糖尿病视网膜病变患者的病变程度及糖化血红蛋白水平与视网膜血管血氧饱和度相关性研究  

The correlation of oxygen saturation of retinal vessels and diabetic retinopathy stages or HbAle levels in patients with diabetic retinopathy

作　　者：花蒂豪 徐奕爽 邢怡桥[1] 

机构地区：[1]武汉大学人民医院眼科中心,430060

出　　处：《中华眼底病杂志》2017年第1期36-39,共4页Chinese Journal of Ocular Fundus Diseases

摘　　要：目的 观察糖尿病视网膜病变（DR）患者病变程度及糖化血红蛋白（HbA1c）水平与视网膜血管血氧饱和度的相关性。 方法 横断面研究。临床确诊为DR的102例患者102只眼及年龄与之匹配的正常健康者（正常对照组）20名20只眼纳入研究。将DR患者分为轻中度非增生型DR（NPDR）组、重度NPDR组及增生型DR（PDR）组，分别为55、26、21例。根据DR患者HbA1c水平分为HbA1c＞9%、HbA1c 7%～9%、HbA1c＜7% 3组，分别为8、33、61例。采用无创视网膜血管血氧饱和度分析仪检测所有受检者视网膜血管血氧饱和度。暗室内采集眼底像，以视盘直径为半径，选取1.0～1.5倍半径的视盘同心圆之间直径＞60 μm的血管进行血氧饱和度分析。观察不同病变程度、不同HbA1c水平的DR患者以及正常对照组受检者视网膜动脉、静脉血氧饱和度及视网膜动静脉血氧饱和度差值。 结果 重度NPDR组患者视网膜动脉血氧饱和度较轻中度NPDR组、正常对照组明显升高，差异有统计学意义（F=13.670，P＜0.05）。PDR组视网膜静脉血氧饱和度较轻中度NPDR组、正常对照组明显升高，差异有统计学意义（F=6.379，P＜0.05）。重度NPDR组视网膜动静脉血氧饱和度差值较轻中度NPDR组、PDR组明显升高，差异有统计学意义（F=5.536，P＜0.05）。HbA1c＞9%组患者视网膜动脉（F=9.989）、静脉（F=10.208）血氧饱和度均较HbA1c 7%～9%组、HbA1c＜7%组明显升高，差异有统计学意义（P＜0.05）。HbA1c＞9%、HbA1c 7%～9%、HbA1c＜7%组患者之间视网膜动静脉血氧饱和度差值比较，差异无统计学意义（F=1.836，P＞0.05）。 结论 不同病变程度的DR患者视网膜血管血氧饱和度存在差异；其中，视网膜动脉血氧饱和度、视网膜动静脉血氧饱和度差值在重度NPDR患者中最高，而视网膜静脉血氧饱和度随病变进展呈上升趋势。随HbA1c水平升高，DR患者视网膜动脉�Objective To evaluate the correlation of oxygen saturation of retinal vessels and diabetic retinopathy （DR） stages or HbA1c level in patients with DR. Methods Cross sectional study. A total of 102 patients （102 eyes） with DR and 20 age-matched healthy controls （20 eyes） （normal control group） were enrolled in this study. DR patients were divided into mild and moderate non-proliferative DR （NPDR） group （55 patients）, severe NPDR group （26 patients） and proliferative DR （PDR） group （21 patients）. DR patients were also divided into 3 groups according to the HbA1c level including HbA1c〉9% （8 patients）, HbA1c 7% - 9% （33 patients） and HbA1c〈7% group （61 patients）. The oxygen saturation of retinal vessel was measured by spectrophotometric oximetry unit in the retinal vessels with a diameter greater than 60 μm in the area around the optic disc. Results The retinal artery oxygen saturation of patients in severe NPDR group was significantly higher than that in mild to moderate NPDR group and normal control group （F=13.670,P〈0.05）. The retinal vein oxygen saturation of patients in PDR group was significantly higher than that in mild to moderate NPDR group and normal control group （F=6.379,P〈0.05）. The difference between retinal artery and vein oxygen saturation of patients in severe NPDR group was significantly bigger than that in mild to moderate NPDR group and PDR group （F=5.536,P〈0.05）. The retinal artery and vein oxygen saturation in patients of HbA1c〉9% group were significantly higher than that in HbA1c 7% - 9% group and HbA1c〈7% group （F=9.989, 10.208;P〈0.05）. The differences between retinal artery and vein oxygen saturation were same between patients in HbA1c〉9%, HbA1c 7%〈9% and HbA1c〈7% group （F=1.836,P〉0.05）. Conclusions The retinal artery and vein oxygen saturation in DR patients are related to the DR stages. Severe NPDR patients show the highest retinal artery oxygen saturation as well as biggest difference between retin

关 键 词：糖尿病视网膜病变 血氧测定法 视网膜血管/病理生理学 

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