【摘要】 目的:了解糖尿病视网膜病变的药物、激光、手术治疗以及仍处于研究阶段的基因疗法和移植治疗的现状。资料来源:检索Medline1995-01/2001-10与糖尿病视网膜病变及其治疗相关的文章,检索词“diabeticretinopathy,treatment”,并限定语言种类为英文。同时应用检索中国期刊全文数据库1994-01/2003-10与糖尿病视网膜病变和治疗的文章,限定文章语言种类为中文,检索词“糖尿病视网膜病变、治疗”。资料选择:对资料进行初审,选择包括处理组和对组的文献,筛除明显不符合研究目的文献,对剩余的文献开始查找全文。纳入标准为:①随机对照研究。②实验或临床研究包含平行对照组。排除重复性研究和综述类文章。资料提炼:共收集到125篇关糖尿病视网膜病变治疗的文章,15个实验研究符合纳入标准。排除的110篇为重复研究。资料综合:糖尿病视网膜病变的治疗手段主要包括:合理有效地控制血糖,药物治疗,激光光凝治疗,手术治疗,基因治疗,移植治疗。其中药物治疗所应用药物主要为糖基化终末产物抑制剂、可溶性糖基化终末产物抑制受体、肌醇的补充、醛糖还原酶、二酰基甘油-蛋白激酶C抑制剂、血管内皮生长因子抑制剂和抑制因子促进剂、抗氧化剂、黏附分子及其单克隆抗体。激光光凝治疗包括全视网膜光凝技术、局部光凝术、黄斑格子样光凝术。结论:对于糖尿病视网膜病变的治疗从以前的单纯控制血糖发展到激光光凝,以及到70年代末开展的玻璃体切割手术等,现在综合应用这些治疗手段,已能够有效地治疗糖尿病视网膜病变,减低了糖尿病视网膜病变的失明率。但目前为止还没有找到能够根治糖尿病视网膜病变的药物。人们希望通过分子生物学的研究,找到一种药物能够从根本上治愈糖尿病视网膜病变,控制糖尿病视网膜病变的发生、发展和变化,目前分子生物学的研究已在这方面开辟了一条新的领域。更多还原

【Abstract】 OBJECTIVE To investigate the drug laser and operation treatments of diabetic retinopathy and discuss the present status of the gene therapy and transplantation which are still under study. DATA SOURCES An online search of Medline database was undertaken to identify the articles about diabetic retinopathy and its treatment published in English between January 1995 and October 2001 with the of“diabetic retinopathy treatment”. The Chinese articles about diabetic retinopathy and its treatment published between January 1994 and October 2003 were also searched in the Chinese journals full-text database by using the keywords of“diabetic retinopathy treatment”. STUDY SELECTION The data were checked preliminarily articles including treatment group and control group were selected and the obvious irrelated ones were excluded and then the full-texts of the rest articles were searched. Inclusive criteria ①randomized control study ② experiments or clinical studies containing parallel control group. The repetitive studies and reviews were excluded. DATA EXTRACTION Totally 125 articles about the treatment of diabetic retinopathy were collected 15 experiments were in accordance with the inclusive criteria and the excluded 110 articles were repetitive studies. DATA SYNTHESIS The main therapeutic methods of diabetic retinopathy included reasonable and effective control of blood glucose drug treatment laser photocoagulation operation gene therapy and transplantation. The main medicines applied in the drug treatment were advanced glycation end products inhibitor soluble advanced glycation end products inhibitor supplement of inosital aldose reductase diacylgcerol-protein kinase C inhibitor vascular endothelial growth factor inhibitor inhibitive factor promoter antioxidant adhesion molecule and its monoclonal antibody. Laser photocoagulation included whole retinal photocoagulation local photocoagulation and yellow spot lattice photocoagulation. CONCLUSION The treatment of diabetic retinopathy has developed from the simple control of blood glucose to laser photocoagulation and vitrectomy which began at the end of 1970s and the comprehensive application of the therapeutic methods has been able to effectively treat diabetic retinopathy reduce the rate of blindness caused by diabetic retinopathy. But the medicine which can cure diabetic retinopathy once and for all to bring under permanent control has not been found. It is hoped that a kind of medicine which can cure diabetic retinopathy once and for all to bring under permanent control through molecular biological study so as to control the occurrence development and changes of retinopathy and the molecular study at present has developed a new field.更多还原