Ozkiris A, Erkiliç K, Koç A, Mistik S
Medical Faculty, Erciyes University, Kayseri, Turkey.
Br J Ophthalmol. 2007 Jan;91(1):69-73. doi: 10.1136/bjo.2006.098285. Epub 2006 Sep 14.
To investigate blood flow velocities in the ophthalmic and central retinal arteries (CRAs) in patients with diabetic retinopathy before and after atorvastatin treatment.
45 patients with type 2 diabetes were included in this double-blind, placebo-controlled study. The patients with diabetes were divided into three subgroups: group 1 (n = 15) included patients with non-proliferative diabetic retinopathy (NPDR); group 2 (n = 15) had patients with proliferative diabetic retinopathy (PDR); and group 3 (n = 15; placebo group) included 8 patients with NPDR and 7 patients with PDR. The patients in groups 1 and 2 (atorvastatin group) received 10 mg atorvastatin daily for 10 weeks. Pre-treatment and post-treatment serum levels of total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol and triglyceride were recorded before and after treatment. Ocular blood flow velocities of the ophthalmic artery and CRA were evaluated by colour Doppler imaging before and after treatment in each group.
The baseline haemodynamic parameters were similar between atorvastatin and placebo groups (p>0.05 for both). Atorvastatin significantly decreased serum levels of total cholesterol, low-density lipoprotein cholesterol and triglycerides in groups 1 and 2 compared with pretreatment levels (p<0.001 for both). The mean peak systolic flow velocities (PSVs) of the ophthalmic artery in group 2, and the mean PSV and resistive indices of the CRA in groups 1 and 2 decreased significantly after atorvastatin treatment (p<0.05 for both), whereas the mean end diastolic flow velocity of the ophthalmic artery and CRA did not change (p>0.05). There was no significant difference in ocular blood flow velocities in the placebo group (p>0.05).
Atorvastatin may have a role in reducing diabetic retinal complications, with improvement in vascular resistance and decrease in the mean PSVs of the ophthalmic artery and CRA. However, further studies with large numbers of patients are needed to obtain the long-term results of this drug.
研究阿托伐他汀治疗前后糖尿病视网膜病变患者眼动脉和视网膜中央动脉（CRA）的血流速度。
45例2型糖尿病患者纳入这项双盲、安慰剂对照研究。糖尿病患者分为三个亚组：第1组（n = 15）包括非增殖性糖尿病视网膜病变（NPDR）患者；第2组（n = 15）为增殖性糖尿病视网膜病变（PDR）患者；第3组（n = 15；安慰剂组）包括8例NPDR患者和7例PDR患者。第1组和第2组（阿托伐他汀组）患者每天服用10 mg阿托伐他汀，共10周。记录治疗前后总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇和甘油三酯的血清水平。每组在治疗前后通过彩色多普勒成像评估眼动脉和CRA的眼部血流速度。
阿托伐他汀组和安慰剂组的基线血流动力学参数相似（两者p>0.05）。与治疗前水平相比，阿托伐他汀显著降低了第1组和第2组患者的总胆固醇、低密度脂蛋白胆固醇和甘油三酯血清水平（两者p<0.001）。阿托伐他汀治疗后，第2组眼动脉的平均收缩期峰值流速（PSV）以及第1组和第2组CRA的平均PSV和阻力指数显著降低（两者p<0.05），而眼动脉和CRA的平均舒张末期流速未改变（p>0.05）。安慰剂组的眼部血流速度无显著差异（p>0.05）。
阿托伐他汀可能在减少糖尿病视网膜并发症方面发挥作用，可改善血管阻力并降低眼动脉和CRA的平均PSV。然而，需要大量患者的进一步研究来获得该药物的长期效果。
