糖尿病患者脉络膜血流动力学研究

Choroidal hemodynamics research in patients with diabetes

摘要:

目的：观察糖尿病(diabetes mellitus，DM)患者脉络膜供血血管的血流动力学变化，探讨DM患者脉络膜循环的改变及其与DR发生、发展的关系。

方法：采用彩色多普勒显像技术(color Doppler flow imaging， CDFI)检测DM患者45例90眼及对照组15例30眼的眼动脉(ophthalmic artery， OA)、颞侧(posterior ciliary artery， PCA₁)及鼻侧睫状后动脉(PCA₂)，记录所有动脉的收缩期峰值血流速度(peak systolic velocities， PSV)、舒张末期血流速度(end diastolic velocities， EDV)及阻力指数(resistive index， RI)，利用统计学分析不同时期的DM患者与对照组间球后血管血流动力学参数差异。

结果：非糖尿病视网膜病变(no diabetic retinopathy， NDR)和非增殖性糖尿病视网膜病变(nonprolifrative diabetic retinopathy， NPDR)与增殖性糖尿病视网膜病变(prolifrative diabetic retinopathy， PDR)组的OA和PCA的血流动力学参数均较正常人有不同程度的变化，且病情越重，改变越明显。

结论：本研究从血流动力学角度证明了DM脉络膜循环的改变， CDFI技术可以精确评价DM患者球后血管的血流状态，对DM患者脉络膜病变的早期诊断具有重要意义。

Abstract:

AIM: To investigate diabetic choroidal hemodynamics in order to provide valuable theories for preventing and treating diabetic retinopathy(DR)and make compensation for the ocular disease of diabetes mellitus(DM).

METHODS: Color Doppler flow imaging(CDFI)was used to quantitate peak systolic velocity(PSV), end diastolic velocity(EDV)and resistence index(RI)of the ophthalmic artery(OA), the temporal posterior ciliary artery(PCA₁), and nasal posterior ciliary artery(PCA₂), in the control group(15 patients)and 45 DM patients. Statistic software was used to analysis the hemodynamic parameters.

RESULTS: Relative to the control, the EDV, PSV and RI have changed in non-diabetic retinopathy(NDR), non- proliferative diabetic retinopathy(NPDR)and proliferative diabetic retinopathy(PDR), and the differences are more evident according to the severity of DR.

CONCLUSION: We conserved the choroidal circulatory properties of DM. CDFI is very valuable to evaluate the hemodynamic changes in diabetic eyes, and has important significance in the early impression of diabetic choroidopathy.