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糖尿病患者の前房蛋白濃度に対するアルドースリダクターゼ阻害薬(以下ARI)点眼液の効果を検討した。糖尿病患者37例74眼をARI点眼群とプラセボ点眼群とに無作意に分け,3か月間1日4回点眼し,フレアー・セルメーターで経時的に測定した。糖尿病網膜症のない群(第1群),福田分類AI期(第2群),AII期以上およびB期(第3群)に分け,分散分析(analysis ofvariance,以下ANOVA)ならびに群間のt—検定を行うと,第2群においてARI点眼薬の前房蛋白濃度抑制効果がみられた(ANOVA, p<0.05)。全例での解析,ならびに第1・3群での解析では,ANOVAによるARI点眼薬の効果はみられなかったが,第3群のARI群の前房蛋白濃度は,4週以降でプラセボ群より低い値となった(p<0.01)。ARI点眼薬は,糖尿病による初期の血液房水柵障害に有効であると考えた。
We evaluated the effect of topical instillation of an aldose reductase inhibitor (ARI) on the protein concentration in the aqueous humor in 74 eyes of 37 diabetic patients. The findings were compared with another group receiving placebo solution. Assign-ment of patients to ARI and placebo group was randomly decided. Eyedrops were instilled 4 times daily for 3 months. Aqueous protein concentration was measured with a laser flare-cell meter at 2, 4, 8, and 12 weeks. Analysis of variance showed that topical ARI suppressed increase of protein in patients with early background retinopathy (p< 0.05). In eyes with advanced background, prepro-liferative or proliferative retinopathy, aqueous protein concentration was significantly lower in ARI group than in placebo group at 4, 8 and 12 weeks of treatment (t-test: p< 0.01). These find-ings seemed to show that topically instilled ARI would suppress breakdown of blood-aqueous barrier in diabetic eyes.
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