，陈青山，刘春民，等．口服递法明片对控制儿童高度近视回顾性研究[J]．中国实用眼科杂志， 2013，31(8)∶1006-1008. DOI： 10.3760/cma.j.issn.1006-4443.2013.08.016 .
返回引文位置Google Scholar
百度学术
万方数据
Deng HW ， Chen QS ， Liu CM ，et al. Retrospective study of orally administered anthocyanoside of high myopia control in children[J]．Chin J Pract Ophthalmol， 2013，31(8)∶1006-1008. DOI： 10.3760/cma.j.issn.1006-4443.2013.08.016 .
Goto CitationGoogle Scholar
Baidu Scholar
Wanfang Data
[6]
Silván JM ， Reguero M ， de Pascual-Teresa S ．A protective effect of anthocyanins and xanthophylls on UVB-induced damage in retinal pigment epithelial cells[J]．Food Funct， 2016，7(2)∶1067-1076. DOI： 10.1039/c5fo01368b .
返回引文位置Google Scholar
百度学术
万方数据
[7]
Wang Y ， Zhao L ， Lu F ，et al. Retinoprotective effects of bilberry anthocyanins via antioxidant，anti-inflammatory，and anti-apoptotic mechanisms in a visible light-induced retinal degeneration model in pigmented rabbits[J/OL]．Molecules， 2015，20(12)∶22395-22410[2021-05-16]．http://www.ncbi.nlm.nih.gov/pubmed/26694327. DOI： 10.3390/molecules201219785 .
返回引文位置Google Scholar
百度学术
万方数据
[8]
Liu Y ， Zhang D ， Hu J ，et al. Visible light-induced lipid peroxidation of unsaturated fatty acids in the retina and the inhibitory effects of blueberry polyphenols[J]．J Agric Food Chem， 2015，63(42)∶9295-9305. DOI： 10.1021/acs.jafc.5b04341 .
返回引文位置Google Scholar
百度学术
万方数据
[9]
The Diabetic Retinopathy Study Research Group. Photocoagulation treatment of proliferative diabetic retinopathy.Clinical application of diabetic retinopathy study (DRS) findings，DRS report number 8[J]．Ophthalmology， 1981，88(7)∶583-600.
返回引文位置Google Scholar
百度学术
万方数据
[10]
谭贵临， Cheng Lingyun . 非诺贝特对糖尿病视网膜病变的防治研究及其临床转化[J]．中华实验眼科杂志， 2019，37(10)∶828-832. DOI： 10.3760/cma.j.issn.2095-0160.2019.10.012 .
返回引文位置Google Scholar
百度学术
万方数据
Tan GL ， Cheng LY . Prevention and treatment research of fenofibrate for diabetic retinopathy and its clinical translation[J]．Chin J Exp Ophthalmol， 2019，37(10)∶828-832. DOI： 10.3760/cma.j.issn.2095-0160.2019.10.012 .
Goto CitationGoogle Scholar
Baidu Scholar
Wanfang Data
[11]
Mukhtar A ， Khan MS ， Junejo M ，et al. Effect of pan retinal photocoagulation on central macular thickness and visual acuity in proliferative diabetic retinopathy[J]．Pak J Med Sci， 2016，32(1)∶221-224. DOI： 10.12669/pjms.321.8758 .
返回引文位置Google Scholar
百度学术
万方数据
[12]
Wong TY ， Sun J ， Kawasaki R ，et al. Guidelines on diabetic eye care：the International Council of Ophthalmology recommendations for screening，follow-up，referral，and treatment based on resource settings[J]．Ophthalmology， 2018，125(10)∶1608-1622. DOI： 10.1016/j.ophtha.2018.04.007 .
返回引文位置Google Scholar
百度学术
万方数据
[13]
田蓓．糖尿病视网膜病变全视网膜光凝治疗的几个问题[J]．眼科， 2014，23(4)∶222-225. DOI： 10.13281/j.cnki.issn.1004-4469.2014.04.002 .
返回引文位置Google Scholar
百度学术
万方数据
Tian B ．Clarify some problems of pan-retinal photocoagulation for diabetic retinopathy[J]．Ophthalmol CHN， 2014，23(4)∶222-225. DOI： 10.13281/j.cnki.issn.1004-4469.2014.04.002 .
Goto CitationGoogle Scholar
Baidu Scholar
Wanfang Data
[14]
Iyer S ， Lagrew MK ， Tillit SM ，et al. The vitreous ecosystem in diabetic retinopathy：insight into the patho-mechanisms of disease[J/OL]．Int J Mol Sci， 2021，22(13)∶7142[2021-07-16]．http://www.ncbi.nlm.nih.gov/pubmed/34281192. DOI： 10.3390/ijms22137142 .
返回引文位置Google Scholar
百度学术
万方数据
[15]
张茉莉，田蓓，魏文斌．复方樟柳碱对糖尿病视网膜病变眼全视网膜光凝后视网膜功能损伤的修复作用[J]．中华实验眼科杂志， 2015，33(2)∶155-158. DOI： 10.3760/cma.j.issn.2095-0160.2015.02.012 .
返回引文位置Google Scholar
百度学术
万方数据
Zhang ML ， Tian B ， Wei WB . Effect of compound anisodine on retinal function repair in diabetic retinopathy after panretinal photocoagulation[J]．Chin J Exp Ophthalmol， 2015，33(2)∶155-158. DOI： 10.3760/cma.j.issn.2095-0160.2015.02.012 .
Goto CitationGoogle Scholar
Baidu Scholar
Wanfang Data
[16]
康皓，徐延山，张红．不同类型糖尿病性黄斑水肿的多焦视网膜电图分析[J]．中华实验眼科杂志， 2011，29(2)∶139-144. DOI： 10.3760/cma.j.issn.2095-0160.2011.02.011 .
返回引文位置Google Scholar
百度学术
万方数据
Kang H ， Xu YS ， Zhang H ．Multifocal electroretinogram findings of different types of diabetic macular edema[J]．Chin J Exp Ophthalmol， 2011，29(2)∶139-144. DOI： 10.3760/cma.j.issn.2095-0160.2011.02.011 .
Goto CitationGoogle Scholar
Baidu Scholar
Wanfang Data
[17]
Pescosolido N ， Barbato A ， Stefanucci A ，et al. Role of electrophysiology in the early diagnosis and follow-up of diabetic retinopathy[J/OL]．J Diabetes Res， 2015，2015∶319692[2021-06-21]．https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4436463/. DOI： 10.1155/2015/319692 .
返回引文位置Google Scholar
百度学术
万方数据
[18]
Baget-Bernaldiz M ， Romero-Aroca P ， Bautista-Perez A ，et al. Multifocal electroretinography changes at the 1-year follow-up in a cohort of diabetic macular edema patients treated with ranibizumab[J]．Doc Ophthalmol， 2017，135(2)∶85-96. DOI： 10.1007/s10633-017-9601-2 .
返回引文位置Google Scholar
百度学术
万方数据
[19]
Robson AG ， Nilsson J ， Li S ，et al. ISCEV guide to visual electrodiagnostic procedures[J]．Doc Ophthalmol， 2018，136(1)∶1-26. DOI： 10.1007/s10633-017-9621-y .
返回引文位置Google Scholar
百度学术
万方数据
[20]
卢彦，刘晓鹏，严励，等．不同程度糖尿病视网膜病变的多焦视网膜电图一阶kernel反应的特征[J]．眼科学报， 2018，33(2)∶83-88. DOI： 10.3978/j.issn.1000-4432.2018.04.01 .
返回引文位置Google Scholar
百度学术
万方数据
Lu Y ， Liu XP ， Yan L ，et al. Characteristics of the first-order kernel of multifocal electroretinogram in different severity grade of early diabetic retinopathy[J]．Eye Sci， 2018，33(2)∶83-88. DOI： 10.3978/j.issn.1000-4432.2018.04.01 .
Goto CitationGoogle Scholar
Baidu Scholar
Wanfang Data
备注信息
A
魏文斌，Email： mocdef.3ab61rtnibnewiew
B

