调脂药治疗糖尿病视网膜病变的研究进展_Chinese Journal of Ocular Fundus Diseases

Authors：

杨继玲 , 邵毅 ,  裴重刚

330006 南昌大学第一附属医院眼科;

Corresponding author：

裴重刚, Email: Freebee992296@yahoo.com.cn

Keywords：

糖尿病视网膜病变/药物疗法; 调脂药/治疗应用; 综述

DOI：

10.3760/cma.j.issn.1005-1015.2014.02.028

Video：

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异常血脂水平与糖尿病视网膜病变(DR)的发生发展相关。调脂药可通过保护血视网膜屏障, 改善血管内皮细胞功能, 逆转视网膜血管渗漏, 减轻视网膜炎症反应, 进而延缓DR进展。目前调脂药主要分为贝特类、他汀类、胆酸结合树脂及烟酸和烟酸衍生物四大类。贝特类及他汀类药物是目前最常用的调血脂药物, 除了具有确切的降血脂药理作用外, 近年来还被应用于DR的治疗。进一步探究血脂、调脂药与DR的关系及糖尿病患者血脂正常时是否可服用调脂药, 具有跨时代的意义, 这将为DR防治提供另一个新的思路。

Citation： 杨继玲, 邵毅, 裴重刚. 调脂药治疗糖尿病视网膜病变的研究进展. Chinese Journal of Ocular Fundus Diseases, 2014, 30(2): 216-219. doi: 10.3760/cma.j.issn.1005-1015.2014.02.028 Copy

