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1.
目的:观察红参粉末治疗糖尿病视网膜病变的临床效果。方法:随机选取2012年1月至2012年12月在我院接受治疗的2型糖尿病合并糖尿病视网膜病变(Diabetic Retinopathy,DR)患者103例。其中30例(57眼)仅采用常规方法治疗,即对照组;其余73例(125眼)在常规治疗的基础上加用红参粉末,即观察组。治疗180天后,观察并比较两组患者的视力、眼底镜、荧光血管造影等检查结果的变化情况。结果:在观察组中,患者经红参粉末治疗后的视力与治疗前相比有所提高,差异具有统计学意义(P〈0.05);而对照组中,患者治疗前后的视力变化无统计学意义(P〉0.05);观察组治疗有效率为76.7%,而对照组治疗有效率为46.7%,差异有显著意义(P〈0.05)。观察组中,男性DR患者治疗有效率为68.8%、女性为92.0%;早期DR治疗有效率为85.4%、晚期为65.1%;糖尿病病程不超过10年的DR患者治疗有效率为88.9%、超过10年的为64.9%,差异均具有统计学意义(P〈0.05)。结论:尽早的发现和及时的治疗可减少糖尿病患者视网膜病变的发生率,从而避免因视网膜病变而引起的严重的视力下降,甚至失明。红参粉末治疗糖尿病视网膜病变有显著的临床效果,特别是对早期糖尿病视网膜病变的疗效更佳,值得临床推广。  相似文献   

2.
糖尿病大鼠视网膜血管铺片技术的改进及形态学观察   总被引:6,自引:0,他引:6  
近年来我国糖尿病的患病率在逐年增加 ,病例总数居世界第二。糖尿病视网膜病变 (DiabeticRetinopathy DR)是糖尿病最为常见和严重的微血管病的并发症之一 ,也是成人主要致盲的疾病之一 ,病程愈长致盲机率愈高。DR发病机理至今尚未完全阐明 ,认为与多种因素的协同作用有关。目前 ,临床尚无有效的防治手段。因此研究 DR的发病机理 ,研制出有效治疗药物的任务迫在眉睫。视网膜毛细血管铺片技术是一种研究 DR理想的方法 ,不仅可清楚地观察到毛细血管的结构、走行、分布。还可进行定量分析细胞之间的比例、血管的密度、管径的大小等。但是 ,…  相似文献   

3.
目的 观察川芎嗪联合氨胍治疗对糖尿病大鼠视网膜血管内皮生长因子(VEGF)表达的影响。探讨川芎嗪联合氨胍治疗糖尿病视网膜病变(DR)的机制。方法 应用链尿佐菌素(STZ)制作糖尿病大鼠模型。分为正常对照组,糖尿病未治疗组,川芎嗪治疗组,氨胍治疗组和川芎嗪联合氨胍治疗组,分别于第4周,第12周和第20周应用免疫组化方法观察各组大鼠视网膜组织VEGF表达的变化。结果 正常大鼠视网膜组织VEF表达仅见于内核层,糖尿病大鼠视网膜组织VEGF阳性表达随周龄的延长而增强,且在毛细血管内和节细胞层可见VEGF表达,治疗12周和20周后,川芎嗪治疗组和氨胍治疗组大鼠视网膜组织VEGF阳性表达比未治疗组明显减弱,但仍高于正常对照组,而川芎嗪联合氨胍治疗组视网膜组织VEGF表达接近正常。结论 川芎嗪联合氨胍治疗可抑制糖尿病大鼠视网膜VEGF的过度表达。是川芎嗪联合氨胍治疗糖尿病视网膜病变(DR)的机制之一。  相似文献   

4.
延长糖尿病模型大鼠生存期对糖尿病视网膜病变的影响   总被引:1,自引:1,他引:0  
目的延长糖尿病模型大鼠生存期,动态观察糖尿病视网膜病变(DR)的形成和发展过程。方法雄性SD大鼠70只,随机分成对照组(20只)和模型组(50只),采用链脲佐菌素(STZ)60 mg/(kg.bw)体重腹腔1次注射造模,分别于69、、12月时处死取眼球,采用视网膜微血管消化铺片技术观察糖尿病视网膜病变的微血管形态学改变。结果糖尿病大鼠DR样病变随着病程的延长病变呈多样性改变,以12月DR出现的小动脉硬化尤为严重。结论糖尿病大鼠生存期的延长对糖尿病视网膜病变的研究有着积极的意义。  相似文献   

