晶状体混浊程度对糖尿病性白内障患者视网膜血氧饱和度的影响

Effect of lens opacity on retinal oxygen saturation in patients with diabetic cataract

摘要:

目的：探讨晶状体混浊程度对糖尿病性白内障患者视网膜血氧饱和度的影响。

方法：横断面研究。选择2017-06/12于我院入院就诊的糖尿病性白内障患者68例68眼作为研究对象，采用视网膜血氧饱和度测量仪测定视网膜动、静脉及其颞上、鼻上、鼻下、颞下分支血氧饱和度，通过视觉质量分析系统Ⅱ测量眼部客观散射指数(OSI)，并根据OSI对晶状体混浊程度进行分级。

结果：本组患者视网膜动脉及其分支血氧饱和度分别为101.39%±10.84%、106.19%±11.40%、103.22%±10.91%、102.36%±20.31%、101.29%±13.88%，视网膜静脉及其分支血氧饱和度分别为62.51%±8.95%、66.37%±10.74%、64.81%±8.97%、58.37%±13.85%、58.66%±19.94%，动静脉血氧饱和度差值为40.72%±12.08%。本组患者68例68眼OSI值为4.21±3.14，其中晶状体1级混浊15眼，2级混浊14眼，3级混浊23眼，4级混浊16眼。Pearson相关分析显示，视网膜动、静脉及其分支与OSI呈负相关(均P<0.01)，而视网膜动、静脉血氧饱和度差值与OSI呈正相关(P<0.01)。不同晶状体混浊程度患者视网膜动、静脉及其分支血氧饱和度比较，差异均有统计学意义(P<0.05)，其中晶状体4级混浊的患者视网膜动、静脉及其分支血氧饱和度均显著低于晶状体1、2、3级混浊的患者，差异均有统计学意义(P<0.05)，而晶状体1、2、3级混浊的患者动、静脉及其分支血氧饱和度比较，差异均无统计学意义(P>0.05)。不同晶状体混浊程度患者视网膜动静脉血氧饱和度差值比较，差异无统计学意义(P>0.05)。

结论：糖尿病性白内障患者晶状体混浊程度为1～3级时，视网膜血氧代谢异常程度不明显，晶状体混浊程度达到4级则会导致患眼视网膜动、静脉及其分支血氧饱和度下降。

Abstract:

AIM: To investigate the effect of crystal turbidity on retinal oxygen saturation in patients with diabetic cataract.

METHODS:This was a cross-sectional study. Totally 68 patients with 68 eyes of diabetic cataract admitted to our hospital from June 2017 to December 2017 were selected as subjects. Retinal oximetry was used to measure the blood oxygen saturation of the retinal veins, veins, and their supraorbital, nasal, subnasal, and infraorbital branches. The objective scatter index(OSI)of the eye was measured by Visual Quality Analysis System II, and the degree of opacity of the lens was graded according to OSI.

RESULTS:The blood oxygen saturation of the retinal artery and its branches in this group were 101.39%±10.84%, 106.19%±11.40%, 103.22%±10.91%, 102.36%±20.31%, and 101.29%±13.88%, respectively. The oxygen saturation of the retinal vein and its branches were 62.51%±8.95%, 66.37%±10.74%, 64.81%±8.97%, 58.37%±13.85%, and 58.66%±19.94%, respectively. The difference between arteriovenous oxygen saturation was 40.72%±12.08%. In this group of patients, 68 patients with 68 eyes had an OSI value of 4.21±3.14. Among them, 15 eyes were turbid at the first stage, 14 eyes were turbid at level 2, 23 eyes were turbid at level 3, and 16 eyes were turbid at level 4. Pearson correlation analysis showed that the retinal veins, veins and their branches were negatively correlated with OSI(both P<0.01). The difference in retinal arterial and venous oxygen saturation was positively correlated with OSI(P<0.01). There were significant differences in the blood oxygen saturation between the retinal veins, veins and their branches in patients with different degrees of lens opacity(P<0.05). The retinal arterial, venous and branch oxygen saturation of patients with opacity of lens 4 was significantly lower than that of patients with opacity of lens 1, 2, and 3, and the difference was statistically significant(P<0.05). There were no significant differences in blood oxygen saturation between the patients with opacity of lens 1, 2, and 3(P>0.05). There was no significant difference in the difference of arteriovenous oxygen saturation between the patients with different degrees of lens opacity(P>0.05).

CONCLUSION: In patients with diabetic cataract, when the degree of lens opacity is 1 to 3, the degree of abnormality of retinal blood oxygen metabolism is not obvious. When the degree of lens opacity reaches 4, the blood oxygen saturation of the retinal veins, veins and their branches will decrease.