糖尿病黄斑水肿及其危险因素的研究进展  

Research progress of diabetic macular edema and its risk factors

作　　者：李玮[1] 吴强[1] 

机构地区：[1]上海交通大学附属上海市第六人民医院眼科,200030

出　　处：《中华实验眼科杂志》2017年第7期664-668,共5页Chinese Journal Of Experimental Ophthalmology

摘　　要：糖尿病黄斑水肿（DME）是糖尿病的常见并发症之一，可导致患者视力严重受损，其发病机制复杂，不仅与血－视网膜屏障的破坏密切相关，且有众多细胞因子参与其形成过程，但具体机制目前尚未完全明确。最近的研究表明，视网膜的某些典型病理表现可以作为其发生的评估标准。糖尿病是由全身多种因素共同参与且协同作用的病理过程，如血糖、血压、血脂，均可通过不同的机制影响全身及视网膜血管功能，导致血管内皮功能障碍，与黄斑水肿的发生和发展密切相关；其他全身危险因素，如糖尿病肾病导致渗透压平衡的改变，贫血引起组织缺血缺氧导致细胞因子升高，肥胖者通过脂肪因子导致血管损伤，吸烟促进机体产生氧化应激反应从而对血管进行损害，以及不同的降糖药物通过相关受体信号传导等机制，均将不同程度地影响黄斑水肿的发生和发展。因此对该病及其危险因素进行全面了解有利于预防DME。本文主要就DME的定义及分型、发病机制、病理表现及全身危险因素的研究进展作一综述。Diabetic macular edema （DME） is a common complication of diabetes that can lead to severely impaired visual acuity. Its pathogenesis is complex,which is closely related to the destruction of blood-retinal barrier, and there are many cytokines involved in its formation, but the exact mechanism is not yet fully clear. Recent researches suggested that some typical pathological characterizations of retina can be used as criteria for evaluating its occurrence, and it is known that a variety of risk factors participated in the pathological process, such as glucose, blood pressure,blood lipids,which are well-known and can be closely correlated with its development through impacting the systemic and retinal vascular functions by complex mechanisms and leading to endothelial dysfunction. While other systemic risk factors, such as diabetic nephropathy which leads to changes in osmotic balance,anemia which increases eytokines caused by ischemia and hypoxia,excessive body weight which leads to vascular damage through fat factor, smoking that produces blood vessel damage by promoting oxidative stress on the body and various hypoglyeemic drugs, will influence the development of maeular edema on different levels. So conducting a comprehensive and newest understanding of this disease and its risk factors are conducive to better prevention efforts for diabetes patients. This review mainly summarizes the latest researches on definition, classification, pathologic characterization and risk factors of DME.

关 键 词：糖尿病 糖尿病视网膜病变 糖尿病黄斑水肿 危险因素 

分 类 号：R587.2[医药卫生—内分泌] R774.5[医药卫生—内科学]