5.
汪梦竹  蔡畅  刘洋  宋洪元  沈炜 《生命科学》2023,(10):1380-1387
糖尿病视网膜病变(diabetic retinopathy, DR)是糖尿病患者最常见的微血管系统并发症之一,是视力丧失的主要原因。增殖性糖尿病视网膜病变(proliferative diabetic retinopathy, PDR)是DR的终末期表现,其主要的病理生理学特征是视网膜新生血管形成(retinal neovascularization, RNV)。但PDR现有治疗方式存在局限性。外泌体作为细胞间沟通交流的重要使者,其携带的非编码RNA和生物活性蛋白质等重要信号分子,通过影响血管内皮细胞的增殖和迁移,在RNV中发挥关键作用。巨噬细胞是一种多功能调节细胞,越来越多的研究表明巨噬细胞外泌体在调控新生血管形成中起重要作用。该文就巨噬细胞外泌体在增殖性糖尿病视网膜病变形成中的作用与机制研究进展进行综述。  相似文献   

6.
STZ诱发实验恒河猴糖尿病性视网膜并发症模型的建立   总被引:3,自引:0,他引:3  
目的 建立糖尿病性视网膜并发症 (DiabeticRetinopathy ,DR)动物模型。方法 本研究选用 4只健康成熟的雄性恒河猴分别以剂量为 6 0mg kg、4 5mg kg静脉一次注射及 30mg kg静脉二次注射 (中间间隔 15d)链脲佐菌素 (Streptozotocin ,STZ)。结果 使用不同剂量的STZ注射恒河猴 ,分别造成了胰岛素依赖性糖尿病 (InsulinDepen dentDiabetesMellitus ,IDDM)及慢性持续性高血糖症 (StateofChronicHyperglycemia,SCH)两种类型的模型 ,从而诱导出不同程度的DR。眼底荧光造影结果显示∶用药后 6 3~ 91d4只实验猴均出现不同程度的视网膜病 ,分别显示早期眼底微血管动脉扩张 ,视网膜出血瘤 ,微血管瘤及新生血管、晚期白内障等。结论 本研究所建立的糖尿病性视网膜并发症模型 ,对于进一步研究糖尿病及其并发症的发病机理 ,筛选及开发治疗糖尿病性视网膜病的新药及药物安全性评价将会具有广阔的应用前景  相似文献   

7.
目的:探讨糖化血红蛋(HbA1c)、空腹血糖(FPG)与2型糖尿病患者视网膜病变(DR)的相关性。方法:对我院2010年1月-2012年12月住院或门诊的336例2型糖尿病(T2DM)患者进行眼底检查或眼底血管荧光素造影检测,按有无视网膜病变分为视网膜病变(DR)组和无视网膜病变(NDR)组,并对HbA1c、FBG水平进行检测。结果:DR组较NDR组HbA1c水平高,差异有统计学意义(P〈0.05),HbA1c水平和DR分期呈正相关(I=0.526,P〈0.001),而DR组和NDR组FPG水平差异无无统计学意义(P〉0.05)。结论:可将HbA1c作为2型糖尿病患者视网膜病变发生和发展的监测指标之一。  相似文献   

8.
目的 探讨2型糖尿病患者尿视黄醇结合(RBP)与视网膜病变相关性。方法 采用酶联免疫法检测158例2型糖尿病患者24h尿视黄醇结合蛋白排泄(24hURBP)及24h尿白蛋白排泄(24hUAE),并同时用眼底镜仔细检查其眼氏。结果 糖尿病视网膜病变(DR)发生率随着24hURBP、24hUAE增加而显著增高,24hURBP、24hUAE也随DR的程度加重而显著增加。结论 2型糖尿病患者DR与尿RBP、尿白蛋白呈正相关。  相似文献   

9.
目的:观察氩激光光凝治疗不同分期糖尿病视网膜病变(diabetic retinopathy,DR)的疗效。方法:对264例513眼DR患者按病变不同分期分别行黄斑格栅样光凝、次全视网膜光凝(sPRP)和全视网膜光凝(PRP)。随访3月-5年,观察患者视力、眼底及荧光血管造影情况。结果:总计有24.0%(123/513)的患眼视力得以上升,49.7%(255/513)视力保持不变,26.3%(135/513)视力下降。非增殖性DR激光治疗有效率为87.5%,增殖性DR有效率58.4%(P<0.05)。1型DM有效率43.5%,2型DM有效率81.4%(P<0.05)。结论:氩激光能有效控制DR,减缓DR患者视力的丧失,非增殖性DR疗效明显优于增殖性DR,2型DM疗效优于1型DM。  相似文献   

