2型糖尿病病人眼前段生物测量值的变化及临床意义  

Changes and clinical significance of anterior segment biometrics in patients with type 2 diabetes mellitus

作　　者：陈妍鹏[1] 仝真真 李毅[1] CHEN Yanpeng;TONG Zhenzhen;LI Yi(Department of Ophthalmology,The First Affiliated Hospital of Hebei North University,Zhangjiakou,Hebei 075000,China)

机构地区：[1]河北北方学院附属第一医院眼科,河北张家口075000

出　　处：《安徽医药》2023年第8期1586-1590,共5页Anhui Medical and Pharmaceutical Journal

基　　金：河北省医学科学研究课题计划(20211086)。

摘　　要：目的研究眼前段生物测量值在2型糖尿病(T2DM)病人中的改变,并探讨其临床意义。方法选取2019年6月至2021年3月期间就诊于北方学院第一附属医院T2DM病人180例(180眼),均行眼底血管荧光造影检查,根据视网膜病变程度分为无糖尿病视网膜病变(NDR)组、非增殖性糖尿病视网膜病变(NPDR)组、增殖性糖尿病视网膜病变(PDR)组,每组60例,另选取同期健康体检者60例(60眼)作为健康对照组。采用A型超声测量眼前段生物测量值,包括角膜中央厚度(CCT)、中央前房深度(ACD)、晶状体厚度(LT)和眼轴长度(AL),计算晶状体位置(LP)、前房拥挤率(CCR)、rACD、rLT、r,并检测T2DM病人糖化血红蛋白(HbA1c)水平,对比不同视网膜病变程度HbA1c水平、四组及不同病程T2DM病人眼前段生物测量值,并分析CCT、ACD、LT、AL与HbA1c、DM病程的相关性。结果四组CCT[(559.21±26.53)、(545.36±25.12)、(532.18±24.35)、(520.23±22.36)µm]、ACD[(2.35±0.21)、(2.48±0.23)、(2.60±0.22)、(2.77±0.24)mm]、LT[(5.03±0.29)、(4.88±0.27)、(4.56±0.31)、(4.32±0.36)mm]、AL[(21.95±0.34)、(22.55±0.36)、(22.84±0.48)、(23.18±0.52)mm]、CCR[(2.13±0.26)、(1.97±0.22)、(1.75±0.18)、(1.56±0.17)]、rLT[(0.23±0.02)、(0.21±0.02)、(0.20±0.01)、(0.18±0.01)]、r[(0.34±0.02)、(0.32±0.01)、(0.31±0.01)、(0.30±0.01)]比较,差异有统计学意义(P<0.05),且组间两两比较,差异有统计学意义(P<0.05);PDR组、NPDR组、NDR组HbA1c[(9.87±1.15)、(8.56±1.03)、(7.84±0.98)%]比较,差异有统计学意义(P<0.05),且组间两两比较,差异有统计学意义(P<0.05);不同DM病程T2DM病人CCT[(558.36±18.32)、(540.36±15.35)、(535.01±10.26)]、ACD[(2.38±0.16)、(2.52±0.12)、(2.57±0.08)mm]、LT[(4.99±0.18)、(4.75±0.16)、(4.68±0.14)mm]、AL[(22.06±0.20)、(22.62±0.21)、(22.74±0.24)mm]、CCR[(2.16±0.23)、(1.88±0.15)、(1.82±0.11)]、rLT[(0.23±0.02)、(0.21±0.02)、(0.20±0.01)]、r[(0.33±0.02)、(0.32±0.01)、(0.31±0.01)]Objective To study the changes of anterior segment biometrics in patients with type 2 diabetes(T2DM),and explore its clinical significance.Methods A total of 180 patients(180 eyes)with T2DM in the First Affiliated Hospital of Hebei North University from June 2019 to March 2021 were selected and all underwent fundus fluorescein angiography.According to the degree of retinopathy,they were divided into non-diabetic retinopathy(NDR)group,non-proliferative diabetic retinopathy(NPDR)group,and proliferative diabetic retinopathy(PDR)group,with 60 cases in each group,and another 60 cases(60 eyes)of healthy physical examination during the same period were selected as the healthy control group.A-mode ultrasound was used to measure the biological measurements of the anterior segment of the eye,including central corneal thickness(CCT),central anterior chamber depth(ACD),lens thickness(LT)and axial length(AL),Calculate lens position(LP),chamber crowd ratio(CCR),rACD,rLT,r,and detection of glycosylated hemoglobin(HbA1c)levels in patients with T2DM,and compare HbA1c levels with different degrees of retinopathy,four groups and different courses of T2DM The biometric values of the anterior segment of the patient's eyes and the correlation between CCT,ACD,LT,AL and the course of HbA1c and course of DM were analyzed.Results There were significant differences in CCT[(559.21±26.53),(545.36±25.12),(532.18±24.35),(520.23±22.36)µm],ACD[(2.35±0.21),(2.48±0.23),(2.60±0.22),(2.77±0.24)mm],LT[(5.03±0.29),(4.88±0.27),(4.56±0.31),(4.32±0.36)mm],AL[(21.95±0.34),(22.55±0.36),(22.84±0.48),(23.18±0.52)mm],CCR[(2.13±0.26),(1.97±0.22),(1.75±0.18),(1.56±0.17)],rLT[(0.23±0.02),(0.21±0.02),(0.20±0.01),(0.18±0.01)],and r[(0.34±0.02),(0.32±0.01),(0.31±0.01),(0.30±0.01)]among the four groups(P<0.05),and the differences were statistically significant between the two groups(P<0.05);The HbA1c levels[(9.87±1.15),(8.56±1.03),(7.84±0.98)%]of PDR group,NPDR group and NDR group were compared,and the difference was sta-tistically si

关 键 词：眼前半段 糖尿病 2型 眼前段生物测量值 糖化血红蛋白 视网膜病变 

分 类 号：R587.2[医药卫生—内分泌] R774.1[医药卫生—内科学]