彩色多普勒评价早期糖尿病视网膜病变的血流变化  

Assessment of blood flow in early diabetic retinopathy with color Doppler

作　　者：王先银[1] 廖明松[1] 王普杰 邓旦[1] 汪盛贤[3] 张燕 刘仪红 

机构地区：[1]解放军成都军区总医院超声科,四川省成都市610083 [2]解放军第五二○医院内科,四川省绵阳市621000 [3]解放军成都军区总医院病理科,四川省成都市610083 [4]绵阳市富临中心医院妇产科,四川省绵阳市621000

出　　处：《中国临床康复》2006年第48期96-97,100,F0003,共4页Chinese Journal of Clinical Rehabilitation

摘　　要：目的:应用彩色多普勒技术检测糖尿病兔视网膜血流频谱,旨在探讨糖尿病视网膜病变早期血流变化的特点及其发生机制。方法:实验于2002-03/06在成都军区总医院动物实验室完成。选择健康新西兰大白兔56只,随机数字表法抽取10只为正常对照组,余46只进行糖尿病模型复制;糖尿病模型复制采用链脲佐菌素,耳缘静脉注射药物后(65mg/kg)24h内血糖高于18.87mmol/L,并能稳定5d即可为成功模型;模型复制成功后随机数字表法分为4个时间点,2,4,6,8周时间点。每组在超声检测后处死,取视网膜行苏木精-伊红染色后光镜检查。常规超声检测视网膜动静脉血流频谱。结果:纳入动物56只,44只动物成功制备模型,且54只动物均进入结果分析。①实验组视网膜中央动脉血流速度在第2周显著增快,最大血流速度高于正常对照组[分别为(13.92±0.69),(12.23±0.43)cm/s],到第4周低于正常对照组[分别为(12.11±0.41),(12.23±0.43)cm/s],从第8周起,视网膜中央动脉血流速度显著低于正常对照组[分别为(10.28±0.48),(12.23±0.43)cm/s],阻力指数和脉动指数在整个实验组变化不明显。②实验组视网膜静脉血流速度从第2周起显著增快,高于正常对照组[分别为(3.63±0.12),(2.98±0.13)cm/s],直至实验结束。结论:糖尿病早期视网膜血流为一过性血流量增加,血流速度一过性增快,以后表现为缺血,而静脉血流速度增加,表明视网膜处于一种高回流状态。视网膜应对血糖改变的血流自我调节能力下降。AIM： To detect the flow frequency spectrum of diabetic rabbits with color Doppler imaging （CD1）, and evaluate the flow characteristic and occurrence mechanism of early diabetic retinopathy （DR）. METHODS： The experiment was conducted in the Animal Laboratory, General Hospital of Chengdu Military Area Command of Chinese PLA between March and June in 2002. Fifty-six healthy New Zealand rabbits were randomized into normal control group （n=10） and diabetic model group （n =46）. Models of early DR were duplicated in rabbits by intravenous injection into auricular marginal vein with 65 mg/kg of streptozotocin （STZ）. The model was successful when blood glucose level was higher than 18.87 mmol/L within 24 hours of injection, stable for 5 days and then divided into four time points： 2^nd 4^th, 6^th and 8^th weeks after modeling. After ultrasound detections, all the rabbits were executed to fetch retina, which was examined microscopically after hematoxylin-eosin staining. The flow frequency spectrum of retina was assayed by routine ultrasound detection. RESULTS： A total of 56 rats were involved in this study, 44 of them were successful models and finally 54 rats entered the result analysis.① Compared with control group, blood flow rate of arteria centralis retinae in model group increased significantly at the 24 week [（12.23±0.43）, （13.92±0.69） cm/s] and recovered at the 4^th week [（12.11±0.41）, （12.23 ±0.43） cm/s], then decreased significantly at the 8^th week [（10.28±0.48）, （12.23±0.43） cm/s]. Resistant index and pulse index did not change significantly in experimental session. ②Blood flow rate of retinal vein increased significantly from the 24 week in experimental session, and higher than that of control group [（2.98±0.13）, （3.63±0.12） cm/s]. CONCLUSION： The flow characteristic of early DR is that blood flow volume of DR increases temporally and quickly in earlier period followed by iscbemia. Blood flow rate of retinal vein increases significantly,

关 键 词：糖尿病视网膜病变 超声检查 多普勒 彩色 血流速度 

分 类 号：R587.1[医药卫生—内分泌]