1型糖尿病患者早期视觉诱发电位和视网膜电图分析
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内蒙古科技发展计划项目(No.20130412)


Clinical study of electrophysiological changes of optic nerves in early period of type 1 diabetes mellitus
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Technology Development Planning Project of Inner Mongolia(No.20130412)

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    摘要:

    目的:探讨1型糖尿病患者早期的视觉电生理变化情况,分析糖尿病视网膜病变的早期与视觉诱发电位和视网膜电图改变的相关性。

    方法:观察组60例1型糖尿病患者,男女比例均等,平均年龄19.42±7.78岁,病程小于5a,矫正视力5.0,平均空腹血糖7.8±3.6mmol/L。进行图形视觉诱发电位和闪光视网膜电图检查。对照组60例正常人,男女比例均等,平均年龄17.2±6.52岁,矫正视力5.0,进行图形视觉诱发电位和闪光视网膜电图检查; 记录两组PVEP参数P100波潜伏期和P100波振幅值,FERG参数a波潜伏值、b波潜伏期、a波振幅值、b波振幅值。

    结果:观察组的参数P100波振幅值、P100波潜伏期与对照组比较,有显著统计学意义(P<0.01),均有振幅值降低,潜伏期延长; 观察组的参数a波潜伏期、a波振幅值、b波潜伏期、b波振幅值与对照组比较差异有显著统计学意义(P<0.01); 观察组平均空腹血糖控制稳定,PVEP P100的振幅值、FERG a、b波的振幅值与糖尿病程无关,而PVEP P100的潜伏值、FERG a、b波的潜伏值与糖尿病程有关。

    结论:图形视觉诱发电位提示糖尿病患者视神经元损伤较为敏感; 闪光视网膜电图是早期发现糖尿病患者视网膜Müller细胞和双极细胞损害的理想手段; 图形视觉诱发电位参数 P100波振幅值、闪光视网膜电图参数b波振幅值可能是糖尿病视网膜临床前期最敏感的诊断指标。

    Abstract:

    AIM:To investigate the value of pattern visual evoked potential(PVEP)and flash electroretinogram(FERG)in early diagnosis and prevention of diabetic retinopathy(DR), analyzing the correlation of early stage DR with PVEP and FERG.

    METHODS:Sixty patients, 30 males and 30 females, participated in observation group. Their average age was 19.42±7.78years. The duration of DM was <5a. Best corrected visual acuity was 5.0. Fasting blood glucose was 7.8±3.6mmol/L. There were 60 subjects, 30 males and 30 females, in control group. Their average age was 17.2±6.52years. Best corrected visual acuity was 5.0. Every participator was tested with PVEP and FERG according to ISCVE standard. The amplitude of PVEP and P100 latency were recorded. And the b-wave latency, b-wave amplitude, a-wave latency, a-wave amplitude were showed down.

    RESULTS:In observation group, P100 amplitude decreased and P100 latency increased, compared to those of control group(P<0.01); b-wave latency, b-wave amplitude, a-wave latency, a-wave amplitude were different from those in control group(P<0.01); the fasting blood glucose kept stable; P100 amplitude, b-wave amplitude and a-wave amplitude were not related to the DM duration; P100 latency, a-wave latency and b-wave latency were related to the DM duration.

    CONCLUSION: PVEP are sensitive to optic neuron damage; FERG is desirable to detect the lesion of Müller cells and bipolar cells. P100 amplitude by PVEP, b-wave amplitude by FERG may be the most sensitive parameter for DR at early stage.

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赵全良,张春香,菅宝芬.1型糖尿病患者早期视觉诱发电位和视网膜电图分析.国际眼科杂志, 2016,16(7):1316-1318.

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  • 收稿日期:2016-03-17
  • 最后修改日期:2016-06-03
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  • 在线发布日期: 2016-06-29
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