糖尿病视网膜病变不同分期患者的HbAlc、FPG、FAZ、MVD水平变化及临床意义  

Changes and clinical significance of glycosylated hemoglobin,fasting blood glucose,foveal avascular area,microvessel density levels in patients with different stages of diabetic retinopathy

作　　者：陈彦霓 段娜[1] 廖锐[1] CHEN Yan-ni;DUAN Na;LIAO Rui(Department of Ophthalmology,the Third People's Hospital of Huizhou,Huizhou 516002,Guangdong,CHINA)

机构地区：[1]惠州市第三人民医院眼科,广东惠州516002

出　　处：《海南医学》2022年第15期1946-1949,共4页Hainan Medical Journal

摘　　要：目的探讨糖尿病视网膜病变不同分期患者的糖化血红蛋白(HbAlc)、空腹血糖(FPG)、黄斑中心凹无血管区域(FAZ)、微血管密度(MVD)水平变化及临床意义。方法选择2018年7月至2020年12月惠州市第三人民医院收治的120例糖尿病患者为研究对象,根据视网膜病变不同分期,将患者分为A组(无视网膜病变,41例)、B组(轻度非增殖性视网膜病变,23例)、C组(中度或重度非增殖性视网膜病变,20例)和D组(增殖性视网膜病变,36例),并选择同期在上述医院体检的50例健康者作为对照组。比较五组受检者的HbAlc、FPG、FAZ、MVD水平,并采用Spearman秩相关分析法分析HbAlc、FPG、FAZ、MVD水平与糖尿病视网膜病变不同分期的相关性。结果对照组受检者的HbAlc、FPG水平分别为(5.48±0.50)mmol/L、(5.77±0.56)mmol/L,均明显低于B组的(10.25±1.01)mmol/L、(10.08±1.00)mmol/L、C组的(10.79±1.06)mmol/L、(10.59±1.04)mmol/L和D组的(11.02±1.09)mmol/L、(10.87±1.07)mmol/L,且A组患者的HbAlc、FPG水平分别为(8.27±0.82)mmol/L、(8.32±0.84)mmol/L,均明显低于B组、C组和D组,差异均有统计学意义(P<0.05),而对照组受检者的HbAlc、FPG水平与A组比较差异均无统计学意义(P>0.05);对照组受检者的FAZ面积为(0.278±0.02)mm^(2),明显小于B组的(0.408±0.04)mm^(2)、C组的(0.420±0.04)mm^(2)和D组的(0.606±0.06)mm^(2),且A组患者的FAZ面积为(0.372±0.03)mm^(2),明显小于D组,差异均有统计学意义(P<0.05),而对照组受检者的FAZ面积与A组比较差异无统计学意义(P>0.05);五组受检者外层视网膜的MVD比较差异无统计学意义(P>0.05);对照组受检者表层视网膜、深层视网膜及脉络膜毛细血管层的MVD分别为(0.527±0.05)%、(0.574±0.06)%、(0.667±0.07)%,均明显高于A组[(0.506±0.05)%、(0.551±0.05)%、(0.639±0.06)%]、B组[(0.485±0.04)%、(0.520±0.05)%、(0.623±0.06)%]、C组[(0.481±0.04)%、(0.516±0.05)%、(0.620±0.06)%]和D组[(0.475±0.04)%、(0.503±0.05)%�Objective To investigate the change and clinical significance of glycosylated hemoglobin(HbAlc),fasting blood glucose(FPG),foveal avascular area(FAZ),microvessel density(MVD)in patients with different stages of diabetic retinopathy.Methods A total of 120 diabetic patients admitted to the Third People's Hospital of Huizhou from July 2018 to December 2020 were selected as the study group.According to different stages of retinopathy,the patients were divided into group A(no retinopathy,41 cases),group B(mild non-proliferative retinopathy,23 cases),group C(moderate or severe non-proliferative retinopathy,20 cases),and group D(proliferative retinopathy,36 cases).Fifty healthy subjects who underwent physical examination in the same period were selected as the control group.The HbAlc,FPG,FAZ,MVD levels of the five groups were compared,and the correlation between HbAlc,FPG,FAZ,MVD and different stages of diabetic retinopathy was analyzed by Spearman rank correlation analysis.Results The HbAlc and FPG levels in the control group were(5.48±0.50)mmol/L and(5.77±0.56)mmol/L,which were significantly lower than(10.25±1.01)mmol/L and(10.08±1.00)mmol/L of group B,(10.79±1.06)mmol/L and(10.59±1.04)mmol/L of group C,(11.02±1.09)mmol/L and(10.87±1.07)mmol/L of group D;the HbAlc and FPG levels of group A were(8.27±0.82)mmol/L and(8.32±0.84)mmol/L,which were significantly lower than those of group B,group C,and group D;the differences were statistically significant(P<0.05);there were no significant differences in HbAlc and FPG levels between control group and group A(P>0.05).The FAZ area of the subjects in the control group was(0.278±0.02)mm^(2),which was significantly smaller than the(0.408±0.04)mm^(2) in group B,(0.420±0.04)mm^(2) in group C,and(0.606±0.06)mm^(2) in group D;the FAZ area of group A was(0.372±0.03)mm^(2),which was significantly smaller than that of group D;the differences were statistically significant(P<0.05);there was no significant difference in FAZ area between control group and group A(P>0.05).The

关 键 词：糖尿病 视网膜病变 分期 糖化血红蛋白 空腹血糖 黄斑中心凹无血管区域 微血管密度 相关性 

分 类 号：R587.2[医药卫生—内分泌]