外周血炎症指标和血小板相关参数与不同OCT分型的视网膜静脉阻塞继发黄斑水肿的关系  

Relationship between peripheral blood inflammatory indexes,platelet-related parameters,and macular edema secondary to retinal vein occlusion based on optical coherence tomography

作　　者：胡卫文 符树宇 黄雄高 邢文锐 陈又珍 HU Weiwen;FU Shuyu;HUANG Xionggao;XING Wenrui;CHEN Youzhen(Department of Ophthalmology,the First Affiliated Hospital of Hainan Medical University,Haikou 570102,Hainan Province,China)

机构地区：[1]海南医学院第一附属医院眼科,海南省海口市570102

出　　处：《眼科新进展》2021年第11期1027-1030,共4页Recent Advances in Ophthalmology

基　　金：国家自然科学基金资助(编号82160199,81860172);海南省科技厅重点研发项目(编号ZDYF2019184)。

摘　　要：目的探索外周血炎症指标和血小板相关参数与不同OCT分型的视网膜静脉阻塞继发黄斑水肿(RVO-ME)的关系。方法回顾性临床研究。纳入2018年6月至2021年6月于海南医学院第一附属医院眼科确诊的RVO-ME患者共100例(100眼)。根据视网膜静脉阻塞部位分为视网膜中央静脉阻塞(CRVO)组和视网膜分支静脉阻塞(BRVO)组;其次,根据RVO-ME患者的OCT形态分为视网膜神经上皮层脱离型(SRD)组、黄斑囊样水肿型(CME)组和混合型ME组。同时,选取已排除眼底疾病的白内障手术患者100例(100眼)作为正常对照组。对各组受试者外周血中性粒细胞/淋巴细胞比值(NLR)、血小板/淋巴细胞比值(PLR)、血小板计数(PLT)、平均血小板体积(MPV)和血小板分布宽度(PDW)进行组间比较。结果CRVO组和BRVO组患者外周血NLR、PLR、MPV和PDW均较正常对照组明显升高,差异均有统计学意义(均为P<0.05),而CRVO组、BRVO组和正常对照组患者的年龄、性别和PLT比较,差异均无统计学意义(均为P>0.05)。根据OCT不同形态分组结果发现,不同类型RVO-ME在不同RVO类型中占比不同(χ^(2)=6.489,P<0.05),其中有15眼SRD由BRVO引起,占比78.9%。混合型ME组患者最佳矫正视力明显差于SRD组和CME组,差异均有统计学意义(均为P<0.05),而三组间患者的年龄、性别和病程比较,差异均无统计学意义(均为P>0.05)。混合型ME组患者的MPV和PDW均高于SRD组和CME组,差异均有统计学意义(均为P<0.05);SRD组、CME组和混合型ME组患者的PLT、NLR和PLR比较,差异均无统计学意义(均为P>0.05)。结论不同OCT分型的RVO-ME患者的MPV和PDW存在差异,血小板的活化和体积增大与混合型ME的发生发展可能相关。Objective To investigate the relationship between peripheral blood inflammatory indexes,platelet-related parameters and macular edema secondary to retinal vein occlusion(RVO-ME)based on optical coherence tomography(OCT).Methods This study was a retrospective clinical study.One hundred RVO-ME patients(100 eyes)diagnosed in the Department of Ophthalmology of the First Affiliated Hospital of Hainan Medical University from June 2018 to June 2021 were selected.According to the site of retinal vein occlusion(RVO),the patients were divided into the central retinal vein occlusion(CRVO)group and branch retinal vein occlusion(BRVO)group.According to the OCT-based morphology,the patients were divided into the serous retinal detachment(SRD)group,cystoid macular edema(CME)group and mixed edema(ME)group.At the same time,100 eyes of 100 patients without ocular fundus diseases and having undergone cataract surgery were selected into the normal control group.The peripheral neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),platelet count(PLT),mean platelet volume(MPV),and platelet distribution width(PDW)were compared among different groups.Results In terms of groups classified by the site of RVO,the NLR,PLR,MPV,and PDW of patients in the CRVO group and BRVO group were significantly higher than those in the normal control group,and the differences were statistically significant(all P<0.05).However,there were no statistically significant differences in age,sex,and PLT among the three groups(all P>0.05).In terms of the groups classified by the OCT-based morphology,different RVO-ME had different proportions in RVO types(χ^(2)=6.489,P<0.05),of which 15 eyes SRD were caused by BRVO,accounting for 78.9%.The best corrected visual acuity of patients in the ME group was significantly lower than that in the SRD group and CME group,and the differences were statistically significant(all P<0.05),but there were no significant differences in age,sex,and course of disease among the three groups(all P>0.05).The MPV and PDW of p

关 键 词：视网膜静脉阻塞继发黄斑水肿 中性粒细胞/淋巴细胞比值 血小板/淋巴细胞比值 平均血小板体积 血小板平均分布宽度 

分 类 号：R774[医药卫生—眼科]