糖尿病视网膜病变治疗前后眼部血流动力学特征  

Ocular Hemodynamic Characteristics before and after Treatment of Diabetic Retinopathy

作　　者：彭新明[1] 陈鹏 刘奕文 王晶[1] 陈光[1] PENG Xinming;CHEN Peng;LIU Yiwen(Department of Ophthalmology,Affiliated Hospital of Hebei University,Hebei 071000,China)

机构地区：[1]河北大学附属医院眼科,保定071000 [2]河北大学医学院基础医学院,保定071000

出　　处：《医学研究杂志》2023年第12期145-149,共5页Journal of Medical Research

基　　金：河北省保定市科技计划项目(2141ZF308)。

摘　　要：目的探讨糖尿病性视网膜病变(diabetic retinopathy,DR)治疗前后眼部血流动力学特征。方法本研究为病例对照研究,采用非随机抽样法。选取2021年12月~2022年4月河北大学附属医院诊治的86例(86只眼)DR患者与43例健康体检者作为研究对象,其中,86例DR患者设为观察组,43例健康体检者设为对照组,对比视网膜中央动脉(central retinal artery,CRA)、收缩期峰值流速(peak systolic velocity,PSV)、舒张末期流速(end-diastolic velocity,EDV)、阻力指数(resistance index,RI)。并根据荧光素眼底血管造影(fluorescein fundus angiography,FFA)及黄斑光学相干断层扫描(optical coherence tomography,OCT)结果将观察组分为PRP组[予以全视网膜光凝术(panretinal photocoagulation,PRP)治疗]与VEGF组[予以玻璃体腔注射抗血管内皮生长因子(vascular endothlial growth factor,VEGF)治疗],每组各43例,观察疗效,对比术前、术后的PSV、EDV、RI变化,并采用受试者操作特征(receiver operating characteristic,ROC)曲线分析PSV、EDV、RI预测疗效的曲线下面积(area under the curve,AUC)、敏感度、特异性。结果观察组的PSV、EDV均低于对照组,而RI高于对照组(P<0.05)。PRP组患者均顺利完成PRP治疗,总有效率为88.37%;且术后1天、1周的PSV、EDV均高于术前,而RI低于术前(P<0.05);术后1周的PSV、EDV与术后1天比较,差异均无统计学意义(P均>0.05),而RI低于术前1天(P<0.05)。VEGF组患者均顺利完成玻璃体腔注射抗VEGF治疗,总有效率为86.04%;且术后1天、1周的PSV、EDV均高于术前,而RI低于术前(P<0.05);术后1周的PSV、EDV低于术后1天,而RI高于术前1天(P<0.05)。ROC曲线分析结果显示,PSV、EDV、RI预测PRP治疗Ⅰ~Ⅲ期DR疗效的AUC值分别为0.879、0.831、0.894(P<0.05);PSV、EDV、RI预测玻璃体腔注射抗VEGF治疗Ⅳ期DR疗效的AUC值分别为0.860、0.881、0.831(P<0.05)。结论PRP与玻璃体腔注射抗VEGF治疗Ⅰ~Ⅳ期DR均具有较好疗效,可有效提高CRA�Objective To investigate the ocular hemodynamic characteristics before and after treatment of diabetic retinopathy(DR).Methods This study was a case-control study using a non-random sampling method.A total of 86 DR patients(86 eyes)and 43 healthy subjects who were diagnosed and treated in the Affiliated Hospital of Hebei University from December 2021 to April 2022 were selected as the research objects.Among them,86 DR patients were set up as the observation group,and 43 healthy subjects were set up as the control group.The central retinal artery(CRA),peak systolic velocity(PSV),end-diastolic velocity(EDV),and resistance index(RI)were compared between the two groups.And according to the results of fluorescein fundus angiography(FFA)and macular optical coherence tomography(OCT),the observation group was divided into PRP group[treated with panretinal photocoagulation(PRP)]and VEGF group[treated with intravitreal injection of anti-vascular endothlial growth factor(VEGF)],43 cases in each group.The curative effect was observed,the changes of PSV,EDV and RI before and after surgery were compared,and the area under the curve(AUC),sensitivity and specificity of PSV,EDV and RI for predicting curative effect were analyzed by receiver operating characteristic(ROC)curve model.Results PSV and EDV in the observation group were lower than those in the control group,but RI was higher than that in the control group(P<0.05).All patients in PRP group successfully completed PRP treatment,with a total effective rate of 88.37%;PSV and EDV at 1day and 1 week after operation were higher than those before operation,while RI was lower than before operation(P<0.05);There was no significant difference in PSV and EDV at 1week after operation compared with 1day after operation(P>0.05),while RI was lower than that at 1day before operation(P<0.05).All patients in VEGF group successfully completed intravitreal injection of anti-VEGF therapy,with a total effective rate of 86.04%;PSV and EDV at 1day and 1 week after operation were higher than thos

关 键 词：糖尿病视网膜病变 视网膜中央动脉 血流动力学 

分 类 号：R774.1[医药卫生—眼科]