白内障伴青光眼血脂比、胰岛素敏感性、眼内压和角膜内皮细胞的相互关系  

Perioperative changes of blood lipid ratio,insulin sensitivity,intraocular pressure and corneal endothelial cells in ultrasonic emulsification treating cataract with glaucoma and their mutual relationships

作　　者：徐家窈[1] 陈海波[1] 刘红山[2] 郑海生[1] 

机构地区：[1]中山大学中山眼科中心海南眼科医院白内障/青光眼专科,海南海口571300 [2]中山大学中山眼科中心海南眼科医院角膜病专科,海南海口571300

出　　处：《广东医学》2017年第10期1515-1518,共4页Guangdong Medical Journal

基　　金：海南省科技合作专项资金立项项目(编号:KJHZ2015-12)

摘　　要：目的探讨白内障伴青光眼超声乳化围术期血脂比、胰岛素敏感性、眼内压和角膜内皮细胞的变化及其相互关系。方法以白内障伴青光眼患者48例为研究对象,患者行超声乳化联合小梁切除术进行治疗。检测比较患者术前、术后3 d、术后1、3个月的最佳矫正视力、血脂比、胰岛素敏感性、眼内压和角膜内皮细胞等,并采用Pearson线性相关分析法分析其血脂比、胰岛素敏感性与最佳矫正视力、眼内压和角膜内皮细胞等的关系。结果与术前比较,患者术后1、3个月的低密度脂蛋白(LDL)/高密度脂蛋白(HDL)、三酰甘油(TG)/HDL、总胆固醇(TC)/HDL等血脂比值、眼内压和内皮细胞密度均降低,最佳矫正视力、胰岛素敏感指数、平均细胞面积和面积变异系数均升高(P<0.05)。Pearson线性相关分析结果显示,患者LDL/HDL、TG/HDL、TC/HDL等血脂比值与其眼内压和内皮细胞密度均呈正相关(P<0.05),与其最佳矫正视力、平均细胞面积和面积变异系数则均呈负相关(P<0.05);患者胰岛素敏感指数与其眼内压和内皮细胞密度均呈负相关(P<0.05),与其最佳矫正视力、平均细胞面积和面积变异系数则均呈正相关(P<0.05)。结论白内障伴青光眼超声乳化联合小梁切除术治疗可有效控制患者眼压,改善视力和角膜内皮细胞完整性,且其血脂比和胰岛素敏感性与其眼内压、视力和角膜内皮细胞等疗效相关指标均相关,可能用于其疗效的辅助评估。Objective To explore the perioperative changes of blood lipid ratio, insulin sensitivity, intraocular pressure and corneal endothelial cells in ultrasonic emulsification treating cataract with glaucoma and their mutual relation- ships. Methods Forty - eight patients with glaucoma and cataract underwent ultrasonic emulsification combined trabecu- lectomy treatment were selected. The best corrected visual acuity, lipid ratio, insulin sensitivity, intraocular pressure and corneal endothelial cells were detected before operation, 3 days after operation, 1 month after operation and 3 months after operation. The Pearson correlation analysis was applied to analyze correlations between blood lipid ratio and insulin sensi- tivity with the best corrected visual acuity, intraocular pressure and corneal endothelial cells. Results Compared with those before operation, LDI_/HDL, TG/HDL, TC/HDL and other lipid ratio, intraocular pressure and endothelial cell density were significantly reduced 1 month and 3 months after operation, while best corrected vision, insulin sensitive in- dex, average cell area and area variation coefficient were significantly increased （ P 〈 0. 05 ）. Pearson correlation analysis showed that LDL/HDL, TG/HDL, TC/HDL and other lipid ratio were significantly positively correlated with intraocular pressure and endothelial cell density （ P 〈 0. 05 ） , while negatively correlated with the best corrected visual acuity, average cell area and area variation coefficient （ P 〈 0.05 ）. And insulin sensitive index was significantly negatively correlated with intraocular pressure and endothelial cell density （ P 〈 0. 05 ） , while positively correlated with the best corrected visual acu- ity, average cell area and area variation coefficient （ P 〈 0. 05 ）. Conclusion Ultrasonic emulsification combined with trabeculectomy treating for glaucoma and cataract can effectively control the intraocular pressure, improve vision and cor- neal endothelial cell integrity. And blood lipid ratio and ins

关 键 词：白内障 青光眼 超声乳化 血脂比 胰岛素敏感性 眼内压 角膜内皮细胞 关系 

分 类 号：R772.2[医药卫生—眼科]