目的：观察前列地尔注射液治疗2型糖尿病早期视网膜病变的临床疗效及对患者血清血管内皮生长因子（ VEGF）和内抑素（ NES）的影响。方法将2型糖尿病非增殖性视网膜病变患者98例随机分为观察组50例、对照组48例。对照组予以常规治疗，观察组在此基础上加用前列地尔注射液10μg静脉滴注，每天1次，14 d为1个疗程。观察2组患者的临床疗效和病变分级，以及治疗前后部分生化和血凝指标、VEGF、NES的变化，并予以比较。结果（1）经过治疗，观察组总有效率为928．0％高于对照组的70．8％，且观察组III期、IV期病例数明显少于对照组，差异有统计学意义（ P ＜0．05）。（2）2组患者血清NES均明显高于治疗前，观察组D-D、ET-1、TC、TG、LDL-C、FPG、HbA1c、hs-CRP、VEGF则明显低于治疗前，而对照组除LDL-C外，上述指标亦低于治疗前（ P ＜0．01），且观察组TC、LDL-C、HbA1c、hs-CRP、VEGF、NES等指标的改变较对照组更为明显（ P ＜0．01）。结论前列地尔注射液可用于治疗2型糖尿病早期视网膜病变，并推测其尚有延缓疾病进展的作用。%Objective To compare the clinical efficacy of alprostadil injection in treatment of early diabetic retinopa -thy in type 2 diabetes mellitus , and observe the effect on serum VEGF and NES .Methods 98 cases of type 2 diabetes melli-tus patients with non-proliferative retinopathy were randomly divided into observation group ( n =50 ) and control group ( n =48).The control group was given conventional treatment , the observation group added alprostadil injection 10ug intravenous infusion, once a day for 14 d.The clinical efficacy and serum VEGF ,NES changes in 2 groups were observed before and after treatment.Results (1) In observation group, the total effective rate was higher than that in control group (92.% vs. 70.8%), and patients of stage III ,IV were obviously less than control group ( P <0.05).(2) After treatment,serum level of NES were higher, D-D,ET-1,TG,TC,LDL-C,FPG,HbA1c,hs-CRP and VEGF were lower than those before treatment (ex-cept LDL-C in control group), there were significant difference( P <0.05), and the changes of TC,HbA1c,hs-CRP,VEGF and NES in observation group was more obvious than control group ( P <0.01).Conclusion Alprostadil injection can be used in the treatment of early diabetic retinopathy in type 2 diabetes mellitus , and could postpone the disease progression .
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