PRP对DR患者视网膜血液循环时间及血流动力学的影响

Effect of PRP on retinal blood circulation time and hemodynamics in patients with DR

摘要:

目的：分析全视网膜激光光凝(PRP)手术对糖尿病视网膜病变(DR)患者视网膜动静脉循环时间及血流动力学的影响，为临床治疗提供参考。

方法：选取2013-05/2018-02期间在本院接受PRP治疗的DR患者80例80眼。分别于治疗前和治疗后3mo使用眼底荧光造影系统记录视网膜静脉分支主干发生层流时间和全部充盈时间(V1和V2)、视网膜动脉分支主干显影时间和全部充盈时间(A1和A2)，并计算视网膜动静脉经过时间(V2-A1)、视网膜动脉经过时间(A2-A1)、视网膜静脉经过时间(V2-V1)及视网膜毛细血管经过时间(V1-A2)； 使用全自动生化分析仪检测红细胞聚集指数、血细胞压积、血浆粘度、全血粘度高切及全血粘度低切； 使用彩色多普勒超声诊断仪记录眼动脉阻力指数(RI)、收缩期最大血流速度(PSV)和舒张末期血流速度(EDV)。

结果：治疗后3mo，本组患者V1-A2时间较治疗前显著延长，红细胞聚集指数、血细胞压积、血浆粘度、全血粘度高切及全血粘度低切较治疗前显著降低，RI较治疗前显著降低，EDV、PSV较治疗前显著升高，差异均有统计学意义(P<0.05)。

结论：PRP手术对DR患者视网膜动静脉循环时间及血流动力学均会产生一定的影响，对视网膜毛细血管经过时间的影响较明显。

Abstract:

AIM: To analyze the effect of pan-retinal photocoagulation(PRP)surgery on retinal arteriovenous circulation time and hemodynamics in patients with diabetic retinopathy(DR), and provide reference for clinical treatment.

METHODS: Eighty patients with DR who underwent PRP treatment in our hospital during May 2013 to February 2018 were selected for 80 eyes. The fundus fluorescein angiography system was used to record laminar flow time and total filling time(V1 and V2), retinal artery branch trunk development time and total filling time(A1 and A2), respectively, before and after treatment. Retinal arteriovenous passage time(V2-A1), retinal artery transit time(A2-A1), retinal vein transit time(V2-V1)and retinal capillary passage time(V1-A2)were recorded; we used automatic biochemical analyzer to detect red blood cells aggregation index, hematocrit, plasma viscosity, whole blood viscosity, high shear and low shear viscosity of whole blood; color Doppler ultrasound was used to record ophthalmic artery resistance index(the RI), peak systolic velocity(PSV)and diastolic the end of the flow velocity(EDV).

RESULTS: At 3mo after treatment, the V1-A2 time of this group was significantly longer than that before treatment. The red blood cell aggregation index, hematocrit, plasma viscosity, high blood viscosity and low blood viscosity were significantly lower than before treatment. RI was significantly lower than before treatment. EDV and PSV were significantly higher than before treatment, and the difference was statistically significant(P<0.05).

CONCLUSION: PRP surgery has a certain effect on the retinal arteriovenous circulation time and hemodynamics in patients with DR, and has a significant effect on the transit time of retinal capillaries.