α-硫辛酸注射液治疗非增殖型糖尿病视网膜病变的疗效观察
Efficacy of alpha-lipoic acid injection on nonproliferative diabetic retinopathy
目的 观察α-硫辛酸注射液治疗非增殖型糖尿病视网膜病变(NPDR)的疗效,并探讨其可能的作用机制.方法 选择2015年3月至2015年12月NPDR患者59例,采用分层随机法将其分成试验组和对照组,两组均给予降糖、降压、调脂等综合治疗,在此基础上,试验组给予α-硫辛酸600 mg加入氯化钠注射液250 ml中避光静脉滴注(最大速度为50 mg/min),每天1次,维持28 d(14 d为一疗程).比较经α-硫辛酸注射液治疗后,试验组患者血清脑源性神经营养因子(BDNF)、高迁移率族蛋白1(HMGB-1)、糖基化终产物受体片断(sRAGE)和单核细胞趋化蛋白-1(MCP-1)水平,并与对照组比较.结果 经α-硫辛酸注射液治疗后,试验组患者血清BDNF浓度明显高于对照组(P=0.023),血清HMGB1、sRAGE浓度明显低于对照组(P =0.045,P=0.017),两组血清MCP-1浓度比较差异未见统计学意义(P>0.05).结论 抗氧化剂α-硫辛酸可以降低NPDR患者血清HMGB1、sRAGE水平,减缓BDNF的下调,从而改善糖尿病视网膜病变患者早期的视网膜神经退行性变.
更多Objective To investigate the efficacy and possible mechanisms of alpha-lipoic acid on patients with non proliferative diabetic retinopathy (NPDR).Methods Fifty-nine NPDR patients from March 2015 to December 2015 were randomly divided into control group and treatment group.Patients in control group received the standard hypoglycemic treatment,antihypertensive therapy,and other comprehensive treatment,on the basis of the above treatment,the patients in treatment group were treated with alpha-lipoic acid 600 mg + 250 ml sodium chloride injection additionally for 28 days.Before and after treatment,the serum levels of BDNF,HMGB-1,sRAGE and MCP-1 of the two groups were detected and compared.Results Compared with the control group,the serum level of BDNF increased significantly in the treatment group (P =0.023),while,the serum levels of HMGB-1 and sRAGE decreased significandy in the treatment group (P =0.045,P =0.017).The serum level of MCP-1 of the two groups had no significant difference (P > 0.05).Conclusions Alpha-lipoic acid can decrease of oxidative stress and serum level of HMGB-1,sRAGE,slow down the reduction of BDNF,to improve the retinal degeneration in NPDR patients.
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