亚临床期糖尿病视网膜病变的mfERG及危险因素的临床观察  

Changes in multifocal electroretinogram( mfE RG) in subclinical diabetic retinopathy patients and the analysis of risk factors

作　　者：黎明明[1] 曾莉[2] 

机构地区：[1]南昌大学医学院,南昌330006 [2]南昌大学第一附属医院眼科

出　　处：《临床眼科杂志》2015年第3期233-237,共5页Journal of Clinical Ophthalmology

摘　　要：目的 (1)应用多焦视网膜电图(mf ERG)的一阶反应研究亚临床期糖尿病视网膜病变(DR)患者与正常人的视网膜功能,分析两组之间的差异。(2)探讨糖化血红蛋白、血脂及糖尿病病程与mf ERG异常变化之间的关系,筛选出亚临床期DR患者的相关危险因素。方法选择已确诊为2型糖尿病的患者40例(75只眼)为实验组,健康体检者20例(36只眼)作为对照组。所有受检者均行多焦视网膜电图检查并且对40WGQJ2型糖尿病患者行糖化血红蛋白、血脂等相关指标检测,对结果进行统计学分析。结果 (1)亚临床期DR患者P1波的振幅表现为环1到环5明显降低,P1波的潜伏期表现为环3到环5显著延迟。(2)亚临床期DR患者的N1波振幅表现为环3及环4振幅降低,N1波潜伏期表现为环5显著延迟。(3)糖化血红蛋白、总胆固醇与亚临床期DR患者mf ERG振幅的降低相关。结论 (1)mf ERG在亚临床期DR中表现为振幅降低及潜伏期延长,mf ERG能在早期客观的评价视网膜的功能。(2)mf ERG P1波振幅的降低与糖化血红蛋白、总胆固醇相关,故亚临床期DR患者糖化血红蛋白、血脂的控制,对于预防及延缓DR的发生发展有重要作用。Objective （1）To measure the mfERG first order kernels in healthy people and in patients with sub-clinical diabetic retinopathy,and to compare the difference between the two groups. （2）To explore the relationships be-tween abnormal mfERG findings and serum HbAlC,serum lipids,and the duration of diabetes mellitus （DM）,and to screen the related risk factors. Methods The experimental group included 40 patients who have been diagnosed with type 2 diabetes mellitus （75 eyes）. Twenty healthy people （30 eyes）served as the control group. Author used RETscan 3. 2 system （Roland,German）to record the first order kernels all subjects （111 eyes）. The diversity of amplitude and implicit time of P1 and N1 waves were analyzed. Serum HbA1C level and serum lipids were also measured. SPSS software was used for statistical analysis. Results （1）In subclinical DM patients,P1 amplitude density decreased significantly in ring 1 to ring 5,and P1 implicit time was delayed in ring 3 to ring 5. （2）N1 amplitude density decreased in ring 3 to ring 4,and N1 implicit time was delayed in ring 5. （3）Amplitude density was associated with the level of HbAlC and total cholesterol to some extent. Conclusion （1）In subclinical diabetic retinopathy patients,amplitude density reduced and implicit time was delayed,which suggested that mfERG is a sensitive method to evaluate the retinal function in early diabetic retinopa-thy. （2）HbAlC and total cholesterol were associated with P1 amplitude density,thus these may be risk factors for the de-velopment of diabetes retinal pathological changes.

关 键 词：亚临床期糖尿病视网膜病变 多焦视网膜电图 危险因素 

分 类 号：R587.2[医药卫生—内分泌]