OCTA对糖尿病患者不同肾功能状态下早期黄斑区视网膜微循环改变的评估价值  

The value of OCTA in assessing early retinal microcirculation changes in the macula in T2DM patients under different renal function states

作　　者：郑玲[1] 田关源 ZHENG Ling;TIAN Guanyuan(Department of Ophthalmology,Jieyang People’s Hospital,Guangdong,Jieyang 522000,China;Department of Nephrology,Jieyang People’s Hospital,Guangdong,Jieyang 522000,China)

机构地区：[1]广东省揭阳市人民医院眼科,广东揭阳522000 [2]广东省揭阳市人民医院肾内科,广东揭阳522000

出　　处：《中国医药科学》2022年第2期19-23,共5页China Medicine And Pharmacy

基　　金：广东省揭阳市卫生健康局医学科学技术研究立项项目(揭市卫〔2019〕66号56)。

摘　　要：目的探讨不同肾功能状态下,光学相干断层扫描血管造影(OCTA)对2型糖尿病(T2DM)早期黄斑区视网膜微循环改变诊断中的应用价值。方法应用分层随机抽样法,分别选取2019年1月至2020年12月于揭阳市人民医院就诊的肾功能正常且无早期黄斑区视网膜微循环病变的T2DM患者为正常A组、肾功能正常但存在早期黄斑区视网膜微循环病变的T2DM患者为正常B组、肾功能异常但无早期黄斑区视网膜微循环病变的T2DM患者为异常A组、肾功能异常且存在早期黄斑区视网膜微循环病变的T2DM患者为异常B组,每组各45例。分析OCTA对T2DM患者不同肾功能状态下早期黄斑区视网膜微循环改变的诊断价值。结果正常B组VD_(3 mm×3 mm)及PD_(3 mm×3 mm)较正常A组明显减少,正常B组FAZ周长较正常A组明显升高,差异有统计学意义(P<0.05);ROC曲线显示VD_(3 mm×3 mm)、PD_(3 mm×3 mm)及FAZ周长对肾功能正常T2DM患者早期黄斑区视网膜微循环改变的最佳预测界值分别为17.362%、18.593%及2.611 mm,具有诊断价值(P<0.05)。异常B组VD_(3 mm×3 mm)及PD_(3 mm×3 mm)均低于异常A组,而异常B组FAZ周长高于异常A组,差异有统计学意义(P<0.05);ROC曲线显示VD_(3 mm×3 mm)、PD_(3 mm×3 mm)及FAZ周长对肾功能异常T2DM患者早期黄斑区视网膜微循环改变具有显著的诊断价值(P<0.05),其最佳预测界值分别为16.691%、18.161%及2.713 mm。结论OCTA对T2DM患者不同肾功能状态下早期黄斑区视网膜微循环改变均有诊断价值。Objective To investigate the value of optical coherence tomography angiography(OCTA)in the diagnosis of early retinal microcirculation changes in the macula in type 2 diabetes mellitus(T2DM)patients under different renal function states.Methods T2DM patients with normal renal function and no early retinal microcirculation lesions in the macula(normal group A),T2DM patients with normal renal function and early retinal microcirculation lesions in the macula(normal group B),T2DM patients with abnormal renal function but no early retinal microcirculation lesions in the macula(abnormal group A),and T2DM patients with abnormal renal function and early retinal microcirculation lesions in the macula(abnormal group B)admitted to Jieyang People’s Hospital from January 2019 to December 2020 were selected and divided into four groups by using stratified random sampling method,with 45 patients in each group.The diagnostic value of OCTA for early retinal microcirculation changes in the macula in T2DM patients with different renal function states was analyzed.Results VD_(3 mm×3 mm)and PD_(3 mm×3 mm)in normal group B were significantly lower than those in normal group A,and the perimeter of foveal avascular zone(FAZ)in normal group B was significantly greater than that in normal group A,with statistical differences(P<0.05).ROC showed the best threshold values for VD_(3 mm×3 mm),PD_(3 mm×3 mm)and FAZ perimeter in predicting early retinal microcirculation changes in the macula in T2DM patients with normal renal function were 17.362%,18.593%and 2.611 mm,respectively,with diagnostic values(P<0.05).VD_(3 mm×3 mm)and PD_(3 mm×3 mm)in abnormal group B were lower than those in abnormal group A,while FAZ perimeter in abnormal group B was greater than that in abnormal group A,with statistical differences(P<0.05).VD_(3 mm×3 mm),PD_(3 mm×3 mm)and FAZ perimeter had significant diagnostic values for early retinal microcirculation changes in the macula in T2DM patients with abnormal renal function(P<0.05),and ROC showed that the best

关 键 词：光学相干断层扫描血管造影 2型糖尿病 早期 黄斑区视网膜微循环改变 

分 类 号：R587.1[医药卫生—内分泌] R774.5[医药卫生—内科学]