利拉鲁肽对早期糖尿病视网膜病变的影响

邹俊 李青 周国艳

【摘要】目的：探讨利拉鲁肽对早期糖尿病视网膜病变的影响。方法：选取早期糖尿病视网膜病变患者66例，分为两组，对照组维持原有的治疗方案， 利拉鲁肽组在此基础上加用利拉鲁肽，治疗12周，比较两组血压、体重指数（BMI）、FBG、PBG、HbA1c、血脂、血管内皮生长因子（Vascular endothelial growth factor VEGF ）以及眼底检查结果。结果：治疗前两组血压、FBG、PBG、HbA1c、CHOL、LDL-C比较无差异（P<0.05），治疗后两组血压、FBG、PBG、HbA1c、CHOL、LDL-C均较治疗前下降（P<0.05），但治疗后两组间比较无差异（P>0.05）；治疗前两组BMI、TG、VEGF无差异（P>0.05）；治疗后两组BMI、TG、VEGF均较治疗前下降，而利拉鲁肽组较对照组下降更显著，差异有统计学意义（P<0.05）；治疗后两组眼底检查结果均较治疗前改善，而利拉鲁肽组较对照组疗效更显著，差异有统计学意义（P<0.05）。结论：利拉鲁肽可以改善早期糖尿病视网膜病变。

【关键词】利拉鲁肽；2型糖尿病；早期糖尿病视网膜病变；VEGF

[中图分类号]R587.2； R774.1 [文献标识码]A [文章编号]2096-5249（2021）03-0023-03

The effect of liraglutide on patients with early diabetic retinopathy

ZOU Jun， LI Qing*， ZHOU Guo-yan （Department of Endocrinology， Xiang dong Hospital， Hunan Normal University， ZhuZhou Hunan 412200， China）

[Abstract] Objective： To investigate the effect of liraglutide on early diabetic retinopathy. Methods： Sixty-six patients with early diabetic retinopathy were selected and divided into two groups. The control group maintained the original treatment plan， and the liraglutide group was treated with liraglutide on this basis. After 12 weeks of treatment， the blood pressure， body mass index （BMI）， FBG， PBG， HbA1c， blood lipids， Vascular endothelial growth factor （VEGF） and fundus examination results were compared between the two groups. Results： There was no difference in blood pressure， FBG， PBG， HbA1c， CHOL， LDL-C between the two groups before treatment （P<0.05）. After treatment， blood pressure， FBG， PBG， HbA1c， CHOL， and LDL-C were all lower than before treatment （P<0.05）， but there is no difference between the two groups after treatment （P>0.05）；There was no difference in BMI， TG， and VEGF between the two groups before treatment（P>0.05）； after treatment， BMI， TG， and VEGF in the two groups decreased compared to before treatment， while the liraglutide group decreased more significantly than the control group， and the difference was statistically significance （P<0.05）； after treatment， the fundus examination results of the two groups were improved compared with before treatment， while the effect of liraglutide group was more significant than that of the control group， and the difference was statistically significant （P<0.05）. Conclusion： Liraglutide can improve early diabetic retinopathy.

[Key words] Liraglutide； type 2 diabetes； early diabetic retinopathy； VEGF

糖尿病視网膜病变（Diabetic retinopathy，DR）是糖尿病特异性的眼底病变，是成人视力障碍的主要原因之一[1]，其发病率约占糖尿病患者的30%～50%[2]。常导致视力下降、视野范围受损、玻璃体积血，进展到中晚期糖尿病视网膜病变时严重影响患者生活质量，甚至失明[3]，因此，对早期糖尿病视网膜病变早期干预治疗尤为重要，目前糖尿病视网膜病变常规治疗手段有限。利拉鲁肽是新型降糖药物，在改善血糖的同时可降低血脂和减轻体重，降低糖尿病肾病蛋白尿，而利拉鲁肽对DR的作用疗效报道较少。有关动物实验表明，胰高血糖素样肽-1受体的激活对DR有保护作用[4]，作用机制暂不明确。……