Fosinopril’s Impact On Retinal Bleeding Of Type2Diabetes

PurposeUse Doppler ultrasound to detect the dynamical parameter of central retinalartery(CRA) bleeding in diabetes patients, observe the changes in the dynamicalparameter of central retinal artery(CRA) bleeding in diabetes patients withhypertension after intake of fosinopril and compare them to normal persons’ CRA.Observe and analyze if the application of fosinopril, the container ofangiotensin-converting enzyme, can improve the change in the dynamical parameterof central retinal artery(CRA).Method1. Subject selection method:selection of case group:1) Diabetes diagnosis standard recommended by WHO(1. with diabetessymptoms, venous plasma glucose concentration≥11.1mmol/L(200mg/dl) at any time;2. venous plasma glucose concentration≥7.0mmol/L (126mg/dl) at empty stomach;3.OGTT,2hours after intake of75g glucose, venous plasma glucoseconcentration≥11.1mmol/L, with20diabetics included in the case group. 2) OGTT is used for blood sugar test, venous plasma glucoseconcentration≥7.0mmol/L at empty stomach.3) Diving sphygmomanometer is used for measurement, with bloodpressure within the scope of140mmHg＜SP＜160mmHg，DP＜100mmHg.4) Make physical test for the patients. No one is found of coronary heartdisease, incomplete function of heart, liver and kidney, and complications such asglaucoma.5) Make eye test for the diabetics to select those without apparent clinic eyeabnormal changes.Selection of healthy comparison group:1) Select10healthy persons.2) Diving sphygmomanometer is used for measurement, with blood pressurewithin the scope of SP＜140mmHg, DP＜90mmHg.3) OGTT is used for test of blood sugar, venous plasma glucose concentration＜7.0mmol/L at empty stomach and2h venous plasma glucose concentration＜11.1mmol/L.4) Make physical test for healthy persons, without coronary heart diseasesfound, or incomplete function of heart, liver or kidney.5) Eye test for healthy persons find no abnormal symptoms in eyes or eyediseases.2. Blood pressure test: every8:00-9:00a.m. for case group. Divingsphygmomanometer is used for measurement of blood pressure.3. Blood sugar test: Roche blood glucose meter is used to test the blood sugarat empty stomach normally before8a.m. for the case group. Particularly for patientstreated with insulin, blood sugar at empty stomach test should be performed beforeinjection of insulin in the morning. Test glycated hemoglobin for once to judge bloodsugar control of patients from the previous case group.4. Doppler test:1) compare the change of CRA blood dynamics between thecase group before administration and the comparison group.2) compare the change ofCRA blood dynamics between the case group after administration and the comparisongroup.3) compare the change of CRA blood dynamics between the case group beforeand after administration.4) The tester lies down flatly, gently closes his/her eyes, andputs the probe on the upper eyelid. Probe frequency5.0-10.0M Hz. Test samplevolume is put1.0-5.0mm behind the nipples. Clear pulse Doppler blood flowspectrum will display.5. Statistical analysis: all data shall be analyzed statistically and drawn withSPSS17.0. All metering data shall be shown with (x+s). Data between the groupsshall be tested and compared with two sample mean difference t. Data between thecase group before and after treatment shall be tested with the self-matching t. Blooddynamic parameters of both eyes of the healthy person comparison group and botheyes of the case group before and after administration stay unchanged. So parametersof both eyes are combined for statistics. The test standard deems P<0.01asmeaningful statistically. Results1. Blood pressure and blood sugar control standard for case group afteradministration: blood pressure after administration(SP＜140mmHg, DP＜90mmHg).Blood sugar control after administration of joint hypoglycemic medicine(＜7.0mmol/lat empty stomach). Mean glycated hemoglobin8.2%.2. Dynamical parameter of central retinal artery Vs, Vd and Vm of the casegroup before administration are all lower than the healthy person group. P＜0.01.Dynamical parameter of central retinal artery PI of the case group beforeadministration is higher than the healthy person group, P＜0.01. Dynamical parameterof central retinal artery RI of the case group before administration is higher than thehealthy person group. P＞0.05.3. Dynamical parameter of central retinal artery Vs, Vd and Vm of the casegroup after administration are all lower than the healthy person group. P＜0.01.Dynamical parameter of central retinal artery PI of the case group after administrationis higher than the healthy person group, P＜0.01. Dynamical parameter of centralretinal artery RI of the case group after administration is higher than the healthyperson group. P＞0.05.4. Dynamical parameter of central retinal artery Vs, Vd and Vm of the casegroup before administration are all higher than the case group after administration. P＜0.01. Dynamical parameter of central retinal artery PI of the case group beforeadministration is lower than the case group after administration, P＜0.01. Dynamicalparameter of central retinal artery RI of the case group before administration is lowerthan the case group after administration. P＞0.05.ConclusionAbnormal dynamic change in CRA bleeding has existed before retinal ailmentof the Type2diabetics occurs. Fosinopril can improve the abnormality in CRAbleeding dynamic indexes of diabetics.