糖尿病视网膜病变患者人工晶体植入联合激光治疗后黄斑水肿发生及其影响因素  

Occurrence and Influencing Factors of Macular Edema after Intraocular Lens Implantation and Laser Treatment in Patients with Diabetes Retinopathy

作　　者：宋欣 刘浩 李旭辉 张筠[2] SONG Xin;LIU Hao;LI Xuhui;ZHANG Jun(Department of Ophthalmology,the People's Hospital of Li County,Baoding 071400,China;Ophthalmology Department of the Third Hospital of Hebei Medical University)

机构地区：[1]蠡县医院眼科,保定市071400 [2]河北医科大学第三医院眼科

出　　处：《中国激光医学杂志》2024年第2期81-85,共5页Chinese Journal of Laser Medicine & Surgery

基　　金：保定市科技计划项目(2241ZF134)。

摘　　要：目的分析糖尿病视网膜病变(diabetic retinopathy,DR)患者行人工晶体植入联合激光治疗后黄斑水肿的发生情况及其影响因素。方法前瞻性选取单眼发病的中重度非增殖型糖尿病视网膜病变DR非增殖期患者110例,均接受单焦人工晶体植入和3次激光治疗,治疗激光功率约200 mW,曝光时间约0.10 s,光斑直径约250μm。对治疗后3个月所有患者的黄斑水肿情况进行统计,并根据黄斑水肿情况分为水肿组和非水肿组。纳入引起受试者发生黄斑水肿的所有可能因素,并通过单因素和多因素统计学分析,寻找影响DR患者人工晶体植入联合激光治疗后发生黄斑水肿的因素。结果治疗后3个月,110例患者中发生黄斑水肿17例,发生率15.5%。水肿组与非水肿组患者的糖尿病病程、DR分期、糖化血红蛋白(glycosylated hemoglobin,HbAlc)、白细胞介素-6(interleukin-6,IL-6)水平的差异均具有统计学意义(P<0.05),性别、年龄、吸烟、饮酒、糖尿病类型、胰岛素使用、总胆固醇水平的差异均无统计学意义(P>0.05);回归分析显示:HbAlc过表达、IL-6过表达、糖尿病病程长、DR分期为Ⅲ期均为DR患者人工晶体植入联合激光治疗后发生黄斑水肿的影响因素(OR>1,P<0.05)。结论DR患者人工晶体植入联合激光治疗后发生黄斑水肿的风险较高,HbAlc过表达、IL-6过表达、糖尿病长病程、DR分期为Ⅲ期都是黄斑水肿发生的影响因素。Objective To analyze the incidence and influencing factors of macular edema in patients with diabetes retinopathy(DR)after intraocular lens implantation and laser treatment.Methods Totally l10 non-proliferative DR patients with monocular onset were prospectively selected,all given single focal intraocular lens implantation and 3 laser treatments.The macular edema status of all the patients was statistically analyzed 3 months after the treatment,and then they were divided into an edema group and a non-edema group based on macular edema status.All the factors leading to macular edema to the patients were considered and both univariate and multivariate statistical analysis were conducted to identify factors relating to the occurrence of macular edema in DR patients given both intraocular lens implantation and lasertherapy.Results Three months after the treatment,17 of the 110 non-proliferative DR patients given both intraocular lens implantation and laser therapy suffered macular edema,indicating an incidence rate of 15.5%.There were significant differences in course of diabetes,DR stage,glycosylated hemoglobin(HbAlc)and interleukin-6(IL-6)levels between the edematous group and nonedematous group(P<0.05),but the difference between the two groups in gender,age,smoking,drinking,diabetes type,insulin use and total cholesterol levels was not remarkable(P>0.05).It was shown via regression analysis that the overexpression of HbAlc and IL-6,long duration of diabetes and stage Ⅲ of DR were the influencing factors of macular edema in DR patients given both intraocular lens implantation and laser treatment(OR>1,P<0.05).Conclusions The risk of macular edema in DR patients given both intraocular lens implantation and laser treatment is high.Overexpression of HbAlc and IL-6,long course of diabetes and DR stage III are all influencing factors of macular edema.

关 键 词：糖尿病视网膜病变 人工晶体植入 激光 黄斑水肿 

分 类 号：R774.1[医药卫生—眼科] R779.63[医药卫生—临床医学]