张茉莉：参与试验设计、研究实施、数据采集及文章撰写；魏文斌：参与选题和研究设计、研究实施、数据分析、论文智力性内容修改和定稿；田蓓：参与试验设计，研究实施及对文章修改

C
所有作者均声明不存在利益冲突
D
首都卫生发展科研专项项目 (首发2020-1-2052)
北京市科委科技计划项目 (Z201100005520045、Z181100001818003)
北京市医院管理局"登峰"人才培养计划项目 (DFL20150201)
评论 （0条）
注册
登录
时间排序
暂无评论，发表第一条评论抢沙发
最新推荐
更多
我国糖尿病视网膜病变临床诊疗指南（2022年）
中华医学会眼科学分会眼底病学组 等
中华眼底病杂志 2023,39(02)
糖尿病视网膜病变患者全视网膜光凝后角膜上皮基底神经丛和朗格汉斯细胞的改变及其相关性
刘刚 等
中华眼视光学与视觉科学杂志 2021,23(01)
全视网膜光凝治疗对糖尿病视网膜病变患者生活质量的影响
杨秀芬 等
中华眼科杂志 2018,54(08)
糖尿病视网膜病变防治专家共识
中华医学会糖尿病学分会视网膜病变学组
中华糖尿病杂志 2018,10(04)
MedAI助手（体验版）
文档即答
智问智答
机器翻译
回答内容由人工智能生成，我社无法保证其准确性和完整性，该生成内容不代表我们的态度或观点，仅供参考。
生成快照
文献快照

你好，我可以帮助您更好的了解本文，请向我提问您关注的问题。

0/2000

《中华医学会杂志社用户协议》 | 《隐私政策》

《SparkDesk 用户协议》 | 《SparkDesk 隐私政策》

网信算备340104764864601230055号 | 网信算备340104726288401230013号

技术支持：

历史对话
本文全部
还没有聊天记录
设置
模式
纯净模式沉浸模式
字号
小中大