目的 探究舒洛地特治疗糖尿病肾病(DN)合并视网膜病变(DR)对血清血管内皮生长因子(VEGF)、血管紧张素转化酶 (ACE)、胰岛素样生长因子-1(IGF-1)水平的影响。方法 采用随机数字表法将72例DN合并DR患者分为研究组和对照 组各36例。对照组患者予以前列地尔+厄贝沙坦+欧洲越桔花青苷/β-胡萝卜素治疗，研究组患者予以舒洛地特序贯 疗法。比较两组患者DR疗效，观察治疗前后尿白蛋白排泄率(UAER)及血清VEGF、ACE、IGF-1水平变化情况。结果 两组患者DR疗效比较差异无统计学意义(P﹥0.05)；治疗16周后，两组患者UAER及血清VEGF、ACE、IGF-1水平均较 治疗前降低，且研究组低于对照组(P﹤0.05)。结论 舒洛地特能有效缓解DN合并DR患者的眼底病变，促进肾功能恢 复，通过降低血清VEGF、ACE、IGF-1各因子表达延缓疾病进展。

Objective To explore the effect of sulodexide on serumvascular endothelial growth factor (VEGF), angiotensin converting enzyme (ACE) and insulin-like growth factor -1 (IGF-1)levels in patients with diabetic nephropathy (DN) and diabetic retinopathy (DR). Methods 72 patients with DN and DR were randomly divided into study group (36 cases) and control group (36 cases). The control was given alprostadil, irbesartan and European bilberry anthocyanin / beta carotene, while the study group was given sequential therapy with sulodexide. The curative effects of DR in the two groups were compared, and the changes of urinary albumin excretion rate (UAER), serum VEGF, ACE and IGF-1 levels were observed before and after treatment. Results There was no significant difference in the curative effects of DR between the two groups (P>0.05). 16 weeks after treatment, the levels of UAER, VEGF, ACE and IGF-1 in the two groups were all significantly decreased, and the decrease in the study group was greater than that in the control group (P<0.05). Conclusion Sulodexide can effectively alleviate the fundus lesions in patients with DN and DR, promote the recovery of renal function, and delay the disease progression through reducing the expression of serum VEGF, ACE and IGF-1.