早期糖尿病视网膜病变血管管径变化的研究  

Assess ment for the changes of retinal vascular caliber in early diabetic retinopathy

作　　者：徐力[1] 李春艳[2] 王春燕[3] 王瑞琪[4] 刘敏[3] 王娟[3] 张晓云[3] XU Li;LI Chunyan;WANG Chunyan;WANG Ruiqi;LIU Min;WANG Juan;ZHANG Xiaoyun(Hainan Eye Hospital and Key Laboratory of Ophthalmology,Zhongshan Ophthalmic Center,Sun Yat-sen University,Haikou 570311,China;The Second Hospital of Yulin,Yulin 719000,China;The Affiliated Hospital,Inner Mongolia Medical University,Hohhot 010050,China;Inner Mongolia Medical University,Hohhot 010050,China)

机构地区：[1]中山大学中山眼科中心海南省眼科医院(海南省眼科医院),海南省眼科重点实验室,海口570311 [2]榆林市第二医院眼科,陕西省榆林市719000 [3]内蒙古医科大学附属医院眼科,呼和浩特010050 [4]内蒙古医科大学,呼和浩特010050

出　　处：《中国实用眼科杂志》2018年第5期353-357,共5页Chinese Journal of Practical Ophthalmology

基　　金：海南省自然科学基金面上项目(818MS171);内蒙古自治区自然科学基金(2015MS0822)

摘　　要：目的观察早期糖尿病视网膜病变(DR)患者视网膜血管管径的变化,探讨其与病变程度的关系。方法收集我院2013年6月至2015年6月Ⅱ型糖尿病住院患者,按照视网膜病变分级分为无视网膜病变组(NDR)和非增殖期视网膜病变组(NPDR),同时招募无糖尿病健康志愿者组成健康对照组(NC)。各组病例分别为NDR组53例和NPDR组30例,对照(NC)组30人,均以右眼为观测眼。以视乳头为中心行眼底照相,应用半自动化眼底血管测量软件(IVAN)对清晰的眼底照相进行测量,得到参数视网膜中央动脉管径相对值(CRAE),视网膜中央静脉管径相对值(CRVE),和动/静脉比值(AVR)进行统计分析。结果CRAE,NPDR组(158.248±3.612)μm(P=0.011)和NDR组(152.785±2.220)μm(P=0.040),均显著宽于NC组(143.953±3.688)μm,差异有统计学意义。CRVE,NPDR组(223.185±5.340)μm宽于NC组(209.760±5.453)μm,差异有统计学意义(P=0.023),而NDR组(213.820±3.282)μm增宽,但与NC组比较差异无统计学意义(P=0.583)。AVR,3组间差异无统计学意义(P=0.482)。结论本研究发现,患者在DR早期,视网膜血管形态学已经发生改变,视网膜动脉有扩张趋势,而在背景期视网膜病变视网膜静脉有扩张趋势。Objective To examine the relationship of retinal vascular caliber with the severity of diabetic retinopathy in early stage of diabetic retinopathy(DR)by semi-automated retinal vascular measurement software(IVAN).Methods Hospitalized patients with type 2 diabetes were divided into non-proliferative retinopathy(NPDR)and without retinopathy(NDR)groups.There were 30 eyes in NPDR group,53 eyes in NDR group,and 30 eyes in NC group recruited in this study,right eyes taken as observed eyes.And healthy volunteer were recruited as normal controls group(NC).IVAN was used to assess retinal vascular caliber from clear digitized color fundus photographs centered on the disc.The parameters of central retinal arteriolar equivalent(CRAE),central retinal venular equivalent(CRVE)and arteriovenous ratio(AVR)were obtained for statistical analysis.Results Compared with the NC group(143.953±3.688)μm,there were significant increase in mean CRAE of NDR group(152.785±2.220)μm(P=0.040)and NPDR group(158.248±3.612)μm(P=0.011).There was significant increase in mean CRVE in NPDR group(223.185±5.340)μm than NC group(209.760±5.453)μm(P=0.023),while the increase in mean CRVE in NDR group(213.820±3.282)μm was not statistically significant(P=0.583).No significantly difference was found in the mean AVR among 3 groups(P=0.482).Conclusions The study indicates that retinal vascular caliber has changed in diabetes patients in early stage of DR,even in those without clinically detectable retinopathy.The dilation of central retinal arteries is observed on subjects without retinopathy,while the dilation of central retinal vein is observed on the stage of background retinopathy.

关 键 词：糖尿病视网膜病变 血管管径 视网膜中央动脉 视网膜中央静脉 

分 类 号：R77[医药卫生—眼科] R587[医药卫生—临床医学]