糖尿病周围神经病变视网膜神经纤维层厚度变化  

Retinal nerve fiber layer thickness changes in diabetic peripheral neuropathy

作　　者：赵博[1] 胡馨[1] 王永毅[1] 陈革[1] 庞妩燕[1] 

机构地区：[1]河南大学淮河医院,河南开封475000

出　　处：《中国实用眼科杂志》2013年第7期827-830,共4页Chinese Journal of Practical Ophthalmology

摘　　要：目的探讨糖尿病周围神经病变（diabeticperipheralneurpathy，DPN）患者视网膜神经纤维层（retinalnervefiberlayer，RNFL）厚度的变化。方法临床病例对照研究。选取2012年3-9月在河南大学淮河医院临床诊断为DPN的2型糖尿病患者112例分为无视网膜病变组（NDR）61例及合并轻、中度非增殖性糖尿病视网膜病变组（NPDR）51例，按CSS（cfinicalscoringsystem）评分将DPN患者分为轻度41例、中度38例和重度33例三组，对照组为排除DPN和DR的2型糖尿病患者48例；应用傅立叶域光学相干断层扫描仪进行以视盘中点为圆心，直径为3．45mm圆周的RNFL厚度的测量，测量参数包括：视盘圆周平均，颞侧、上方、鼻侧和下方RNFL厚度，分析各组间RNFL厚度的差异。结果DPN患者视盘圆周平均和下象限RNFL厚度较对照组明显下降：NPDR组、NDR组和对照组三组比较各象限RNFL厚度下降；NDR组和对照组比较视盘圆周平均值和下象限RNFL厚度下降，NPDR组和NDR组比较视盘圆周平均值，上象限和下象限RNFL厚度值均变薄；DPN患者轻、中、重度三组比较各象限RNFL厚度明显变薄；重度组和中度组及重度组和轻度组之间比较各象限RNFL厚度均明显下降。结论DPN患者在出现DR之前就已经出现RNFL的变薄，并随着DR的出现RNFL厚度进一步降低；随着DPN病情的加重，RNFL厚度呈进行性下降。Objective To investigate retinal nerve fiber layer （RNFL） thickness changes using fourier domain optical coherence tomography （OCT） in patients with diabetic peripheral neuropathy （DPN）. Methods One hundred and twelve cases with DPN diagnosed with type 2 diabetes were in- cluded in NDR group （61 cases） and NPDR group （51 cases）. According the Clinical Scoring Sys- tem （CSS）, all patients were divided into mild group （41 cases）, moderate group （38 cases） and se- vere group （33 cases）. The control group included 48 patients with type 2 diabetes but non-DPN and NDR. The RNFL thickness was measured with fourier domain OCT. Each subject had circular scans around the optic nerve with a circle size of 3.45mm. The measuring parameter included the RNFL thickness of the temporal, superior, nasal, inferior quadrant and the mean of the whole layer. The RNFL thickness in different group was analyzed. Results The RNFL thickness of the mean and inferior quadrant in DPN group was descended obviously compared with the control group; Com- pared with the NPDR group, NDR group and the control group, the RNFL thickness of each quad- rant were descended significantly. In NPDR group, the RNFL thickness of mean and inferior quad- rant was significantly descended than that of the control group. In NPDR group the RNFL thickness of mean, superior and inferior quadrant were thinner than that in NDR group. In DPN cases, com- pared with mild group, moderate group and severe group, the RNFL thickness of each quadrant be-came thinner significantly. The RNFL thickness of each quadrant in severe group descended more significantly than that in mild group and moderate group. Conclusions The RNFL thickness be- come thinner before DR in DPN patients, and will reduce more significantly following the emerging of DR. Along with the aggravating of the DPN, the RNFL thickness descend progressively.

关 键 词：糖尿病周围神经病变 视网膜神经纤维层 厚度 

分 类 号：R779.63[医药卫生—眼科]