10.
目的:探讨醛糖还原酶(AR)基因启动区C(-106)T多态性与糖尿病视网膜病变(DR)的关系。方法:235例江苏汉族人群,其中2型糖尿病无视网膜病变组(NDR)63例,2型糖尿病伴视网膜病变组(DR)82例,正常对照组(YC)90例,用PCR-RFLP方法检测AR基因C(-106)T基因型,比较各组等位基因及基因型分布频率。结果:未发现NDR组和NC组之间AR基因C(-106)T各等位基因及基因型频率有显著差异(P分别为0.4505,0.7279);DR组中CT及TT基因型频率均高于NC组,CC基因型频率低于NC组(P=0.0239),DR组T等位基因频率显著高于NC组,C等位基因频率显著低于NC组(P=0.0038)。结论:AR基因启动区C(-106)T多态性与江苏汉族人群DR相关,T等位基因可能是DR的遗传危险因子。  相似文献   

11.
12.
《Endocrine practice》2020,26(4):429-443
Objective: To characterize the relationship between diabetic retinopathy (DR) and diabetic nephropathy (DN) in Chinese patients and to determine whether the severity of DR predicts end-stage renal disease (ESRD).Methods: Bilateral fundic photographs of 91 Chinese type 2 diabetic patients with biopsy-confirmed DN, not in ESRD stage, were obtained at the time of renal biopsy in this longitudinal study. The baseline severity of DR was determined using the Lesion-aware Deep Learning System (RetinalNET) in an open framework for deep learning and was graded using the Early Treatment Diabetic Retinopathy Study severity scale. Cox proportional hazard models were used to estimate the hazard ratio (HR) for the effect of the severity of diabetic retinopathy on ESRD.Results: During a median follow-up of 15 months, 25 patients progressed to ESRD. The severity of retinopathy at the time of biopsy was a prognostic factor for progression to ESRD (HR 2.18, 95% confidence interval 1.05 to 4.53, P = .04). At baseline, more severe retinopathy was associated with poor renal function, and more severe glomerular lesions. However, 30% of patients with mild retinopathy and severe glomerular lesions had higher low-density lipo-protein-cholesterol and more severe proteinuria than those with mild glomerular lesions. Additionally, 3% of patients with severe retinopathy and mild glomerular changes were more likely to have had diabetes a long time than those with severe glomerular lesions.Conclusion: Although the severity of DR predicted diabetic ESRD in patients with type 2 diabetes mellitus and DN, the severities of DR and DN were not always consistent, especially in patients with mild retinopathy or microalbuminuria.Abbreviations: CI = confidence interval; DM = diabetic mellitus; DN = diabetic nephropathy; DR = diabetic retinopathy; eGFR = estimated glomerular filtration rate; ESRD = end-stage renal disease; HbA1c = hemoglobin A1c; HR = hazard ratio; NPDR = nonproliferative diabetic retinopathy; PDR = proliferative diabetic retinopathy; SBP = systolic blood pressure; T2DM = type 2 diabetes mellitus; VEGF = vascular endothelial growth factor  相似文献   

13.
Diabetes is a major cause of morbidity and mortality worldwide. It can affect many organs and, over time, leads to serious complications. Diabetic retinopathy (DR), a specific ocular complication of diabetes, remains the leading cause of vision loss and vision impairment in adults. This work is the first in Eastern Morocco aimed at identifying the different stages of DR and to determine their frequencies and associated risk factors. It is a case-control study conducted from December 2018 to July 2019 at the ophthalmology department of Al-Irfane Clinic (Oujda). Data were obtained from a specific questionnaire involving 244 diabetic patients (122 cases with retinopathy vs 122 controls without retinopathy). All results were analyzed by the EPI-Info software. This study shows a predominance of proliferative diabetic retinopathy (PDR) with 57.4% of cases (uncomplicated proliferative diabetic retinopathy (UPDR): 23.8%; complicated proliferative diabetic retinopathy (CPDR): 33.6%). The non-proliferative diabetic retinopathy (NPDR) represents 42.6% (minimal NPDR: 8.2%; moderate NPDR: 26.2%; severe NPDR: 8.2%). The determinants of DR were insulin therapy, high blood pressure, poor glycemic control and duration of diabetes. Regarding the chronological evolution, retinopathy precedes nephropathy. Diabetic nephropathy (DN) was present in 10.6% of cases especially in patients with PDR. In summary, the frequency of PDR was higher than that of NPDR. DR appears before DN with a high frequency of DN in patients with PDR. Good glycemic control and blood pressure control, as well as early diagnosis are the major preventive measures against DR.  相似文献   

