糖尿病大鼠视网膜中央动、静脉血流动力学观察  

Study on hemodynamics of central retinal artery and vein in diabetic rats by color Doppler imaging

作　　者：陈瑛[1] 张康兰[2] 刘兰芬[3] 丁吉元[4] 张莲英[2] 

机构地区：[1]济南军区青岛第一疗养院特检科,山东青岛266071 [2]上海第二军医大学济南临床医学院眼科,山东济南250031 [3]上海第二军医大学济南临床医学院超声科,山东济南250031 [4]上海第二军医大学济南临床医学院病理科,山东济南250031

出　　处：《中国医学影像技术》2005年第7期998-1002,共5页Chinese Journal of Medical Imaging Technology

摘　　要：目的通过对糖尿病(DM)大鼠视网膜中央动脉(CRA)、静脉(CRV)血流检测,结合视网膜血管消化铺片结果,研究糖尿病早期视网膜血流动力学的变化规律。方法采用右下腹腔内一次性注射Streptozotocin60mg/kg诱导Wistar大鼠糖尿病模型52只,分别于成模后1、2、3、4、5和6个月,行彩色多普勒超声(CDI)检查,检查结束后处死大鼠,取出左眼球固定于4%多聚甲醛中,行视网膜血管消化铺片、PAS染色。糖尿病大鼠成模后1～6个月分别标记为DM1、DM2、DM3、DM4、DM5、DM6。结果DM1时,CRA的收缩期血流峰值(PSV)减低,与对照组比较有显著性差异(P<0.05);随病程延长,PSV、舒张末期血流峰值(EDV)和平均流速峰值(MV)减低持续减低,在DM6达到最低水平;阻力指数(RI)、搏动指数(PI)及CRV血流参数在DM5、6时显著增高;DM3,视网膜血管周细胞出现形态学改变;DM4以后,周细胞逐渐减少,内皮细胞逐渐增多,逐渐出现大量的、闭塞的血管和血管瘤。结论CRA的PSV、EDV的改变发生在糖尿病视网膜微血管出现病理改变之前,是糖尿病早期视网膜血流变化最敏感的指标;MV、PI、RI的改变提示视网膜微血管病理性改变的发生,与血管闭塞和大量无灌注区的形成有关。通过对CRA、CRV血流参数的变化的观察可以推测糖尿病视网膜病变(DR)的病变程度。Objective To investigate hemodynamics of the central retinal artery (CRA) and central retinal vein (CRV) in the diabetic rats with color Doppler imaging(CDI). Methods A total of 52 streptozotocin-induced diabetic rats were included in the study. CDI was used to measure hemodynamic parameters of CRA and CRV in the diabetic rats at the 1,2,3,4,5,6 months, respectively. Peak systolic velocity (PSV), end diastolic velocity (EDV), Mean velocity (MV), resistive index (RI) and pulsetility index (PI) were measured. The left eyes of diabetic rats were dissected immediately after CDI scanning and make retinopathy digest preparations. All diabetic rats were divided into DM1, DM2, DM3, DM4, DM5, DM6 based on the time of having diabetes. Results PSV of CRA in DM1 diabetic rats was remarkably lower than control group (P < 0.05 ). PSV, EDV and MV in CRA became gradually lower following diabetes getting severe. Therefore, the lowest PSV, EDV and MV readings were in DM6. On the contrary, RI, PI and circulatory parameters of CRV in the diabetic rats increased in DM5 and DM6. Under the light microscope, the morphological changes of pericytes were observed in the retinal digest preparations in DM3. Stenosis, occlusion and aneurysm of the retinal blood vessels occurred in the diabetic rats after DM4. Conclusion PSV, EDV of CRA occurred at the early stage of diabetes before structural pathology (stenosis and occlusion) formation, which was a sensitive indicator of retina involvement. Changes of MV, RI and PI were related to occlusion of the vessels and perfusion defect in the retina at late stage of diabetes. Hemodynamic change in CRA and CRV is important information in assessment of retinal pathology and severity of the diabetes.

关 键 词：糖尿病视网膜病变 超声检查 多普勒 彩色 视网膜动脉 视网膜静脉 

分 类 号：R445.1[医药卫生—影像医学与核医学] R587.1[医药卫生—诊断学]