视网膜神经纤维层厚度和视网膜中央动脉血流动力学指数对早期糖尿病视网膜病变的诊断价值  

Diagnostic Value of Retinal Nerve Fiber Layer Thickness and Central Retinal Artery Hemodynamic Index in Early Diabetic Retinopathy

作　　者：赵丽娜[1] 钟德斌[1] 李丽萍[1] 钟为辉 丁莹 ZHAO Lina;ZHONG Debin;LI Liping;ZHONG Weihui;DING Ying(Guangzhou Development Zone Hospital,Guangzhou 510730,China;不详)

机构地区：[1]广州开发区医院,广东广州510730

出　　处：《中外医学研究》2022年第5期69-72,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

基　　金：广州市卫生健康科技项目(20201A010080)。

摘　　要：目的:探讨视网膜神经纤维层(RNFL)厚度和视网膜中央动脉血流动力学指数对早期糖尿病视网膜病变的诊断价值。方法:选取广州开发区医院2020年5月-2021年11月收治的120例(120只眼)糖尿病视网膜病变患者,根据患者眼底病变程度分为非增殖期糖尿病视网膜病变(NPDR)组70例(70只眼),增殖期糖尿病视网膜病变(PDR)组50例(50只眼),另选取同期健康志愿者50例(50只眼)作为对照组,进行光学相干断层扫描和超声检测。比较三组视乳头区和黄斑区RNFL厚度,视网膜中央动脉收缩期峰值流速(PSV)、舒张末期流速(EDV)及阻力指数(RI)。结果:与对照组相比,NPDR组和PDR组视乳头区中央、上方、下方、颞侧、鼻侧的RNFL厚度均较薄,且PDR组显著薄于NPDR组(P<0.05)。与对照组相比,NPDR组黄斑区鼻侧1 mm、上方3 mm、颞侧3 mm、鼻侧3 mm处的RNFL厚度较薄(P<0.05);与对照组及NPDR组相比,PDR组黄斑区各个检测点的RNFL厚度均较薄(P<0.05)。PSV和EDV随着视网膜病变的加重逐渐降低,NPDR组、PDR组的PSV和EDV均低于对照组,PDR组低于NPDR组(P<0.05);RI随着视网膜病变的加重逐渐升高,NPDR组、PDR组的RI高于对照组,PDR组高于NPDR组(P<0.05)。结论:对于糖尿病患者,糖尿病视网膜病变患者视乳头区和黄斑区RNFL厚度均异常变薄,视网膜中央动脉血流动力学异常,其对早期糖尿病视网膜病变具有较高的诊断价值。Objective:To investigate the diagnostic value of retinal nerve fiber layer (RNFL) thickness and central retinal artery hemodynamic index in early diabetic retinopathy.Method:A total of 120 patients (120 eyes) with diabetic retinopathy admitted to Guangzhou Development Zone Hospital from May 2020 to November 2021 were selected and divided into non proliferative diabetic retinopathy (NPDR) group (70 cases,70 eyes) and proliferative diabetic retinopathy (PDR) group (50 cases,50 eyes) according to the degree of fundus lesion.In addition,50 healthy volunteers (50 eyes) in the same period were selected as the control group,all of which accepted optical coherence tomography and ultrasonic detection.The thickness of RNFL in optic papilla area and RNFL in macula area,peak systolic velocity (PSV),end diastolic velocity (EDV) and resistance index (RI) of central retinal artery were compared among the three groups.Result:Compared with the control group,the thickness of RNFL in the center,upper,lower,temporal and nasal sides in NPDR group and PDR group were significantly thinner,and the thickness of RNFL in PDR group were thinner than those in NPDR group (P<0.05).Compared with the control group,the RNFL thickness at nasal 1 mm,upper 3 mm,temporal 3 mm and nasal 3 mm in the NPDR group were thinner (P<0.05),and the RNFL thickness at each detection point in PDR group were thinner than those in the control group and NPDR group (P<0.05).PSV and EDV decreased gradually with the aggravation of retinopathy,PSV and EDV in NPDR group and PDR group were lower than those in the control group,and which in PDR group was lower than that in NPDR group (P<0.05).RI increased gradually with the aggravation of retinopathy,and RI in NPDR group and PDR group were higher than that in the control group,and which in PDR group was higher than that in NPDR group (P<0.05).Conclusion:For diabetic patients,the thickness of RNFL in the papilla and macular area is very thin,and the hemodynamics of the central retinal artery is abnormal.It has a high diagnos

关 键 词：糖尿病视网膜病变 视网膜神经纤维层厚度 视网膜中央动脉 血流动力学 

分 类 号：R774.1[医药卫生—眼科] R587.2[医药卫生—临床医学]