糖尿病性白内障患者术后黄斑水肿的影响因素分析  

Analysis of factors influencing macular edema in patients with diabetes cataract after surgery

作　　者：李明 徐方 许之娟 Li Ming;Xu Fang;Xu Zhijuan(Department of Ophthalmology,Jiaozhou Central Hospital of Qingdao,Qingdao 266300,Shandong Province,China)

机构地区：[1]胶州中心医院眼科,山东省青岛市266300

出　　处：《国际眼科杂志》2025年第1期140-143,共4页International Eye Science

基　　金：青岛市胶州中心医院院内立项项目(No.JZZX-007)。

摘　　要：目的:探讨糖尿病性白内障患者手术治疗后发生黄斑水肿的危险因素,为术后防治提供参考依据。方法:选取青岛市胶州中心医院眼科2022-01/2024-01实施超声乳化手术治疗后且发生黄斑水肿的糖尿病性白内障患者55例55眼作为水肿组,另外年龄与性别基本匹配的接受相同手术治疗但未发生黄斑水肿的糖尿病性白内障患者59例59眼作为对照组,分析房水中干扰素诱导蛋白-10(IP-10)、巨噬细胞趋化蛋白-1(MCP-1)、血管内皮生长因子(VEGF)与患者术后黄斑水肿的关系。结果:水肿组的年龄、糖尿病病程、最佳矫正视力(BCVA)、糖化血红蛋白(HbA1c)、肌酐测定值、房水中IP-10、MCP-1、VEGF水平均大于对照组(均P<0.05);糖尿病病程延长、BCVA、HbA1c升高、肌酐升高及房水中IP-10升高、MCP-1升高、VEGF升高是糖尿病性白内障患者手术后发生黄斑水肿的危险因素(均P<0.05)。结论:糖尿病性白内障患者手术治疗后发生黄斑水肿与糖尿病病程延长、BCVA、HbA1c升高、肌酐升高及房水中IP-10升高、MCP-1升高、VEGF升高有关,临床应该针对性地提前给予干预措施。·AIM:To explore the risk factors of macular edema in patients with diabetes cataract after surgery,and provide reference for postoperative prevention and treatment.·METHODS:A total of 55 diabetes cataract patients(55 eyes)with macular edema after phacoemulsification surgery at the ophthalmology department of Jiaozhou Central Hospital of Qingdao from January 2022 to January 2024 were selected as edema group.In addition,59 patients(59 eyes)with diabetes cataract who received the same surgical treatment but did not develop macular edema were treated as control group,and the relationship between interferon-induced protein-10(IP-10),macrophage chemotactic protein-1(MCP-1),vascular endothelial growth factor(VEGF)and postoperative macular edema was analyzed.·RESULTS:Age,diabetes course,best corrected visual acuity(BCVA),glycated hemoglobin(HbA1c),creatinine,levels of IP-10,MCP-1 and VEGF in aqueous humor in the edema group were higher than those in the control group(all P<0.05).The risk factors for postoperative macular edema in patients with diabetes cataract were prolonged duration of diabetes,BCVA,increased HbA1c,increased creatinine and IP-10 in aqueous fluid,increased MCP-1 and increased VEGF(all P<0.05).·CONCLUSION:Macular edema after surgical treatment in diabetes cataract patients is associated with prolonged duration of diabetes,BCVA,HbA1c,creatinine,IP-10,MCP-1,and VEGF,and clinical interventions should be given in advance.

关 键 词：糖尿病性白内障 超声乳化手术 白内障 黄斑水肿 危险因素 

分 类 号：R587.2[医药卫生—内分泌] R779.66[医药卫生—内科学]