眼动脉超声血流参数对糖尿病视网膜病变的诊断价值  

Value of ophthalmic artery ultrasound parameters to the diagnosis of diabetic retinopathy

作　　者：李洪旭 卢晓潇[1] 王薇[1] 黄雪兰[1] 卢晓蕾[1] 郑春梅[1] 曹霞[1] 张婷 杨泽林 LI Hong-xu;LU Xiao-xiao;WANG Wei;HUANG Xue-lan;LU Xiao-lei;ZHENG Chun-mei;CAO Xia;ZHANG Ting;YANG Ze-lin(Physical Diagnosis Room,the First Af filiated Hospital of Jiamusi University,Jiamusi,Heilongjiang 154002,China)

机构地区：[1]佳木斯大学附属第一医院物理诊断室,黑龙江佳木斯154002

出　　处：《中华实用诊断与治疗杂志》2023年第5期518-521,共4页Journal of Chinese Practical Diagnosis and Therapy

基　　金：黑龙江省卫生健康委科研基金项目(20210909020005)。

摘　　要：目的 观察糖尿病视网膜病变患者眼动脉超声血流参数变化,探讨其对2型糖尿病患者发生视网膜病变的诊断价值。方法 2型糖尿病患者39例,根据眼底照相检查结果分为视网膜病变组25例(50只眼)和无视网膜病变组14例(28只眼)。2组均行眼动脉超声检查,测量眼动脉收缩峰值流速(peak systolic velocity, PSV)、舒张末期流速(end diastolic velocity, EDV),计算阻力指数(resistance index, RI)。比较2组眼动脉PSV、EDV、RI;绘制ROC曲线,评估PSV、EDV、RI对2型糖尿病患者发生视网膜病变的诊断效能。结果 视网膜病变组眼动脉PSV[(32.56±6.58)cm/s]、EDV[(6.99±3.12)cm/s]均低于无视网膜病变组[(36.68±5.80)、(10.65±3.08)cm/s](t=2.791,P=0.007;t=5.032,P<0.001),RI(0.79±0.07)大于无视网膜病变组(0.71±0.06)(t=-4.930,P<0.001)。眼动脉PSV、EDV、RI分别以35.70 cm/s、7.73 cm/s、0.79为最佳截断值,诊断2型糖尿病患者发生视网膜病变的AUC分别为0.689(95%CI:0.566~0.812,P<0.001)、0.829(95%CI:0.740~0.919,P<0.001)、0.809(95%CI:0.716~0.902,P<0.001),灵敏度分别为65.5%、93.1%、51.0%,特异度分别为75.5%、71.4%、89.7%;三者联合检测诊断2型糖尿病患者发生视网膜病变的AUC为0.762(95%CI:0.644~0.881,P<0.001),灵敏度为74.3%,特异度为83.1%。结论 眼动脉超声可动态监测2型糖尿病患者眼动脉血流动力学变化,眼动脉PSV、EDV、RI联合检测有助于2型糖尿病患者早期诊断视网膜病变。Objective To observe the changes of ophthalmic artery ultrasound parameters in patients with 2 diabetic retinopathy,and to explore its value to the diagnosis of diabetic retinopathy in patients with type 2 diabetes.Methods Thirty-nine patients with type 2 diabetes were divided into 25 patients(50 eyes)with retinopathy(retinopathy group)and 14 patients(28 eyes)without retinopathy(non-retinopathy group)according to the results of fundus photography.The ophthalmic artery ultrasound was performed in both groups to measure the peak systolic velocity(PSV)and end diastolic velocity(EDV),and the resistance index(RI)was calculated.The PSV,EDV and RI were compared between two groups.ROC curves were drawn to evaluate the diagnostic efficiencies of PSV,EDV and RI on diagnosing diabetic retinopathy in patients with type 2 diabetes.Results The PSV and EDV were lower in retinopathy group[(32.56±6.58),(6.99±3.12)cm/s]than those in non-retinopathy group[(36.68±5.80),(10.65±3.08)cm/s](t=2.791,P=0.007;t=5.032,P<0.001),and the RI was higher in retinopathy group(0.79±0.07)than that in non-retinopathy group(0.71±0.06)(t=-4.930,P<0.001).When the optimal cut-off values of PSV,EDV and RI were 35.70 cm/s,7.73 cm/s and 0.79,the AUCs for diagnosing diabetic retinopathy in patients with type 2 diabetes were 0.689(95%CI:0.566-0.812,P<0.001),0.829(95%CI:0.740-0.919,P<0.001)and 0.809(95%CI:0.716-0.902,P<0.001),with the sensitivities of 65.5%,93.1%and 51.0%,and the specificities of 75.5%,71.4%and 89.7%,respectively.The AUC of combination of them three was 0.762(95%CI:0.644-0.881,P<0.001),with a sensitivity of 74.3%,and a specificity of 83.1%.Conclusion Ophthalmic artery ultrasound can dynamically monitor the changes of ocular hemodynamics in patients with type 2 diabetes,and the combination of PSV,EDV and RI contributes to early diagnosis of diabetic retinopathy.

关 键 词：糖尿病视网膜病变 2型糖尿病 视网膜病变 彩色多普勒超声 眼动脉 

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