1.	芬欧布瑞特, 庄稼英.调脂药在糖尿病视网膜病变防治中扮演的角色[J].糖尿病天地(临床), 2011, 5:458-461.
2.	高丽涛, 柳力敏, 张媛媛, 等.糖尿病视网膜病变的危险因素分析[J].眼科新进展, 2011, 31:742-744.
3.	葛坚, 赵家良, 黎晓新.糖尿病视网膜病变[M]//葛坚, 赵家良, 黎晓新.眼科学.2版.北京:人民卫生出版社, 2013:305-308.
4.	张芳林.调脂药物在糖尿病中的应用[J].中国处方药, 2003, 1:16-19.
5.	李青.血脂变化与糖尿病性视网膜病变的关系[J].湖南医学高等专科学校学报, 2001, 3:6-8.
6.	Li J, Wang JJ, Chen D, et al. Systemic administration of HMG-CoA reductase inhibitor protects the blood-retinal barrier and ameliorates retinal inflammation in type 2 diabetes[J].Exp Eye Res, 2009, 89:71-78.
7.	Bordet R, Ouk T, Petrauh O, et al. PPARα:a new pharmacological target for neuroprotection in stroke and neurodegenerative diseases[J]. Biochem Soc Trans, 2006, 34:1341-1346.
8.	Keech AC, Mitchell P, Summanen PA, et al. Effect of fenofibrate on the need for laser treatment for diabetic retinopathy (FIELD study):a randomized controlled trial[J]. Lancet, 2007, 370:1687-1697.
9.	Inoue I, Shino K, Noji S, et al. Expression of peroxisome proliferatou-activated receptor α(PPAR α) in primary cultures of human vascular endothelial cells[J]. Biochem Bioph Res Co, 1998, 246:370-374.
10.	Chen XR, Besson VC, Palmier B, et al. Neurological recovery-promoting, anti-inflammatory, and anti-oxidative effects afforded by fenofibrate, a PPAR α aagonist, in traumatic brain injury[J]. J Neurotrauma, 2007, 24:1119-1131.
11.	Deplanque D, Gele P, Petrauh O, et al. Peroxisome proliferatoractived receptor-alpha activation as a mechanism of preventive neuroprotection induced by chronic fenofibrate treatment[J]. J Neurosci, 2003, 23:6264-6271.
12.	ACCORD Study Group, ACCORD Eye Study Group, Chew EY, et al. Effects of medical therapies on retinopathy progression in type 2 diabetes[J]. N Engl J Med, 2010, 363:233-244.
13.	赵婷, 徐倩.非诺贝特治疗糖尿病视网膜病变的临床研究[J].临床医学, 2011, 31:51-52.
14.	Anwer T, Sharma M, Pillai KK, et al. Protective effect of bezafibrate on streptozotocin-induced oxidative stress and toxicity in rets[J]. Toxicology, 2007, 229:165-172.
15.	Ferrara N. Role of vascular endothelial growth fact or in regulate on of physiological angiogenesis[J]. Am J Physiol, 2001, 280:1358-1366.
16.	Klein R, Sharrett AR, Klein BE, et al. The association of atherosclerosis, vascular risk factors, and retinopathy in adults with diabetes:the atherosclerosis risk in communities study.[J].Ophthalmology, 2002, 109:1225-1234.
17.	Medina RJ, O Neill CL, Devine AB, et al.The pleiotropic effects of simvastatin on retinal microvascular endothelium has important implications for ischaemic retinopathies[J].Ophthalmology, 2002, 109:1225-1234.
18.	张岫美.调脂药与抗动脉粥样硬化药[M]//杨宝峰.药理学. 7版.北京:人民卫生出版社, 2008:265-269.
19.	Dandona P. Effects of antidiabetic and antihyperlipidemic agents on C--reactive protein[J].Mayo Clin Proc, 2008, 83:333-342.
20.	Sen K, Misra A, Kumar A, et al. Simvastatin retards progression of retinopathy in diabetic patients with hypercholesterolemia[J]. Diabetes Res Clin Pract, 2002, 56:1-11.
21.	Tamura H, Miyamoto K, Kiryu J, et al. Intravitreal injection of corticosteroid attenuates leukostasis and vascular leakage in experimental diabetic retina[J]. Invest Ophthalmol Vis Sci, 2005, 46:1440-1444.
22.	Joussen AM, Poulaki V, Mitsiades N, et al. Nonsteroidal anti-inflammatory drugs prevent early diabetic retinopathy via TNF-alpha suppression[J]. FASEB J, 2002, 16:438-440.
23.	Joussen AM, Poulaki V, Qin W, et al. Retinal vascular endothelial growth factor induces intercellular adhesion molecule-1 and endothelial nitric oxide synthase expression and initiates early diabetic retinal leukocyte adhesion in vivo[J]. Am J Pathol, 2002, 160:501-509.
24.	Koizumi K, Poulaki V, Doehmen S, et al. Contribution of TNF-alpha to leukocyte adhesion, vascular leakage, and apoptotic cell death in endotoxin-induced uveitis in vivo[J]. Invest Ophthalmol Vis Sci, 2003, 44:2184-2191.
25.	王晓凌, 崔海平.考来烯胺对2型糖尿病大鼠胆汁酸代谢的影响[J].世界华人消化杂志, 2012, 20:3575-3579.

