AIM: To analyze the effect of calcium dobesilate combined with hypoglycemics for patients with diabetic retinopathy (DR) and cataract, and the influence on microcirculation of eye fundus, hypoxia inducible factor-1α (HIF-1α), vascular endothelial growth factor (VEGF) level. METHODS: Totally 98 DR patients with cataract (126 eyes) from January 2013 to December 2015 in our hospital were selected as the research objects, and were divided into two groups randomly(treatment group:64 eyes in 49 patients, control group: 62 eyes in 49 patients). The control group was treated with acarbose tablet and metformin, while treatment group was treated with calcium dobesilate additionally. The clinical effect, the glycemic control effect, serum HIF-1α and VEGF level, eye function and fundus microcirculation of two groups after 12mo were compared. RESULTS: After 12mo, the total effective rates of two groups were 87.5%,61.3% respectively, which indicated significantly difference (P0.05). After 1-month treatment, the plasma viscosity, erythrocyte aggregation index, erythrocyte deformability index, erythrocyte sedimentation rate and hematocrit in the treatment group were significantly lower than those in the control group (P0.05).治疗1mo后,治疗组患者的血浆黏度、红细胞聚集指数、红细胞变形指数、血沉、红细胞压积显著低于对照组,差异有统计学意义(P<0.05);治疗组患者的视网膜睫状后短动脉和中央动脉的PSV、EDV均显著高于对照组,差异有统计学意义(P<0.05),RI 显著低于对照组,差异有统计学意义(P<0.05).治疗12mo后,两组患者的HIF-1a和VEGF显著降低,差异有统计学意义(P<0.05),治疗组和对照组的HIF-1a水平分别为35.90 ±11.36、46.75 ±12.08mmol/L, VEGF水平分别为89.72±13.61、110.30±16.74mmol/L,治疗组的HIF-1a和VEGF均显著低于对照组,差异有统计学意义(P<0.05).结论:羟苯磺酸钙与降糖药联用治疗伴有视网膜病变的糖尿病性白内障患者,能够有效控制血糖,提高临床疗效,改善眼底微循环,缓解病情进展,下调HIF-1a和VEGF水平,抑制血管增生.
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