目的 探討阿托伐他汀聯(lián)合前列地爾注射液治療糖尿病視網膜病變的臨床療效。方法 選取河北醫(yī)科大學第三醫(yī)院2018年6月-2019年1月收治的糖尿病視網膜病變患者72例，隨機分為對照組（36例）和治療組（36例）。對照組靜脈滴注前列地爾注射液，10 μg加入100 mL生理鹽水，1次/d。治療組患者在對照組的基礎上口服阿托伐他汀鈣片，初始劑量1片/次，1次/d，后續(xù)逐漸增加至4片/次，1次/d。兩組患者均連續(xù)治療1個月。觀察兩組患者臨床療效，同時比較治療前后兩組患者血清細胞間黏附分子-1（ICAM-1）、腫瘤壞死因子-α（TNF-α）、超敏C反應蛋白（hs-CRP）、白細胞介素-10（IL-10）、總膽固醇（TC）、三酰甘油（TG）、低密度脂蛋白膽固醇（LDL-C）和高密度脂蛋白膽固醇（HDL-C）水平以及眼底微動脈瘤數(shù)目。結果 治療后，對照組臨床有效率為72.22%，顯著低于治療組的91.67%，兩組比較差異有統(tǒng)計學意義（P<0.05）。治療后，兩組患者眼底微動脈瘤數(shù)目均明顯降低（P<0.05），且治療組降低更明顯（P<0.05）。治療后，兩組患者血清ICAM-1、TNF-α、hs-CRP、TC、TG、LDL-C水平明顯降低（P<0.05），而IL-10和HDL-C水平明顯升高（P<0.05），且治療組比對照組改善更明顯（P<0.05）。結論 阿托伐他汀聯(lián)合前列地爾注射液治療糖尿病視網膜病變臨床療效顯著，可有效改善血清炎癥因子和血脂水平，且安全性高，具有一定的臨床推廣應用價值。

Objective To investigate the clinical efficacy of atorvastatin combined with alprostadil in treatment of diabetic retinopathy. Methods Patients (72 cases) with diabetic retinopathy in the Third Hospital of Hebei Medical University from June 2018 to January 2019 were randomly divided into control (36 cases) and treatment (36 cases) groups. Patients in the control group were iv administered with Alprostadil Injection, 10 μg added into normal saline 100 mL, once daily. Patients in the treatment group were po administered with Atorvastatin Calcium Tablets on the basis of the control group, the initial dose was 1 tablet/time, once daily, and gradually increased to 4 tablets/time, once daily. Patients in two groups were treated for 1 month. After treatment, the clinical efficacy was evaluated, and the serum levels of ICAM-1, TNF-α, hs-CRP, IL-10, TC, TG, LDL-C and HDL-C, and the number of fundus microaneurysms in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control group was 72.22%, which was significantly lower than 91.67% in the treatment group, and there were differences between two groups (P<0.05). After treatment, the number of fundus microaneurysms in two groups was significantly decreased (P<0.05), and which in the treatment group was significantly less than that in the control group (P<0.05). After treatment, the serum levels of ICAM-1, TNF-α, hs-CRP, TC, TG, LDL-C in two groups was significantly decreased (P<0.05), but the levels of IL-10 and HDL-C were significantly increased (P<0.05), and these indexes in the treatment group were significantly better than those in the control group (P<0.05). Conclusion Atorvastatin combined with alprostadil has a significant clinical effect in treatment of diabetic retinopathy, which can effectively improve serum inflammatory factors and blood lipid levels with high safety, which has a certain clinical application value.

R977

河北省衛(wèi)生廳指令性項目（20160149）