糖尿病患者有临床意义黄斑水肿的脉络膜厚度及相关因素分析  

Evaluation of choroidal thickness and its related factors in diabetic patients with clinically significant diabetic macular edema

作　　者：王少程[1] 林思勇[2,3] 邸阜生[1] 王金羊[4] 曹曦[4] 杨金奎[4] 

机构地区：[1]天津市第三中心医院内分泌科,天津医科大学第三临床学院,天津市人工细胞重点实验室,300170 [2]中南大学爱尔眼科学院,长沙410083 [3]天津爱尔眼科医院眼科,300192 [4]首都医科大学附属北京同仁医院内分泌科,糖尿病研究防治北京市重点实验室,北京100730

出　　处：《国际生物医学工程杂志》2015年第4期225-229,I0003,共6页International Journal of Biomedical Engineering

基　　金：北京市重大科技计划资助项目（D12110000412001）

摘　　要：目的应用增强深度成像相干光断层扫描（EDI—OCT）技术观察糖尿病患者有临床意义黄斑水肿（cSME）的中心凹下脉络膜厚度（SFCT）及相关因素分析。方法选取40例正常对照组（A组）、49例2型糖尿病患者不伴CSME组（B组）及37例2型糖尿病患者伴CSME组（C组）纳入本研究，其中男性67例，女性59例。应用海德堡频域OCT对全部研究对象进行EDI．OCT检查。组间SFCT的比较采用单因素方差分析法（ANOVA），以有无CSME为因变量，以相关因素为自变量进行logistic回归分析。CSME的SFCT与患者糖尿病病程、空腹血糖（FBG）、糖化血红蛋白（HbAlc）、甘油三酯（TG）、总胆固醇（TC）、低密度脂蛋白（LDL）、高密度脂蛋白（HDL）、尿白蛋白排泄率（UAER）等因素的相关性应用Pearson相关分析。结果A组的平均SFCT为（271．49±36．18）μm，B组的平均SFCT为（260．48±35．27）μm，2者比较差异无统计学意义（P〉0．05）；C组的平均SFCT为（227．90±34．73）μm，与A组比较，差异有统计学意义（P 〈0．01）；B组与C组比较，差异有统计学意义（P〈0．01）。2型糖尿病患者有临床意义黄斑水肿的平均SFCT分别与LDL和UAER具有相关性（r=-0．609、-0．681，P〈0．01），而与患者的糖尿病病程、FBG、HbA1c、TG、TC、HDL、肌酐、收缩压（SBP）及舒张压（DBP）均无相关性（P〉0．05）。结论C组的平均SFCT较A、B组变薄，且C组糖尿病伴CSME患者的LDL和UAER水平与SFCT呈负相关，即随着LDL和UAER水平升高，SFCT呈减低趋势。Objective To evaluate the correlation of sub-foveal choroidal thickness （SFCT） variation in type 2 diabetic patients with clinically significant diabetic macular edema （CSME） and the related factors using enhanced depth imaging optical coherence tomography technique （EDI-OCT）. Methods A total of 40 normal volunteers （group A）, 49 type 2 diabetic patients without CSME（group B） and 37 type 2 diabetic patients with CSME （group C） were recruited, including 67 male and 59 female. All study subjects received EDI-OCT examination. The SFCT in A, B and C groups were compared using one-way ANOVA analysis. The correlations between SFCT and duration of diabetes, fasting blood glucose （FBG）, glycoseylated hemoglobin HbAlc, low density lipoprotein （LDL）, triglyceride （TG）, total cholesterol （TC）, high density lipoprotein （HDL）, systolic blood pressure （SBP） and diastolic blood pressure （DBP） were analyzed using logistic regression analysis. Results Average SFCT in group A was （271.49±36.18）μm. Average SFCT in group B was （260.48±35.27）μm, and compared with group A, the difference was not statistically significant （P〉0.05）. Average SFCT in group C was （227.90±34.73）μm, and compared with group A, the difference was statistically significant （P〈0.01）. There was a significant difference of SFCT between groups B and C （P〈0.01）. There was no statistically correlation between average SFCT and duration of diabetes, FBG, HbAlc, TG, TC, HDL, creatinine, SBP and DBP （P〉0.05）, while a statistically correlation between SFCT and LDL or urinary albumin excretion rate （UAER） was observed in the study （r=-0.609, -0.681, P〈0.01）. Conclusions Compared with groups A and B, SFCT in type 2 diabetic patients with CSME was significantly thinner. UAER and LDL levels in type 2 diabetic patients with CSME were negatively correlated with SFCT, that is to say, with the increasing of UAER and LDL levels, SFCT in type 2 diabetic patients with CSME decreas

关 键 词：有临床意义黄斑水肿 脉络膜 相干光断层扫描 

分 类 号：R587.1[医药卫生—内分泌] R774.5[医药卫生—内科学]