糖尿病视网膜病变患者广域荧光造影结果与血常规白细胞系指标的相关性  

Relationship between white blood cell indexes and ultra wide-field fluorescein angiography results in patients with diabetic retinopathy

作　　者：黄黎黎[1] 李乐乐 王敏 朱妍 张冬梅 宋愈[1] HUANG Lili;LI Lele;WANG Min;ZHU Yan;ZHANG Dongmei;SONG Yu(Department of Ophthalmology,Affiliated Hospital 2 of Nantong University,Nantong 226001,Jiangsu Province,China)

机构地区：[1]南通大学第二附属医院,江苏省南通市226001

出　　处：《眼科新进展》2022年第12期975-979,共5页Recent Advances in Ophthalmology

摘　　要：目的探讨糖尿病视网膜病变(DR)患者在广域荧光造影(UWFA)中,不同的造影表现与其血常规白细胞系指标的相关性。方法回顾性研究。研究对象为2016年1月至2019年3月在南通大学第二附属医院确诊为2型糖尿病合并DR的患者。所有患者均行UWFA检查,将造影表现的微血管渗漏、无灌注区、新生血管、纤维增殖膜进行分级,与DR患者外周血中白细胞系指标、糖化血红蛋白(HbA1c)等进行相关性分析。结果共纳入115例(199眼)DR患者,UWFA检查显示,154眼(77.39%)有4级微血管渗漏;105眼(52.76%)为0级毛细血管无灌注,94眼(47.23%)为1级毛细血管无灌注;118眼(59.30%)为0级新生血管,42眼(21.11%)为1级新生血管,39眼(19.60%)为2级新生血管;183眼(91.96%)为0级纤维增殖膜,16眼(8.04%)为1级纤维增殖膜。Spearman相关性分析结果显示,微血管渗漏与中性粒细胞/淋巴细胞比值(NLR)、中性粒细胞、单核细胞比率相关(r=0.186、0.150、0.105,P=0.027、0.048、0.039),毛细血管无灌注与单核细胞比率和嗜酸性粒细胞比率相关(r=0.144、0.123,P=0.042、0.044),新生血管与单核细胞比率相关(r=0.280,P=0.038),纤维增殖膜与单核细胞比率相关(r=0.418,P=0.002)。单因素及多因素分析结果显示,只有嗜酸性粒细胞比率与增生型DR独立相关(OR=1.250,95%CI:1.039~1.505,P=0.018)。结论DR患者UWFA表现微血管渗漏、毛细血管无灌注、新生血管、纤维增殖膜与白细胞系指标存在相关性。Objective To investigate the correlation between various ultra wide-field fluorescein angiography(UWFA)results and white blood cell indexes in blood routine examination of patients with diabetic retinopathy(DR).Methods The patients diagnosed with type 2 diabetes mellitus(T2DM)combined with DR in the Second Affiliated Hospital of Nantong University from January 2016 to March 2019 were included in this retrospective study.The UWFA examination was performed for all patients,and the capillary leakage,non-perfusion area,neovascularization,and fibro-proliferative membrane shown by angiography were graded,and their correlation with the white blood cell indexes and glycosylated hemoglobin(HbA1c)in peripheral blood of DR patients was analyzed.Results A total of 115 DR patients(199 eyes)were included.The UWFA examination revealed that 154 eyes(77.39%)had grade 4 capillary leakage;105 eyes(52.76%)had a grade 0 capillary non-perfusion area,and 94 eyes(47.23%)had a grade 1 capillary non-perfusion area;118 eyes(59.30%)had grade 0 neovascularization,42 eyes(21.11%)had grade 1 neovascularization,and 39 eyes(19.60%)had grade 2 neovascularization;183 eyes(91.96%)had grade 0 fibro-proliferative membranes,and 16 eyes(8.04%)had grade 1 fibro-proliferative membranes.Spearman correlation analysis results showed that the capillary leakage was correlated with the neutrophil-to-lymphocyte ratio(NLR)(r=0.186,P=0.027),neutrophil ratio(r=0.150,P=0.048),and monocyte ratio(r=0.105,P=0.039);the capillary non-perfusion area was correlated with the monocyte ratio(r=0.144,P=0.042)and the eosinophil ratio(r=0.123,P=0.044);the neovascularization was correlated to the monocyte ratio(r=0.280,P=0.038);the fibro-proliferative membrane was correlated to the monocyte ratio(r=0.418,P=0.002).The univariate and multivariate analysis demonstrated that only the eosinophil ratio was independently associated with proliferative DR(odds ratio=1.250,95%confidence interval:1.039-1.505,P=0.018).Conclusion The capillary leakage,non-perfusion area,neovascularization,an

关 键 词：糖尿病性视网膜病变 广域荧光造影 白细胞 单核细胞比率 

分 类 号：R774.1[医药卫生—眼科]