糖尿病视网膜病变患者眼血流动力学改变的分析

Analysis on Ocular Hemodynamics of Patients with Diabetic Retinopathy

目的:观察糖尿病视网膜病变眼血流动力学的改变情况。方法:利用彩色多普勒超声诊断仪(color Doppler imagining,CDI)测定32例(64只眼)糖尿病视网膜病变(diabetic retinopathy,DR)患者球后血流状态,并与正常人30例(60只眼)进行对照。其中32例DR患者接受了荧光素眼底血管造影(fundusfluorescein angiography,FFA)检查,包括非增殖型(NPDR)20例和增殖型(PDR)12例。结果:DR与正常对照组相比,眼动脉(OA)、视网膜中央动脉(CRA)的最大收缩期血流速度(PSV)、舒张末期血流速度(EDV)和总平均速度(Vm)均降低,搏动指数(PI)和阻力指数(RI)增高,视网膜中央骨静脉(CRV)的最大血流速度(Vmax)、最低血流速度(Vmin)和Vm增高,其中NPDR各数值比较具有统计学意义(P<0.05),PDR各数值比较差异有统计学意义(P<0.01)。结论:DR患者小动脉闭塞,血流速度下降,舒张期血管阻力增高,使血流减少。CDI检测对DR早期诊断及发病机制研究有重要临床意义。

Objective： To investigate the changes of ocular hemodynamics of patients with diabetic retinopathy （DR）. Methods. The retrobulbar hemodynamics of 32 patients （64eyes） with DR was determined by color Doppler imagining （CDI） and thirty volunteers （60 eyes） without DR were contrasted. Thirty two cases with DR was examined by Fundus Fluorescein angiography among them, including 20 cases with nonproliferation （NPDR） and 12 cases wih proliferation （PDR）. Results. Compared with the normal volunteers , systolic peak blood flow velocity （S PV）, end- diastolic blood flow velocity（EDV） and velocity of mean （Vm） of the optical artery （OA） and the central retinal artery （CRA） of the patients with DR were slower, pulsatility index （PI） and resistant index （RI） were higher in both OA and CRA. The maximum blood flow velocity （Vmax） , the minimum blood flow velocity（Vmin） and the mean velocity （Vm） of central bone vein of retina were higher. There was a significant difference between numerical value in background DR group （P 〈0.05） , and more significant difference （P〈0.01） in the proliferation DR group. Conclusions： That arterioles are blocked, velocity of blood stream is decreased, and the vascular resistance is heightened of the patients with DR make the blood flow reduce. CDI detection is of an important clinical significance for diagnosis of early DR and the study on its etiology.