糖尿病视网膜病变患者眼眶内血流动力学变化的多因素分析  

Multiple factor analysis of intraorbital hemodynamic results in diabetic retinopathy

作　　者：黄厚斌[1] 张卯年[1] 张康兰[2] 蒋华[2] 张胜兰[3] 梁春香[4] 

机构地区：[1]解放军总医院眼科,北京100853 [2]济南军区总医院眼科 [3]济南军区总医院内分泌科 [4]济南军区总医院心内科彩超室

出　　处：《中华眼底病杂志》2004年第2期98-100,共3页Chinese Journal of Ocular Fundus Diseases

摘　　要：目的　观察糖尿病视网膜病变 (DR)患者眼眶内血流动力学变化的影响因素 ,探讨与 DR发病相关的危险因素。　方法　对 6 8例糖尿病患者眼动脉、睫状后动脉、视网膜中央动脉、视网膜中央静脉、涡静脉等进行彩色多普勒血流成像 (CDFI)检测 ,并将其检测所得的收缩期流速、舒张期流速、搏动指数、阻力指数、平均流速、加速度等 31项血流动力学指标与患者收缩期血压、舒张期血压、血糖、性别、年龄、病程等共 37项指标进行主成分分析 ,提取出主成分 ,再以此为自变量 ,眼底病变程度为结果变量 ,进行 logistic回归分析。　结果　 37个原始指标经主成分分析后综合为 9个主成分 ,分别反映眼动脉的流速、睫状后动脉的流速、眼动脉的血流阻力、视网膜中央动脉的流速、视网膜中央动脉的血流阻力、睫状后动脉的血流阻力、时间相关因素、静脉血液回流、性别等 ,logistic回归分析结果表明眼动脉血流阻力、视网膜中央动脉流速、睫状后动脉血流阻力、时间和静脉回流是与 DR病变有关的危险因素 ,回归系数分别为 1.2 2 6、- 1.135、- 1.339、3.5 95、1.2 74。　结论　时间因素是影响 DR病变的主要高危因素 ,影响 DR病变发展的眶内血流动力学异常主要为眼动脉的血流阻力增加、视网膜中央动脉的流速下降、睫状后动脉的血流阻力?Objective To determine the affected factors of intraorbital hemodynamic results in diabetic retinopathy (DR) and the risk factors related to the occurrence of DR. Methods Posterior ciliary artery (PCA), central retinal artery (CRA), central retinal vein (CRV), and vortex vein (VV) of 68 patients with DR were measured by color Doppler flow image (CDFI). Thirty-one hemodynamic parameters, including systolic velocity, diastolic velocity, mean velocity, resistive index, pulsatility index and accelerative velocity of ophthalmic artery (OA), and other variates (blood pressure, blood sugar, gender, age, duration of the disease, and so on) were collected and clustered in a principal components analysis following a forward, stepwise logistic regression on these components. Results Nine principal components were extracted from 37 original variates, reflecting the velocity of OA, velocity of PCA, resistance of OA, velocity of CRA, resistance of CRA, resistance of PCA, time-related factor, venous drainage factor and gender factor, respectively. In the result of logistic regression, resistance of OA, velocity of CRA, resistance of PCA, time-related factor, and venous drainage factor were the risk factors related to DR. Conclusion The first risk factor affecting DR is time, and intraorbital hemodynamic abnormity influencing the development of diabetic retinopathy may be the increase of resistance of OA, decrease of velocity of CRA, decrease of resistance of PCA, and increase of venous drainage.

关 键 词：糖尿病 视网膜病变 血流动力学 影响因素 并发症 

分 类 号：R774.1[医药卫生—眼科]