脉络膜厚度对糖尿病患者视网膜病变病情影响的研究  

Choroidal thickness and its relationship with diabetic retinopathy

作　　者：孟繁超[1] 张春侠[1] 韩彦辉[1] 苏燕[1] 王东林[1] 

机构地区：[1]济南市明水眼科医院,250200

出　　处：《临床眼科杂志》2016年第6期488-491,共4页Journal of Clinical Ophthalmology

摘　　要：目的研究脉络膜厚度对糖尿病患者视网膜病变病情的影响。方法选取于我院2013年1月至2015年12月收治的90例糖尿病患者作为治疗对象,早期糖尿病视网膜病变(DR)治疗研究(ETDRS)标准规定DR可分为5类:无DR无糖尿病黄斑水肿(DR-/DME-)组17例(17只眼);非增生型糖尿病视网膜病变(NPDR)无糖尿病黄斑水肿(NPDR+/DME-)组23例(23只眼);增生型糖尿病视网膜病变(PDR)无糖尿病黄斑水肿(PDR+/DME-)组10例(10只眼);NPDR伴糖尿病黄斑水肿(NPDR+/DME+)组34例(34只眼);PDR伴糖尿病黄斑水肿(PDR+/DME+)组6例(6只眼)。对照组选取同期在我院体检中心进行体检的90例健康体检者。全部研究对象进行增强深部成像相干光断层扫描(EDI-OCT)。对中心凹下脉络膜厚度(SFCT)进行比较,判断其在不同阶段DR中存在的差异,分析脉络膜厚度对DR病情的影响。结果对照组、无DR无糖尿病黄斑水肿组、NPDR无糖尿病黄斑水肿组、PDR无糖尿病黄斑水肿组、NPDR伴糖尿病黄斑水肿组、PDR伴糖尿病黄斑水肿的SFCT平均值分别为(273士24)、(272±23)、(260±26)、(244士25)、(227±27)、(214±30);对照组各组SFCT均大于观察组,差异具有统计学意义(P<0.05),其中PDR无糖尿病黄斑水肿(PDR+/DME-)组SFCT值小于无DR无糖尿病黄斑水肿(DR-/DME-)组,差异具有统计学意义(P<0.05),NPDR伴糖尿病黄斑水肿(NPDR+/DME+)组SFCT值小于PDR无糖尿病黄斑水肿(PDR+/DME-)组,差异具有统计学意义(P<0.05)。结论脉络膜厚度的变化与DR之间存在联系,二者相互影响,使病情加重,对患者脉络膜厚度进行监测,将有助于综合分析糖尿病患者的视网膜病变情况。Objective To study the relationship of choroidal thickness with diabetic retinopathy. Methods Ninety early diabetic retinopathy（ ETDRS） patients were recruited between January 2013 and December 2015. Patients were classified as non-DR without diabetic macular edema（ DME）（ DR-/ DME-group,n = 17 eyes）,non-proliferative diabetic retinopathy（ NPDR） without DME（ NPDR ＋ / DME-group,n = 23 eyes）,proliferative diabetic retinopathy（ PDR） without DME（ PDR ＋ / DME-group,n = 10 eyes）,NPDR with DME（ NPDR ＋ / DME ＋ group,n = 34 eyes）,and PDR with DME（ PDR ＋ / DME ＋ group,n = 6 eyes）. We selected 50 cases of healthy subjects as a control group. Enhanced depth imaging optical coherence tomography（ EDIOCT） was used to measure choroidal thickness. Results Generally,choroidal thickness decreases with the progress of diabetic retinopathy. In the control group,DR-/ DME- group,NPDR ＋ / DMEgroup,PDR ＋ / DME- group,NPDR ＋ / DME ＋ group,and PDR ＋ / DME ＋ group,the SFCT values were 273 ± 24,272± 23,260 ± 26,244 ± 25,227 ± 27,214 ± 30 μm,respectively. SFCT was reduced in patients,and the difference was statistically significant（ P〈0. 05）. The PDR ＋ / DME- patients had smaller SFCT values than DR ＋ / DME ＋ patients（P〈0. 05）,and NPDR ＋ / DME ＋ patients had smaller SFCT values than PDR ＋ / DME- patients（ P〈0. 05）. Conclusion The choroidal thickness changes with the degree of diabetic retinopathy. Measurement of the choroidal thickness may be helpful for monitoring the progress of diabetic retinopathy.

关 键 词：脉络膜厚度 糖尿病视网膜病变 相干光断层扫描 

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