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[摘要]
目的:探讨糖尿病患者黄斑中心凹下脉络膜厚度(SFCT)与脉络膜血流动力学指数及糖化血红蛋白之间的关系。
方法:选择在我院眼科及内分泌科住院治疗的2型糖尿病患者78例156眼作为研究对象。其中男39例,女39例,平均(59.8±6.2)岁。根据ETDRS糖尿病视网膜病变分级方法,将患者分为无视网膜病变组、轻中度NPDR组、重度NPDR组、PDR组。采用EDI-OCT与超声多普勒对四组患者进行脉络膜厚度测量与脉络膜血流动力学指数测量。并记录所有患者的血糖化血红蛋白含量。采用多元线性回归分析SFCT与血流动力学指数与糖化血红蛋白的相关性。
结果:NDR患者组舒张末期血流速度(EDV)明显高于其它患者组,SFCT较其它各组偏薄,差异有统计学意义。四组患者收缩期峰值血流速度(PSV)无统计学差异; 重度NPDR组血管阻力指数(RI)高于NDR组及轻中度NPDR组; PDR组RI进一步增高,差异有统计学意义。SFCT与糖化血红蛋白有显著正相关性(b=0.540,P<0.001); SFCT与DR分级(P=0.341)、PSV(P=0.770)、EDV(P=0.131)及RI(P=0.084)无显著相关性。
结论:糖尿病患者SFCT与血流动力学各指数无相关性。糖化血红蛋白是糖尿病患者SFCT的影响因素之一。
[Key word]
[Abstract]
AIM: To investigate the relationship between the subfoveal choroidal thickness(SFCT)and both choroidal hemodynamic index and glycosylated hemoglobin in diabetic subjects.
METHODS: Seventy-eight type 2 diabetic patients(156 eyes)from ophthalmology and endocrinology ward of our hospital were enrolled in this study, including 39 females and 39 males, with a mean age of(59.8±6.2)years. According to early treatment diabetic retinopathy study(ETDRS)grading method, all samples were divided into diabetic retinopathy(DR)group, mild or moderate nonproliferative diabetic retinopathy group, severe nonproliferative diabetic retinopathy(NPDR)group and proliferative diabetic retinopathy(PDR)group. The SFCT and choroidal hemodynamic index were measured by enhanced depth imaging optical coherence tomography(EDI-OCT)and Color Doppler Imaging. Recording glycosylated hemoglobin content of all samples. Using multivariate linear regression to analyse the relationship between the SFCT and both choroidal hemodynamic index and glycosylated hemoglobin.
RESULTS: The end diastolic velocity(EDV)was significant higher and the SFCT was significant thinner in no diabetic retinopathy(NDR)group than other groups. There was no significant difference of peak systolic velocity(PSV)between four groups.The resistance index(RI)was significant higher in severe NPDR group than NDR group and mild or moderate group,the RI in PDR group was hihgest than other group with statistically significance.The SFCT was correlated positively(b=0.540,P<0.001)with the glycosylated hemoglobin. No significant correlation was found between the SFCT and the choroidal hemodynamic index(DR,P=0.341; PSV,P=0.770; EDV,P=0.131; RI,P=0.084).
CONCLUSION: Our results suggest that there is no significant correlations between the SFCT and the choroidal hemodynamic index; glycosylated hemoglobin is one of the factors that affect the SFCT in diabetic patients.
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