HRF、OCT早期检查及RBP4检测在糖尿病性视网膜病变中的诊断价值  

Diagnostic value of HRF, OCT and RBP4 in diabetic retinopathy

作　　者：封东来[1] 魏东[1] 李芳[1] 罗先策[1] 梁斌[1] 张娣[2] FENG Donglai;WEI Dong;LI Fang;LUO Xiance;LIANG Bin;ZHANG Di(Department of Endocrinology and Metabolism, Chengdu Second People's Hospital, Chengdu 610015, China)

机构地区：[1]成都市第二人民医院内分泌代谢科,成都610015 [2]成都市第二人民医院眼科,成都610015

出　　处：《空军医学杂志》2019年第4期347-349,365,共4页Medical Journal of Air Force

摘　　要：目的探究分析共焦扫描激光多普勒视网膜血液仪(heidelberg retina flowmeter,HRF)和光学相干断层扫描(optical coherence tomography,OCT)2种眼底检查手段在糖尿病性视网膜病变(diabetic retinopathy,DR)中的诊断价值,监测DR患者视黄醇结合蛋白4(retinol binding protein 4,RBP4)水平变化并分析其意义。方法选取成都市第二人民医院在2017年1-12月收治的DR患者60例120只眼作为研究对象(观察组),并选取同期正常者30例60只眼(正常组)和糖尿病无视网膜病变者30例60只眼(对照组)进行比较,应用HRF对鼻、颞侧视乳头旁视网膜、视网膜无可见血管区的血流量、血流速度和红细胞移动速率等血液动力学指标进行检测,应用OCT对视网膜中心凹厚度进行测定,应用胶乳比浊法对RBP4水平进行测定;比较各组数据并分析其意义。结果各组的血流参数间比较满足方差齐性检验,组间比较差异有统计学意义(P<0.05)。观察组黄斑中心凹视网膜厚度显著高于对照组和正常组,差异有统计学意义(P<0.001);且对照组的黄斑中心凹视网膜厚度也明显高于正常组,差异有统计学意义(P<0.05)。观察组RBP4含量显著高于对照组和正常组,差异有统计学意义(P<0.01);且对照组的RBP4含量也明显高于正常组,差异有统计学意义(P<0.01),RBP4含量与糖尿病严重程度具有一定的正相关性。结论 HRF检查和RBP4指标在DR患者中有较为明显的变化,二者可作为DR诊断的主要检查方法和检测指标,而OCT在DR辅助诊断中也有重要价值。Objective To explore and analyze the diagnostic value of heidelberg retinal hematology (HRF) and optical coherence tomography (OCT) in diabetic retinopathy (DR), and to monitor the changes of retinol binding protein 4 (RBP4) levels in DR patients and analyze their significance. Methods Sixty patients with diabetic retinopathy (120 eyes) treated in our hospital between January 2017 and December 2017 were selected as the subjects (observation group), while another 30 normal subjects (60 eyes, normal group) and 30 diabetic patients without retinopathy (control group) were selected for comparison. All the subjects were tested by confocal scanning laser Doppler retinal hemodynamics instrument for blood flow, blood flow velocity and erythrocyte migration rates in nasal, temporal parapapillary retinas and retinas without visible blood vessels. Optical coherence tomography was used to measure the central retinal fovea thickness of the subjects. The level of retinol binding protein 4 was determined by latex turbidimetry. The data of each group was compared and its significance was analyzed. The blood flow parameters of these groups were compared. Results There was statistically significant difference between these groups (P<0.05). The macular fovea retinal thickness in the observation group was significantly above that of the control group and the normal group, and the difference was statistically significant (P<0.001). The macular fovea retinal thickness in the control group was also well above that of the normal group, and the difference was statistically significant (P<0.05). The level of RBP4 in the observation group was significantly higher than that of the control group and the normal group. The difference was statistically significant (P<0.01). The level of RBP4 in the control group was also significantly higher than that of the normal group (P<0.01). The level of RBP4 was positively correlated with the severity of diabetes mellitus. Conclusion The changes of HRF and RBP4 are obvious in DR patients. They can be use

关 键 词：共焦扫描激光多普勒视网膜血液仪 光学相干断层扫描 糖尿病性视网膜病变 眼底检查 视黄醇结合蛋白4 诊断价值 

分 类 号：R587.2[医药卫生—内分泌]