糖化血红蛋白测定在白内障术前检查中的意义

Assessment of the measurement of HbAlc in the examination before cataract surgery

目的 评价糖尿病并发性白内障术前糖化血红蛋白(HbAlc)测定的意义。方法 白内障病人146例,行白内障超声乳化联合人工晶体植入手术(Phaco+IOL)。其中老年性白内障75例为A组,糖尿病并发性自内障71例,术前行HbAlc测定,按测定值分成B(≤80A,)、C(>8％)两组。比较等效超声乳化时间(EPT)、术后前房炎症反应和术后激素使用情况,并行统计学分析。结果 A、B、C三组EPT无显著性差异(P>0.05)。C组术后炎症反应和激素使用显著多于A组和B组(P<0.05,P(0.01);A组和B组术后炎症反应和激素使用情况相似(P>0.05)。结论 术前测定HbAlc,对合理选择糖尿病并发性白内障患者的手术时机有重要意义。

Objective To evaluate the measurement of HbAlc before cataract surgery in diabetic patients. Methods One hundred and forty-six patients with cataract who underwent phacoemulsification and intraocular lens implantation were divided into three groups; 75 patients with senile cataract belonged to group A, the other 71 patients with complicated cataract fell into group B(≤8% )and group C( >8% )by the measurement of HbAlc. Equivalent phaco time (EPT) , ocular inflammation following cataract surgery and dosage of corticosteroid were compared by statistical analysis. Results There was no significant difference in EPT among these three groups (P >0.05). The patients in group C had more serious inflammation and higter dosage of corticosteroid than those in group A and B ( P < 0. 05 ,P < 0. 01). The inflammation and the dosage of corticosteroid between group A and B were similar ( P > 0. 05). Conclusion To select diabetic patients with the HbAlc no more than 8% can alleviate ocular inflammation following cataract surgery and lessen the dosage of corticosteroid. The measurement of HbAlc before surgery is of importance to select proper surgical time for complicated cataract with diabetes mellitus.