Muller细胞在增殖性糖尿病性视网膜病变中的作用  

Evaluat the muller cells＇s role in retinal neovascularization

作　　者：刘红[1] 谷万章[1] 陶源[1] 周丽霞[1] Zueva M.V. 

机构地区：[1]哈尔滨二四二医院眼科,150066 [2]莫斯科Helmholtz眼病研究所

出　　处：《中国实用眼科杂志》2009年第9期935-938,共4页Chinese Journal of Practical Ophthalmology

摘　　要：目的评价Muller细胞在糖尿病性视网膜病变（DR）视网膜新生血管形成中的作用。方法对239例（478只眼）非增殖期、增殖前期及早期增殖期DR病人进行了闪光视网膜电图（ERG）、局部ERG以及12、32、40赫兹闪烁光ERG检查，并计算纤维指数：闪光ERG的b波幅值／12赫兹闪烁光ERG幅值。此外，对37例增殖前期DR病人每间隔2～4个月进行动态电生理观察1-1．5年。结果非增殖期DR的32、40赫兹闪烁光ERGb波幅值位于正常低限，闪光ERG的a波幅值中度降低，为（54＋9．6）μv，b波幅值正常；12赫兹闪烁光ERG幅值明显降低，为（25．8±9．4）μv，纤维指数平均为（9．3±1．4）单位。增殖前期DR的所有视网膜电反应均中度下降，闪光ERG的b波幅值为（179＋19）μv，12赫兹闪烁光ERG幅值为（13．0±6．4）μv，纤维指数为10，16单位，平均（13．8＋1．3）单位，有极显著增高（P〈0．001）。早期增殖期DR的闪光视网膜电图的a波和32、40赫兹闪烁光视网膜电图幅值继续下降，分别为（30．0±12．2）μv、（8．8±2．7）μv和（4．0±2．1）μv，纤维指数平均为：（13．5±2．2），有极显著增高（P〈O．001）。动态观察表明，原来增高的纤维指数突然下降，说明近期出现视网膜新生血管的可能性极大。结论纤维指数增高是视网膜缺血缺氧的共同特点，表明Muller细胞的代谢活性代偿性增高，证实其在视网膜新生血管形成中起重要作用。Objective To evaluate the muller cells＇ role in retinal neovascularization. Methods A total of 239 （478eyes）patients with NPDR, pre-PDR and PDR in the early stage were carried on BF-ERG, local electroretinogram and 12, 32, 40Hz flickerERG examination and fiber exponent： BF-ERG b-wave amplitude value/12Hz flicker ERG width value were calculated in addition, 37 patient with pre-PDR were carried on dynamic state electricity physiology observation for 1-1.5 years in 2-4 months intervals. Results 1N propagate NPDR 32, 40Hz ticker ERG b-wave width value were at normal low limit, BF-ERG a-wave width value was lower in the degree, equaled to （54±9.6）0 v, b-wave width value was normal, 12Hz flicker ERG width value was significantly lower which was （25.8±9.4） 0 v and fiber exponent equivalent to 9.3±1.4; while in pre-PDR all of retinal response were all in medium degree descend, BF-ERG b-wave width value was （179±19） la v, 12Hz BF-ERG width value was equivalent to （13.0±6.4） la v, fiber exponent was 10-16 units in average of 13.8±1.3, which improved significantly （p〈0.001）. In the early stage of PDR, BF-ERG a-wave and 32.40Hz width value was kept on decrease obviously, equaled to （30.0±12.2）μv, （8.8±2.7）μv and （4.0±2.1 ）μv, fiber exponent was equal to 13.5±2.2, which was improved obviously （p〈0.001）. Dynamic observation indicated that the original higher value of fiber exponent suddenly descend showed greater possibility of the recent retinal neovascularization. Conclusions Higher fiber exponent are the common characteristics of retinal neovascularization and indicate the increases of muller cell＇s metabolic activity compensatory. That confirm muller cells play an important role in trigging of retinal NV.

关 键 词：MULLER细胞 增殖性糖尿病性视网膜病变 

分 类 号：R779.6[医药卫生—眼科] R339.146[医药卫生—临床医学]