Xu Kai, Qian Hanliang, Zou Meibo
Department of Ophthalmology, Taizhou Second People's Hospital Affiliated to Yangzhou University, Taizhou, Zhejiang 225500, P.R. China.
Department of Ophthalmology, Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu 212001, P.R. China.
Exp Ther Med. 2020 Apr;19(4):2519-2526. doi: 10.3892/etm.2020.8478. Epub 2020 Jan 30.
Effects of triamcinolone acetonide (TA) combined with aminoguanidine (AG) on vascular endothelial function, vascular endothelial growth factor (VEGF) expression and retinal function in diabetic retinopathy (DR) patients were studied. A total of 100 patients with DR admitted to the Taizhou Second People's Hospital Affiliated to Yangzhou University from January 2016 to December 2018 were collected and randomly divided into observation group (n=50) and control group (n=50). The control group was only treated with TA (4 mg), while the observation group was additionally treated with AG (50 mg/kg). The therapeutic effect and adverse reactions were observed, and the changes in blood glucose (GLU), blood lipid, serum inflammatory cytokines and oxidative stress indexes before and after treatment were detected. Moreover, the serum VEGF level was examined, the central macular thickness (CMT), retinal neovascularization (RNV) leakage area and best corrected visual acuity (BCVA) of retinopathy were observed, and the vascular endothelial function indexes such as nitric oxide (NO), endothelin-1 (ET-1) and intercellular adhesion molecule-1 (ICAM-1) were detected. The therapeutic effect in the observation group was significantly better than that in control group (P<0.05). In observation group after treatment, the levels of GLU, total cholesterol (TC), triglyceride (TG), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), myeloperoxidase (MPO), malondialdehyde (MDA) and catalase (CAT) in the serum, VEGF, CMT and RNV, as well as NO, ET-1 and ICAM-1 were remarkably decreased (P<0.05), while those of superoxide dismutase (SOD) and BCVA were evidently increased (P<0.05). The changes were more significant at 3 months after treatment than those at 1 month. TA combined with AG can inhibit inflammation and oxidative stress, improve vascular endothelial function and retinal function and reduce VEGF expression in DR patients. The overall effect of the combined therapy is good, and its application is worth popularizing.
研究了曲安奈德（TA）联合氨基胍（AG）对糖尿病视网膜病变（DR）患者血管内皮功能、血管内皮生长因子（VEGF）表达及视网膜功能的影响。收集2016年1月至2018年12月在扬州大学附属泰州第二人民医院收治的100例DR患者，随机分为观察组（n = 50）和对照组（n = 50）。对照组仅接受TA（4 mg）治疗，而观察组额外接受AG（50 mg/kg）治疗。观察治疗效果及不良反应，检测治疗前后血糖（GLU）、血脂、血清炎症细胞因子及氧化应激指标的变化。此外，检测血清VEGF水平，观察视网膜病变的中心黄斑厚度（CMT）、视网膜新生血管（RNV）渗漏面积及最佳矫正视力（BCVA），并检测一氧化氮（NO）、内皮素-1（ET-1）和细胞间黏附分子-1（ICAM-1）等血管内皮功能指标。观察组治疗效果明显优于对照组（P < 0.05）。观察组治疗后，血清中GLU、总胆固醇（TC）、甘油三酯（TG）、白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）、髓过氧化物酶（MPO）、丙二醛（MDA）和过氧化氢酶（CAT）水平、VEGF、CMT和RNV，以及NO、ET-1和ICAM-1均显著降低（P < 0.05），而超氧化物歧化酶（SOD）和BCVA明显升高（P < 0.05）。治疗后3个月的变化比1个月时更显著。TA联合AG可抑制炎症和氧化应激，改善血管内皮功能和视网膜功能，降低DR患者的VEGF表达。联合治疗的总体效果良好，值得推广应用。
