2型糖尿病患者尿微量白蛋白与脉络膜厚度的相关性研究  

Relationship between the choroidal thickness and urinary albumin excretion rate in patients with type 2 diabetic nephropathy

作　　者：高丽芬[1] 路晖[1] 王作芬[1] GAO Lifen;LU Hui;WANG Zuofen(Department of Ophthalmology,Zibo Central Hospital,Zibo 255000,China)

机构地区：[1]淄博市中心医院眼科,山东淄博255000

出　　处：《潍坊医学院学报》2018年第2期122-124,共3页Acta Academiae Medicinae Weifang

摘　　要：目的观察2型糖尿病肾病(DN)患者脉络膜厚度与尿微量白蛋白排泄率(UAER)的关系,探讨糖尿病患者脉络膜病变与DN的相关性。方法 168例2型糖尿病住院患者,根据UAER分为3组:无蛋白尿组63例,微量白蛋白组60例和蛋白尿组45例,另选择30例健康体检者作为对照组。采用光学相干断层扫描仪(OCT)深度增强成像(EDI)模式测量对照组和糖尿病各组患者黄斑中心凹下以及中心凹鼻侧1mm(N1mm),鼻侧3mm(N3mm),颞侧1mm(T1mm)及颞侧3mm(T3mm)的脉络膜厚度变化。结果无论是对照组还是糖尿病患者,黄斑中心凹下的平均脉络膜厚度(CT)最大,且CT值随远离黄斑距离的加大而降低(P<0.05),在等距点上颞侧CT值大于鼻侧,即T1mm>N1mm,T3mm>N3mm(P<0.05);对照组与无白蛋白尿组各位点CT值无显著差异(P>0.05);微量白蛋白尿组和蛋白尿组各位点CT显著高于对照组和无蛋白尿组(P<0.05)。糖尿病患者24h UAER与黄斑中心凹、距离黄斑中心凹1mm和3mm的颞侧和鼻侧CT呈负相关(r=0.356,-0.283,-0.302,-0.268,-0.249,P<0.05)。结论糖尿病患者脉络膜厚度随DN进展而变薄,提示糖尿病脉络膜病变与DN存在相关性。Objective To investigate the relationship between the choroidal thickness and urinary albumin excretion rate in type 2 diabetic nephropathy and to discuss the correlation of diabetic choroidopathy with diabetic nephropathy. Methods One hundred and sixty-eight hospitalized patients with type 2 diabetes were divided into three groups according to urine albumin excretion ratio： normal albuminuria group（ n = 63）,microalbuminuria group（ n = 60）and proteinuria group（ n = 45）,and 30 cases of healthy physical examination were chosen as control group. The choroidal thickness was measured by enhanced depth imaging optical coherencetomography（ EDI-OCT）. Results The average value of subfovea I choroidal thickness reached its maximum thickness,and the value of choroidal thickness was decreased with increasing distance away from the macula both in control group and in diabetic group（ P〈0. 05）. The value of choroidal thickness on the isometric point was greater at temporal side than at the nasal side,namely T1 mm 〉N1 mm,T3 mm 〉N3 mm（ P〈0. 05）; There was no significant difference in choroidal thickness between control group and no albuminuria group（ P〉0. 05）. The values of choroidal thickness were significantly higher in microalbuminuria and albuminuria group than control group and no albuminuria group（ P〈0. 05）. Of diabetic patients 24 h urinary albumin excretion rate was negatively correlated with the values of choroidal thickness of subfovea I,1 mm and 3 mm away from macular at he temporal side and nasal side（ r = 0. 356,-0. 283,and-0. 302,-0. 268,-0. 249,P〈0. 05）. Conclusion Choroidal thickness become thinning with the progress of diabetic nephropathy,indicating the correlation between diabetic choroidopathy and diabetic nephropathy.

关 键 词：糖尿病脉络膜病变 糖尿病肾病 脉络膜厚度 

分 类 号：R773.4[医药卫生—眼科]