糖尿病无明显视力下降患者黄斑区血流密度观察及中医证型研究  

Observation on Macular Blood Flow Density of Patients with No Obvious Sight Loss Caused by Diabetes and Study on Traditional Chinese Medicine Syndrome Types

作　　者：张梅珍 刘求红[2] ZHANG Meizhen;LIU Qiuhong(Ophthalmology Department of Physical Examination Center,Baiyun Hospital of Guangdong Second Traditional Chinese Medicine Hospital,Guangzhou Guangdong 510405,China;Department of Ophthalmology,The First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou Guangdong 510000,China)

机构地区：[1]广东省第二中医院白云院区体检眼科,广东广州510405 [2]广州中医药大学第一附属医院眼科,广东广州510405

出　　处：《新中医》2023年第18期54-60,共7页New Chinese Medicine

基　　金：广东省医学科学技术研究基金(C2019127)。

摘　　要：目的:探讨糖尿病无明显视力下降患者黄斑区血流密度及中心凹无血管区(FAZ)面积变化,及不同中医证型黄斑区血流密度变化规律。方法:收集2型糖尿病患者98例(192眼)设为糖尿病组,并根据VOLK镜+90D裂隙灯前置镜眼底检查结果分为2个亚组,即有视网膜微血管病变且处于非增殖期者设为糖尿病非增殖组(NPDR组) 46例(91眼),无视网膜病变者设为糖尿病0期组52例(101眼);另选取正常健康人44例(84眼)设为对照组。所有入组受试者均接受光学相干断层扫描血管成像技术(OCTA)检查,获得视网膜浅层黄斑区血流密度及黄斑区FAZ面积值。比较各组黄斑区血流密度及FAZ面积,同时对糖尿病患者不同性别、糖尿病病程、糖化血红蛋白、空腹血糖、餐后2 h血糖、中医证型与黄斑区血流密度、FAZ面积的相关性进行分析。结果:糖尿病患者中男、女患者黄斑区血流密度、FAZ面积比较,差异无统计学意义(P>0.05)。不同病程的糖尿病患者的黄斑血流密度差异有统计学意义(P<0.05);两两比较,病程≥10年者血流密度低于病程<5年者(P<0.05);病程5~10年者血流密度与病程<5年、病程≥10年者比较,差异无统计学意义(P>0.05);不同病程的患者FAZ面积比较,差异均无统计学意义(P>0.05)。不同糖化血红蛋白水平的糖尿病黄斑区血流密度、FAZ面积差异有统计学意义(P<0.05);两两比较,糖化血红蛋白>9%患者黄斑血流密度低于糖化血红蛋白水平<7%、7%~9%者(P<0.05),FAZ面积大于<7%、7%~9%者(P<0.05);糖化血红蛋白7%~9%者黄斑区血流密度低于糖化血红蛋白<7%者(P<0.05),FAZ面积大于糖化血红蛋白<7%者。糖尿病患者空腹血糖水平与黄斑区血流密度、FAZ面积均不存在相关性(P>0.05)。不同中医证型的糖尿病黄斑区血流密度、FAZ面积差异有统计学意义(P<0.05);两两比较,气阴两虚证、阴阳两虚证患者黄斑区血流密度低于痰湿内蕴证及阴虚内热证Objective:To discuss the macular blood flow density of patients with no obvious sight loss caused by diabetes,the area changes of central foveal avascular zone(FAZ) and the change law of macular blood flow density of different traditional Chinese medicine(TCM) syndrome types.Methods:A total of98 patients(192 eyes) with type Ⅱ diabetes were collected and set as the diabetes group,which was further divided into two subgroups according to the results of fundus examination with VOLK lens + pre-set lens of 90D slit lamp,including the non-proliferative diabetic retinopathy(NPDR) group with 46 cases(91 eyes) with non-proliferative retinal microangiopathy,and the diabetes at stage 0 group with 52 cases(101 eyes) with no retinopathy;another 44 healthy persons were selected(84 eyes) as the control group.All enrolled subjects were given optical coherence tomography angiography(OCTA) examination to get the macular blood flow density of superficial retina and macular FAZ area.The macular blood flow density and FAZ area in each group were compared;the correlation of different gender,course of diabetes,glycosylated hemoglobin,fasting blood sugar,2-hour postprandial blood glucose and TCM syndrome types with macular blood flow density and FAZ area of patients with diabetes was analyzed.Results:There was no significant difference being found in the comparisons of macular blood flow density and FAZ area between male and female patients with diabetes(P>0.05).Comparing the macular blood flow density of patients with diabetes of different courses,there was significant difference(P<0.05);in pairwise comparison,the blood flow density of patients with a course of ≥10 years was lower than that of those with a course5 years(P>0.05);there was no significant difference being found in the comparison of blood flow density between patients with a course of 5-10 years and those with a course of5 years and ≥10,respectively(P>0.05);there was no significant difference being found in the comparisons of average FAZ area between patients with di

关 键 词：视网膜微血管病变 糖尿病 黄斑血流密度 黄斑中心凹无血管区面积 中医证型 

分 类 号：R587.2[医药卫生—内分泌]