14.
Ahn BY  Song ES  Cho YJ  Kwon OW  Kim JK  Lee NG 《Proteomics》2006,6(4):1200-1209
Circulating autoantibodies specific for retinal proteins are associated with retinal destruction in patients with diabetic retinopathy (DR). In this study, we screened diabetic sera for the presence of anti-retinal autoantibodies with an aim of developing diagnostic markers for DR. Immunoblot analysis of DR patients' sera with human retinal cytosolic proteins revealed a higher incidence of anti-retinal autoantibodies, compared to normal blood donors or diabetic patients without DR. Anti-retinal protein autoantibody profiles of DR patient sera were obtained by 2-DE immunoblot analysis. Specifically, 20 protein spots reactive with DR patient sera were identified by ESI-MS/MS. Of these spots, 14 were specific for DR patients, and 4 reacted with both non-proliferative DR (non-PDR) and PDR sera. The anti-aldolase autoantibody was selected as a DR marker candidate, and specific reactivity of DR patient sera was confirmed by immunoblot analysis with rabbit aldolase. The serum anti-aldolase autoantibody level was measured by ELISA. DR patients showed significantly higher autoantibody levels than normal donors or diabetic patients without retinopathy. However, no significant differences were observed between non-PDR and PDR patients, suggesting that the level of anti-aldolase autoantibody is not determined by the severity of retinopathy in diabetic patients. Our data collectively demonstrate that the anti-aldolase autoantibody serves as a useful marker for DR diagnosis.  相似文献   

15.
2型糖尿病性视网膜病变临床因素分析   总被引:5,自引:0,他引:5  
目的:探讨影响2型糖尿病视网膜病变(DR)发病的相关临床因素。方法:回顾性分析483例2型糖尿病患者的临床资料。结果:2型糖尿痛DR患病率为35%(169/483),其中非增殖型视网膜病变(NPDR)73.4%(124/169),增殖型视网膜病变(PDR)26.6% (45/169)。DR患者的病程、SBP、合并肾脏病变、合并心脏病变、HbA1c、TC、TG、LDL-c、BUN和Cr均显著高于NDR患者(P<0.05);Logistic回归分析显示病程、年龄、SBP、TC、LDL-c、合并心脏病变和/或肾脏病变是DR发病的危险因素。结论:DM病程、患病年龄、SBP、HbA1c、TC、LDL-c、合并心脏病变和/或肾脏病变、肾功能是DR发生发展的危险因素。  相似文献   

16.
《IRBM》2022,43(6):614-620
BackgroundDiabetic retinopathy (DR) is one of the major causes of blindness in adults suffering from diabetes. With the development of wide-field optical coherence tomography angiography (WF-OCTA), it is to become a gold standard for diagnosing DR. The demand for automated DR diagnosis system based on OCTA images have been fostered due to large diabetic population and pervasiveness of retinopathy cases.Materials and methodsIn this study, 288 diabetic patients and 97 healthy people were imaged by the swept-source optical coherence tomography (SS-OCT) with 12 mm × 12 mm single scan centered on the fovea. A multi-branch convolutional neural network (CNN) was proposed to classify WF-OCTA images into four grades: no DR, mild non-proliferative diabetic retinopathy (NPDR), moderate to severe NPDR, and proliferative diabetic retinopathy (PDR).ResultsThe proposed model achieved a classification accuracy of 96.11%, sensitivity of 98.08% and specificity of 89.43% in detecting DR. The accuracy of the model for DR staging is 90.56%, which is higher than that of other mainstream convolution neural network models.ConclusionThis technology enables early diagnosis and objective tracking of disease progression, which may be useful for optimal treatment to reduce vision loss.  相似文献   

