糖尿病患者视网膜血管直径变化分析  

Retinal vessel diameter variation analysis in diabetic patients

作　　者：王习哲[1] 刘大川[1] 

机构地区：[1]首都医科大学宣武医院眼科,100053

出　　处：《中华眼科杂志》2016年第5期358-361,共4页Chinese Journal of Ophthalmology

摘　　要：目的探讨糖尿病患者视网膜血管形态变化的影响因素。方法病例对照研究。选择2014年1至3月在首都医科大学宣武医院内分泌科住院的2型糖尿病患者155例，按有无DR将患者分为无DR（NDR）组（85例）与DR组（70例）。睫状肌麻痹后彩色眼底照相，测量距离视乳头中心1．0～1．5PD范围的血管直径，分析视网膜动脉直径、静脉直径与高血压、糖尿病病程、DR分期的相关关系。两组患者的视网膜静脉直径及视网膜动脉直径比较采用独立样本t检验。单因素相关性分析分别检测视网膜动、静脉直径与年龄、DR分期、高血压病程、糖尿病病程的相关性。分别以视网膜动、静脉直径为因变量，以DR分期、高血压病程、糖尿病病程、胰岛素使用时间、年龄为自变量，使用步进法，进行多重线性回归。结果DR组与NDR组视网膜静脉直径分别为（90．37±7．95）和（83．45±7．80）μm，差异有统计学意义（t=5．446，P=0．000）。视网膜静脉直径分别与DR分期和糖尿病病程呈正相关（r=0．377，0．250；P=0．000，0．002）。DR分期（b=2．382，P=0．000）与视网膜静脉直径存在线性关系（R2=0．142，F=25．285）。回归方程为：视网膜静脉直径=84．269＋2．382×DR分期。DR组与NDR组视网膜动脉直径分别为（48．23±7．08）和（53．53±6．22）μm，差异有统计学意义（t=4．962，P=0．000）。视网膜动脉直径分别与DR分期、糖尿病病程、高血压病病程呈负相关（r=-0．453，-0．343，-0．199；P=0．000，0．000，0．013）。DR分期（t=2．091，P=0．000）和年龄（t=0．182，P=0．000）与视网膜动脉直径存在线性关系（R2=0．290，F=31．088）。回归方程为：视网膜动脉直径=64．011—2．091×DR分期-0．182×年龄。结论糖尿病患者随DR加重，视网膜静脉直径增大，视网膜动脉直径减小。糖尿病、高血压病程与视网膜动脉、静脉Objective To explore the influence factors of retinal vascular changes in diabetes patients. Methods Case control study. One hundred and fifty-five type 2 diabetes patients were divided into NDR group （n=80） and DR group （n=70） according to the presence of diabetic retinopathy. Fundus photographs were taken after pupil dilated, the diameter of retinal arterioles and venules were measured between 1.0 PD and 1.5 PD. To analyze the relationship between retinal artery diameter, vein diameter and hypertension, diabetes duration, and DR stage. With retinal artery and vein diameter as the dependent variable, DR stage, hypertension, diabetes duration, insulin using time and age as independent variables, using step method, multiple linear regression was undergoing. Results The diameter of retinal vein in DR group and NDR group were （90.37＋7.95） and （83.45±7.80） μm, the difference was statistically significant （t=5.446, P=0.000）. Retinal vein diameter was positively correlated with DR stage and diabetes duration （r=0.377, 0.250; P=0.000, 0.002）. DR stage （b=2.382, P=0.000） had a linear relationship with retinal vein diameter （R2=0.142, F=25.285）. The regression equation was： retinal vein diameter =84.269 ＋2.382. DR stage. Retinal artery diameter was negatively correlated with DR stage, diabetes duration, and hypertension duration （r=-0.453,-0.343,-0.199. P=0.000, 0.000, 0.013）. DR stage （b=-2.091, P=0.000） and age （b=-0.182, P=0.000） has a linear relationship with retinal artery diameter （R2=0.290, F=31.088）. The regression equation was： retinal artery diameter =64.011-2.091. DR stage -0.182. age. Conclusions With DR developed, retinal vein diameter increases, retinal artery diameter decreases in diabetic patients. The duration of diabetes mellitus and hypertension were not related to the diameter of retinal artery and vein.

关 键 词：糖尿病视网膜病变 视网膜血管 视网膜动脉 视网膜静脉 

分 类 号：R587.2[医药卫生—内分泌] R774.1[医药卫生—内科学]