2型糖尿病患者中不同影响因素下角膜生物力学特性的变化趋势分析  

Analyzing the changing trend of corneal biomechanical properties under different influencing factors in T2DM patients

作　　者：李涛 赵玲 邓秀英 漆星 吕静 林志武 刘兴德 吴小利 唐娟 Li Tao;Zhao Lin;Deng Xiuying;Qi Xing;Lv Jing;Lin Zhiwu;Liu Xingde;Wu Xiaoli;Tang Juan(Department of Ophthalmology,the ziyang lertral Hospital,Ziyang 641300,China;Department of Ophthalmology,Le-zhi County People's Hospital,Lezhi 641500,China;Department of Ophthalmology,Ziyang Psychiatric Hospital,Ziyang 641300,China)

机构地区：[1]资阳市中心医院,641300 [2]资阳市乐至县人民医院,641500 [3]资阳市精神病医院,641300

出　　处：《临床眼科杂志》2024年第4期320-324,共5页Journal of Clinical Ophthalmology

基　　金：四川省老年医学学会课题计划项目(24SCLN0115);2024年度河北省医学科学研究课题计划(20240294);四川省资阳市医学科学课题计划项目(KY2023001和KY2023023);四川省资阳市科学技术局计划项目(zykjjsc20yyjc202304)。

摘　　要：目的探讨2型糖尿病(T2DM)患者的相关危险因素,以及这些危险因素与角膜生物力学[角膜滞后量(CH)和角膜阻力因子(CRF)]之间的关系。方法回顾性临床研究。选取从2022年2月至2023年3月就诊于资阳市中心医院的T2DM患者650例,采用Logistic回归分析对患者性别、年龄、糖尿病病程、高血压病史、吸烟史、饮酒史、体质量指数(BMI)、舒张压(DBP)、空腹血糖(FBG)、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDLC)、低密度脂蛋白胆固醇(LDLC)、糖化血红蛋白(HbA1C)进行独立危险因素评估,同时进一步根据糖尿病病程、FBG、DR分期、HbA1c(%)等不同病变程度分组,通过眼反应分析仪(ORA)测量患者的CH和CRF值,分析两者的数值变化趋势。结果研究显示T2DM病程、吸烟史、BMI、FBG、DR、HbA1c、TC、TG、LDLC是T2DM的共同危险因素,HDLC是其保护因素(均P<0.05)。随着糖尿病病程延长、空腹血糖的升高、HbA1C的累计,CH和CRF值逐渐降低,特别是HbA1c(%)>12时CH和CRF数值降低幅度最大,分别为(1.85±0.33)mmHg和(1.28±0.69)mmHg。与NonDR组相比,轻度NPDR、中度NPDR、重度NPDR和PDR组中CH和CRF值逐渐降低,其中PDR组中CH、CRF值最低,组间方差分析显示CH、CRF值差异具有统计学意义(P<0.05)。结论在2型糖尿病患者中,早期测量患者角膜生物力学特性,评估CH和CRF数值变化,及时采取干预措施,对于降低糖尿病性角膜病变具有重要作用。Objective To analyze the changing trend of corneal hysteresis(CH)and corneal resistance factor(CRF)values under different influencing factors in type 2 diabetes mellitus(T2DM)patients.Methods A total of 650 patients with T2DM visited the First People’s Hospital of Ziyang from February 2022 to March 2023 were included.All patients underwent ophthalmoscopy and fundus nuorescein angiography(FFA).Logistic regression analysis was used to evaluate the independent risk factors of gender,age,course of diabetes,hypertension,smoking,drinking,body mass index(BMI),diastolic pressure,fasting blood glucose(FBG),triacylglycerol(TG),total cholesterol(TC),high density lipopretein cholesferel(HDL-C),low density lipoprotein cholesferol(LDL-C)and hemoglobin A1c(HbA1c)related with T2DM.At the same time,according to the course of T2DM,FBG,diabetic retinopathy(DR)stage,HbA1c(%)and other different pathological changes,the corneal hysteresis(CH)and CRF values were measured by the ophthalmic response analyzer(ORA),and the change trend of their values was analyzed.Results In this study,the course of T2DM,smoking history,BMI,FBG,DR,HbA1c,TC,TG,LDL-C were common risk factors for T2DM,while HDL-C was a protective factor,with statistically significant differences(P<0.05).With the prolongation of T2DM,the increase of FBG,and the accumulation of HbA1C,the values of CH and CRF gradually decreased,especially in HbA1c(%)>12,the values of CH(1.85±0.33)mmHg and CRF(1.28±0.69)mmHg decreased the most.Compared with the Non-DR group,the CH and CRF values gradually decreased in the mild-nonproliferative diabetic retinopathy(NPDR),moderate-NPDR,severe-NPDR,and PDR groups,with the lowest CH and CRF values in the PDR group.Analysis of variance between groups showed statistically significant differences in CH and CRF values(P<0.05).Conclusions In patients with T2DM,early measurement of corneal biomechanical properties by ORA so as to evaluate the change trend of CH and CRF values in different situations will help to identify and prevent diabetic keratopat

关 键 词：2型糖尿病 角膜滞后量 角膜阻力因子 眼反应分析仪 糖尿病性角膜病变 

分 类 号：R772.2[医药卫生—眼科] R587.2[医药卫生—临床医学]