依帕司他联合牛磺酸对糖尿病性白内障患者术后炎症和氧化应激因子的影响-现代医学

依帕司他联合牛磺酸对糖尿病性白内障患者术后炎症和氧化应激因子的影响

单位：陕西省汉中市中心医院眼科, 陕西汉中 723000

分类号：R776.1

出版年·卷·期（页码）：2020·39·第五期（602-607）

摘要：

目的：研究依帕司他联合牛磺酸对糖尿病性白内障患者疗效及对炎症和氧化应激因子的影响。方法：将90例（152眼）糖尿病性白内障患者随机分为观察组和对照组，观察组45例75眼，对照组45例77眼，两组患者均接受超声乳化人工晶体植入术治疗，术后对照组给予牛磺酸滴眼液滴眼，观察组在对照组基础上给予依帕司他治疗。治疗前后采用标准对数视力表进行日常生活视力检查；于术前及术后3、7和14 d对眼前节并发症进行评分；治疗前后测定血清丙二醛（MDA）、超氧化物歧化酶（SOD）和总抗氧化能力（TAC）水平；采用美国国立眼科所有关生存质量（QOL）问卷进行生活质量评价。结果：观察组矫正视力0.5以上的患者比例显著高于对照组（P<0.05）；经重复测量资料方差分析发现，两组患者术后3、7和14 d眼前节症状综合评分均降低，且观察组眼前节症状综合评分低于对照组；两组MDA、SOD和TAC水平治疗前后差异均有统计学意义（P<0.001），MDA水平治疗前高于治疗后，SOD和TAC水平治疗前低于治疗后，同时MDA、SOD和TAC水平治疗前后差值差异有统计学意义（P<0.05），观察组MDA、SOD和TAC水平治疗前后差值高于对照组；观察组生活质量评分显著高于对照组（P<0.05）。结论：术后联合应用依帕司他和牛磺酸可发挥双重调节眼内渗透压作用，同时减少手术引起的应激损伤，有利于术后视力恢复，减少术后并发症发生，改善预后。

Objective: To study the effects of epalrestat combined with taurine on the efficacy of cataract in diabetic patients and its effects on inflammation and oxidative stress factors. Methods: 90 cases(152 eyes) of diabetic cataracts were randomly divided into the observation group and the control group. The observation group consisted of 45 cases (75 eyes) and the control group consisted of 45 cases (77 eyes). Both groups were treated with phacoemulsification and intraocular lens implantation. The control group was given taurine eye drops, and the observation group was given epalrestat on the basis of the control group. Before and after treatment, daily visual acuity examination was performed using standard logarithmic visual acuity chart. The anterior segment complication was scored before and 3, 7, 14 days after surgery. Serum malondialdehyde (MDA), superoxide dismutase (SOD) and total antioxidant capacity (TAC) levels was measured before and after treatment. Quality of life (QOL) assessment was performed using the QOL questionnaire from the National Ophthalmology Institute. Results: The proportion of corrected visual acuity of 0.5 in the observation group was significantly higher than that in the control group (P<0.05). The results of variance analysis of repeated measurements showed that the synthetical evaluation of anterior segment symptoms in the control group and the observation group decreased in 3, 7 and 14 days after operation, while the synthetical evaluation of anterior segment symptoms in the observation group was lower than that in the control group, the difference was significant (P<0.001). The difference of MDA, SOD and TAC levels before and after treatment in the observation group was higher than that in the control group (P<0.05). The quality of life score in the observation group was significantly higher than that in the control group (P<0.05). Conclusion: The combination of epalrestat and taurine after operation can double the regulation of intraocular osmotic pressure and reduce the stress damage caused by surgery, which is conducive to postoperative visual recovery, reduce postoperative complications and improve the prognosis of patients.

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