2型糖尿病患者微血管病变与视网膜血管直径的相关性  

Correlation between Microangiopathy and Retinal VesselDiameter in Patients with Type 2 Diabetes Mellitus

作　　者：王梅 姜超 裴存文 刘磊 段运动[2] WANG Mei;JIANG Chao(Chengde Medical University,Hebei Chengde 067000,China)

机构地区：[1]承德医学院,河北承德067000 [2]河北省承德市中心医院,河北承德067000

出　　处：《河北医学》2023年第2期339-344,共6页Hebei Medicine

基　　金：河北省承德市科学技术研究与发展计划项目,(编号:201701A020)。

摘　　要：目的:探讨2型糖尿病(T2DM)微血管病变与视网膜血管直径之间的关系。方法:收集2018年至2019年在承德市中心医院住院治疗的213例T2DM患者。根据眼底照相半自动测量视网膜血管直径并计算视网膜中央动脉等效值(CRAE)、视网膜中央静脉等效值(CRVE)、动静脉比值(AVR)。按不同微血管病变分为4组:无微血管病变(NC)组有94例,单一糖尿病视网膜病变(DR)组有69例,单一糖尿病肾病(DN)组有24例,糖尿病肾病伴视网膜病变(DNR)组有26例。比较4组患者的基本临床资料,比较非增殖期DR患者不同分期之间的血管差异性,使用无序多分类logistic回归分析微血管病变与视网膜血管直径之间的关系。结果:在NC组、DR组、DN组和DNR组四组分组中,CRVE分别为(257.05±22.40)μm、(266.97±23.66)μm、(270.24±17.67)μm及(278.64±25.91)μm,静脉直径逐渐增大,差异具有统计学意义(P<0.001);AVR分别为(0.69±0.06)、(0.66±0.06)、(0.65±0.06)及(0.64±0.08),动静脉比值逐渐减小,差异具有统计学意义(P<0.001)。在210例非增殖期DR患者中,无DR组有117例,DRⅠ期组有39例,DRⅡ期组有32例,DRⅢ期组有22例。Spearman相关分析发现CRVE与非增殖期DR分期正相关(r=0.235,P=0.001),AVR与非增殖期DR分期负相关(r=-0.217,P=0.002)。无序多分类logistic回归分析结果显示CRVE、AVR与微血管病变显著相关;视网膜静脉直径增大和动静脉比值减小是糖尿病微血管病变发生的独立危险因素。结论:视网膜静脉直径增大和动静脉比值减小预示着2型糖尿病患者全身微循环病变越重。Objective:To investigate the relationship between microangiopathopathy and retinal vessel diameter in type 2 diabetes mellitus(T2DM).Methods:A total of 213 patients with T2DM hospitalized in Chengde Central Hospital from 2018 to 2019 were collected.The retinal vessel diameter was measured semi-automatically according to fundus photography,and the central retinal artery equivalent value(CRAE),central retinal vein equivalent value(CRVE),and arteriovenous ratio(AVR)were calculated.Patients were divided into 4 groups according to different microangiopathopathy:94 cases in the NC group,69 cases in the DR group,24 cases in the DN group,and 26 cases in the DNR group.The basic clinical data of the 4 groups of patients were compared,and the vascular differences among the non-proliferative DR patients at different stages were compared.Disordered multiple logistic regression was used to analyze the relationship between microangiopathopathy and retinal vessel diameter.Results:In the NC group,DR group,DN group,and DNR group,the CRVEs were(257.05±22.40)μm,(266.97±23.66)μm,(270.24±17.67)μm and(278.64±25.91)μm,respectively.The venous diameter increased gradually and the difference was statistically significant(P<0.001).AVRs were(0.69±0.06),(0.66±0.06),(0.65±0.06)and(0.64±0.08),respectively.The arteriovenous ratio decreased gradually and the difference was statistically significant(P<0.001).Among 210 patients with non-proliferative DR,there were 117 cases in the DR-free group,39 cases in the DRⅠgroup,32 cases in the DRⅡgroup,and 22 cases in the DRⅢgroup.Spearman correlation analysis showed that CRVE was positively correlated with the non-proliferative DR stage(r=0.235,P=0.001),and AVR was negatively correlated with the non-proliferative DR stage(r=-0.217,P=0.002).Disordered multiple logistic regression analysis showed that CRVE and AVR were significantly correlated with microangiopathy.The increase in retinal vein diameter and decrease in the arteriovenous ratio are independent risk factors for diabetic microang

关 键 词：视网膜血管直径 糖尿病 微血管病变 

分 类 号：R587.2[医药卫生—内分泌]