糖尿病黄斑水肿类型与相关因素  

Relationship between the Classification of Diabetic Macular Edema and Its Related Factors

作　　者：刘丽英[1] 董方田[1] 李蕙[1] 

机构地区：[1]中国医学科学院北京协和医学院北京协和医院眼科,北京100730

出　　处：《中国医学科学院学报》2007年第6期797-802,共6页Acta Academiae Medicinae Sinicae

摘　　要：目的探讨糖尿病黄斑水肿(DME)的类型及严重程度,及其与糖尿病视网膜病变(DR)程度、糖尿病病程及类型、使用胰岛素情况和视力损害之间的关系。方法回顾性分析1172例荧光素眼底血管造影确诊的DR患者的检查结果、病程、分型、使用胰岛素情况和视力等临床资料。分析各期DR中DME的发生率以及DME与以上相关因素的关系。结果1172例DR患者中,394例(633只眼)DME,占33.62%。局限型DME265只眼(41.86%)、弥漫型368只眼(58.14%)。轻度DME246只眼(38.86%)、中度189只眼(29.86%)、重度198只眼(31.28%)。DME的类型(r=0.975,P=0.025)及分级(r=1.000,P=0.000)与DR的各期存在显著相关性,随着DR病变程度加重DME有加重趋势。患者的视力随着DME的加重明显下降(r=-0.984,P=0.003),黄斑弥漫型水肿较局限型水肿对视力的损害更重。糖尿病病程与DME的类型、分级具有显著相关性(r=0.962,P=0.009),DME主要发生在糖尿病病程6年以上的患者,病程越长,水肿比例越高,水肿越严重。DME在2型糖尿病及使用胰岛素的患者中较多。结论DME的类型及严重程度与糖尿病病程、糖尿病视网膜病变的分期、视力、使用胰岛素的情况均存在显著相关性。Objective To explore the relationship between the classification and degree of diabetic macular edema （DME） and the stages of diabetic retinopathy （ DR）, diabetic duration, classification of diabetes, use of insulin, and visual loss. Methods We retrospectively analyzed the stages of DR, diabetic duration, classification of diabetes, use of insulin, and visual loss in 1 172 DR patients with fundus fluorescein angiography （FFA）. The occurrence of DME in DR in each stage and the relationships between its related factors were analyzed. Results In 1 172 patients, 633 eyes in 394 patients had DME （33.62%）, including 265 （41.86%） with focal DME and 368 （58.14%） with diffuse DME. There were 246 （38.86%） eyes with mild DME, 189 （29.86%） with moderate DME, and 198 （31.28%） with severe DME. Significant correlations exhisted among the classification of DME （ r = 0. 975, P = 0. 025 ） , the degree of DME （ r = 1. 000, P = 0. 000）, and the stage of DR. DME deteriorated with the increase of the stages of DR. The visual loss significantly correlated with the degree of DME （ r = - 0. 984, P = 0. 003 ）. The visual acuity was lower in patients with diffuse DME than those with focal DME. The diabetic duration significantly correlated with the classification and degree of DME （ r = 0. 962, P = 0. 009 ）. DME was mostly seen in patients with a disease course of six years or longer, and its severity and incidence increased along with the prolonged period. Also, The incidence of DME increased in patients with type 2 diabetes and patients who used insulin. Conclusion The classification and degree of DME correlates with the stages of DR, diabetic duration, the classification of diabetes, the use of insulin, and visual loss.

关 键 词：糖尿病视网膜病变 黄斑水肿 眼底荧光素血管造影术 

分 类 号：R774.1[医药卫生—眼科] R774.5[医药卫生—临床医学]