17.
BackgroundAngiotensin-converting enzyme (ACE) stimulates angiogenesis that leads to the development of diabetic retinopathy (DR). Alu repetitive elements in ACE gene increase the expression of this enzyme. We investigated the frequency of Alu repetitive elements, insertion/deletion (I/D) polymorphism, in angiotensin-converting enzyme among diabetic retinopathy patients and whether this polymorphism is associated with the severity of retinopathy in Jordanians with type 2 diabetes.MethodsA total of 277 subjects participated in this case/ control study (100 diabetic patients without DR, 82 diabetic patients with DR, and 95 healthy control). Blood samples were withdrawn, followed by DNA extraction. Alu repetitive elements were examined by polymerase chain reaction followed by gel electrophoresis.ResultsThe genotype and allele frequencies among diabetic patients, were close to healthy controls (genotypes, II 44.4 vs. 44.7%, ID 44.4 vs. 42.6%, DD 12.2 vs. 12.8%, P = 0.402 and 0.677 respectively, alleles, I 65.6 vs. 66%, D 34.4 vs. 34%, P=0.863). Complicated diabetics with retinopathy showed similar genotype and allele frequency to those without complications. The severity of diabetic retinopathy in affected individuals was not correlated with I/D polymorphism (P=0.862).ConclusionsWe conclude that the presence of Alu repetitive elements did not increase the development or progression risk to retinopathy in Jordanian type 2 diabetic patients. No association between I or D alleles with the severity of DR was detected.  相似文献   

18.
19.

Background

Although diabetic retinopathy (DR) is considered to be a major cause of blindness, this is the first meta-analysis to investigate the pooled prevalence of DR in mainland China.

Methodology/Principal Findings

We conducted a search of all English reports on population-based studies for the prevalence of DR using Medline, EMbase, Web of Science, Google (scholar), and all Chinese reports were identified manually and on-line using CBMDisc, Chongqing VIP database, and CNKI database. A meta-analysis was carried out. The fixed effects model or random effects model was used as a statistical test for homogeneity. Nineteen studies were included. The prevalence of DR, non-proliferative diabetic retinopathy (NPDR) and proliferative diabetic retinopathy (PDR) in the pooled general population was 1.3% (95%CI: 0.5%–3.2%), 1.1% (95%CI: 0.6%–2.1%), and 0.1% (95%CI: 0.1%–0.3%), respectively, but was 23% (95%CI: 17.8%–29.2%), 19.1% (95%CI: 13.6%–26.3%), and 2.8% (95%CI: 1.9%–4.2%) in the diabetic group. The prevalence rate of DR in the pooled rural population was higher than that in the urban population, 1.6% (95%CI: 1.3%–2%), and the diabetic population, 29.1% (95%CI: 20.9%–38.9%). The prevalence of DR was higher in the Northern region compared with the Southern region.

Conclusions/Significance

The prevalence of DR in mainland China appeared a little high, and varied according to area. NPDR was more common. This study highlights the necessity for DR screening in the rural areas of China.  相似文献   

20.

Purpose

To explore the relationship between chronic kidney disease and diabetic retinopathy in a representative population of Korean diabetic adults.

Methods

We analyzed data from the Korea National Health and Nutrition Examination Surveys (2008-2010). A total of 15,409 individuals (weighted frequency, 32,168,636) aged 19 and over who completed ophthalmologic and renal functional examinations were evaluated. Chronic kidney disease (CKD) was defined as an estimated glomerular filtration rate of < 60 ml/min/1.73 m2 or proteinuria greater than 1+. Seven standard photographs from the Early Treatment for Diabetic Retinopathy Study were obtained from each eye after pharmacological pupil dilatation. Diabetic retinopathy (DR) was defined as the presence of 1 or more retinal microaneurysms or retinal blot hemorrhages with or without more severe lesions. Vision-threatening diabetic retinopathy (VTDR) was defined as the presence of a clinically significant macular edema (CSME) or proliferative diabetic retinopathy.

Results

CKD was significantly associated with DR and VTDR (odds ratio (OR), 95% confidence interval (CI); 2.49(1.43-4.35) and 3.74(1.56-8.95), respectively) in the diabetic population. After controlling for confounders, however, CKD was significantly associated only with DR [adjusted OR (aOR), 95% CI; 2.34(1.04-5.28)]. In the subgroup analysis for CKD, only proteinuria was significantly associated with DR and VTDR (aOR, 95% CI; 4.56(1.51-13.77) and 5.61(1.06-29.87), respectively) in this population.

Conclusions

Our results show that CKD appears to be associated with DR and VTDR in a Korean diabetic population. In particular, proteinuria, not decreased eGFR, is more significantly associated with DR or VTDR.  相似文献   

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