糖尿病视网膜病变患者脉络膜厚度和血流动力学参数的变化及其影响因素
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Changes of choroidal thickness and hemodynamic parameters and their influencing factors in patients with diabetic retinopathy
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    摘要:

    目的:研究糖尿病视网膜病变患者脉络膜厚度和血流动力学参数的变化及其影响因素。

    方法:选取2013-01/2015-01在我院诊断为2型糖尿病的患者100例100眼,将患者分为3组:无糖尿病视网膜病变(non-diabetic retinopathy,NDR)组患者34例,非增殖期糖尿病视网膜病变(non-proliferative diabetic retinopathy,NPDR)组36例,增殖期糖尿病视网膜病变(proliferative diabetic retinopathy,PDR)组30例。再根据OCT的视网膜黄斑区扫描结果,将糖尿病视网膜病变患者分成两组:糖尿病黄斑水肿(diabetic macular edema,DME)组28例,无糖尿病黄斑水肿组38例。选择同期在我院接受体检的35例正常人群作为对照组。比较各组患者距黄斑中心凹不同距离的脉络膜厚度和鼻侧睫状后动脉的血流动力学参数及其影响因素。

    结果:随着患者糖尿病视网膜病变的加重,距黄斑中心凹不同距离的脉络膜厚度均呈下降趋势,NPDR和PDR组患者距黄斑中心凹不同距离的脉络膜厚度薄于对照组,差异有统计学意义(P<0.05),NDR组患者距黄斑中心凹不同距离的脉络膜厚度与对照组比较,差异无统计学意义(P>0.05)。糖尿病视网膜病变合并DME患者和非DME患者距黄斑中心凹不同距离的脉络膜厚度比较,差异无统计学意义(P>0.05)。Pearson相关性分析显示,糖尿病视网膜病变患者脉络膜厚度与糖尿病病程、空腹血糖、HbA1c、眼轴长度、收缩压及舒张压均无显著相关性(P>0.05),而与logMAR BCVA之间有相关性(P<0.01)。NDR组和NPDR组患者的PSV和EDV明显低于对照组,RI高于对照组,PDR组患者的PSV和EDV明显低于其他三组,RI高于其他三组,差异有统计学意义(P<0.05)。

    结论:随着2型糖尿病患者视网膜病变程度的加重,脉络膜厚度呈下降的趋势,脉络膜厚度监测有利于全面分析2型糖尿病视网膜病变患者的病情。

    Abstract:

    AIM: To study the changes of choroidal thickness and hemodynamic parameters in patients with diabetic retinopathy and their influencing factors.

    METHODS: From January 2013 to January 2015, 100 patients(100 eyes)with type 2 diabetes were divided into 3 groups: 34 patients without diabetic retinopathy(NDR), 36 patients with non proliferative diabetic retinopathy(NPDR)group, and 30 patients with proliferative diabetic retinopathy(PDR). According to the results of OCT, the patients with diabetic retinopathy were divided into 2 groups: diabetic macular edema(DME)group(28 cases), and 38 cases without diabetic macular edema. During the same period in our hospital 35 subjects for physical examination were selected as the control group. The hemodynamic parameters of the posterior ciliary artery in different groups of patients at different distance from the center of the macular were compared, analyzing influencing factors.

    RESULTS: With the aggravation of diabetic retinopathy, the choroidal thickness in different distance from the center of the macular decreased. The choroidal thickness of NPDR and PDR group were thinner than that of the control group(P<0.05). The choroidal thickness of NDR group was not different from the control group(P>0.05). There was no significant difference in the choroidal thickness between the DME patients and non DME patients(P>0.05). Pearson correlation analysis showed that there was no significant correlation between choroidal thickness of patients with diabetic retinopathy and diabetic duration, fasting blood glucose, HbA1c, eye axis length, systolic blood pressure and diastolic blood pressure(P>0.05), but there was a correlation with BCVA(logMAR)(P<0.01). EDV and PSV in NDR group and NPDR group were significantly lower than those in control group, RI was higher than that in control group. PSV and EDV in PDR group were significantly lower than those in other three groups, RI was higher than the other three groups, and the difference was statistically significant(P<0.05).

    CONCLUSION: With the severity of retinopathy in type 2 diabetic patients, the choroidal thickness decreased, and the thickness of the choroid is beneficial in the comprehensive analysis of 2 diabetic retinopathy.

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徐芳,赵淼焱,刘菊.糖尿病视网膜病变患者脉络膜厚度和血流动力学参数的变化及其影响因素.国际眼科杂志, 2016,16(6):1052-1055.

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  • 收稿日期:2015-12-22
  • 最后修改日期:2016-05-18
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  • 在线发布日期: 2016-05-31
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