1. 芬欧布瑞特, 庄稼英.调脂药在糖尿病视网膜病变防治中扮演的角色[J].糖尿病天地(临床), 2011, 5:458-461.
2. 高丽涛, 柳力敏, 张媛媛, 等.糖尿病视网膜病变的危险因素分析[J].眼科新进展, 2011, 31:742-744.
3. 葛坚, 赵家良, 黎晓新.糖尿病视网膜病变[M]//葛坚, 赵家良, 黎晓新.眼科学.2版.北京:人民卫生出版社, 2013:305-308.
4. 张芳林.调脂药物在糖尿病中的应用[J].中国处方药, 2003, 1:16-19.
5. 李青.血脂变化与糖尿病性视网膜病变的关系[J].湖南医学高等专科学校学报, 2001, 3:6-8.
6. Li J, Wang JJ, Chen D, et al. Systemic administration of HMG-CoA reductase inhibitor protects the blood-retinal barrier and ameliorates retinal inflammation in type 2 diabetes[J].Exp Eye Res, 2009, 89:71-78.
7. Bordet R, Ouk T, Petrauh O, et al. PPARα:a new pharmacological target for neuroprotection in stroke and neurodegenerative diseases[J]. Biochem Soc Trans, 2006, 34:1341-1346.
8. Keech AC, Mitchell P, Summanen PA, et al. Effect of fenofibrate on the need for laser treatment for diabetic retinopathy (FIELD study):a randomized controlled trial[J]. Lancet, 2007, 370:1687-1697.
9. Inoue I, Shino K, Noji S, et al. Expression of peroxisome proliferatou-activated receptor α(PPAR α) in primary cultures of human vascular endothelial cells[J]. Biochem Bioph Res Co, 1998, 246:370-374.
10. Chen XR, Besson VC, Palmier B, et al. Neurological recovery-promoting, anti-inflammatory, and anti-oxidative effects afforded by fenofibrate, a PPAR α aagonist, in traumatic brain injury[J]. J Neurotrauma, 2007, 24:1119-1131.
11. Deplanque D, Gele P, Petrauh O, et al. Peroxisome proliferatoractived receptor-alpha activation as a mechanism of preventive neuroprotection induced by chronic fenofibrate treatment[J]. J Neurosci, 2003, 23:6264-6271.
12. ACCORD Study Group, ACCORD Eye Study Group, Chew EY, et al. Effects of medical therapies on retinopathy progression in type 2 diabetes[J]. N Engl J Med, 2010, 363:233-244.
13. 赵婷, 徐倩.非诺贝特治疗糖尿病视网膜病变的临床研究[J].临床医学, 2011, 31:51-52.
14. Anwer T, Sharma M, Pillai KK, et al. Protective effect of bezafibrate on streptozotocin-induced oxidative stress and toxicity in rets[J]. Toxicology, 2007, 229:165-172.
15. Ferrara N. Role of vascular endothelial growth fact or in regulate on of physiological angiogenesis[J]. Am J Physiol, 2001, 280:1358-1366.
16. Klein R, Sharrett AR, Klein BE, et al. The association of atherosclerosis, vascular risk factors, and retinopathy in adults with diabetes:the atherosclerosis risk in communities study.[J].Ophthalmology, 2002, 109:1225-1234.
17. Medina RJ, O Neill CL, Devine AB, et al.The pleiotropic effects of simvastatin on retinal microvascular endothelium has important implications for ischaemic retinopathies[J].Ophthalmology, 2002, 109:1225-1234.
18. 张岫美.调脂药与抗动脉粥样硬化药[M]//杨宝峰.药理学. 7版.北京:人民卫生出版社, 2008:265-269.
19. Dandona P. Effects of antidiabetic and antihyperlipidemic agents on C--reactive protein[J].Mayo Clin Proc, 2008, 83:333-342.
20. Sen K, Misra A, Kumar A, et al. Simvastatin retards progression of retinopathy in diabetic patients with hypercholesterolemia[J]. Diabetes Res Clin Pract, 2002, 56:1-11.
21. Tamura H, Miyamoto K, Kiryu J, et al. Intravitreal injection of corticosteroid attenuates leukostasis and vascular leakage in experimental diabetic retina[J]. Invest Ophthalmol Vis Sci, 2005, 46:1440-1444.
22. Joussen AM, Poulaki V, Mitsiades N, et al. Nonsteroidal anti-inflammatory drugs prevent early diabetic retinopathy via TNF-alpha suppression[J]. FASEB J, 2002, 16:438-440.
23. Joussen AM, Poulaki V, Qin W, et al. Retinal vascular endothelial growth factor induces intercellular adhesion molecule-1 and endothelial nitric oxide synthase expression and initiates early diabetic retinal leukocyte adhesion in vivo[J]. Am J Pathol, 2002, 160:501-509.
24. Koizumi K, Poulaki V, Doehmen S, et al. Contribution of TNF-alpha to leukocyte adhesion, vascular leakage, and apoptotic cell death in endotoxin-induced uveitis in vivo[J]. Invest Ophthalmol Vis Sci, 2003, 44:2184-2191.
25. 王晓凌, 崔海平.考来烯胺对2型糖尿病大鼠胆汁酸代谢的影响[J].世界华人消化杂志, 2012, 20:3575-3579.

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