颈动脉粥样硬化与糖尿病视网膜病变的关系

Relationship between carotid atherosclerosis and diabetic retinopathy

目的探讨颈动脉粥样硬化与糖尿病视网膜病变(DR)的关系。方法将92例DM患者的眼底病变分为无糖尿病视网膜病变期(NDR)、背景期(BDR)、增生前期(PPDR)及增生期(PDR)4期,彩色多普勒显像检测20例正常对照(NC)和92例DM患者双侧颈总动脉、颈内动脉、眼动脉、视网膜中央动脉、视网膜中央静脉的血流动力学变化及颈动脉粥样斑块情况,依据颈动脉有无斑块分为有斑块组和无斑块组。结果颈动脉粥样硬化检出率NDR、BDR组与NC组相比无统计学差异;PPDR、PDR组与NC组相比有统计学差异。有斑块组颈总动脉、颈内动脉、眼动脉、视网膜中央动脉、视网膜中央静脉的血流速度均比无斑块组降低,且有统计学差异。结论随着DR程度的加重,颈动脉粥样硬化的检出率呈明显升高趋势;颈动脉粥样斑块导致同侧眼血流速度下降。

Objective To investigate the relationship between carotid atherosclerosis and diabetic retinopathy.Methods 92 diabetic patients were divided into four stages：no diabetic retinopathy（NDR）,background diabetic retinopathy（BDR）,pre-proliferative diabetic retinopathy（PPDR）,and proliferative diabetic retinopathy（PDR）.Color Doppler imaging（CDI） was used to quantitate the hemodynamic parameters of common carotid artery（CCA）,internal carotid artery（ICA）,ophthalmic artery（OA）,central retinal artery（CRA） and central retinal vein（CRV）,and to check carotid atherosclerosis.Results There was no significant difference among groups of NDR（16.7%,6/36）,BDR（20.7%,12/58） and control（10%,4/40）（all P〉0.05）in the detection-rate of carotid atherosclerosis.The detection rate was significantly increased in both the PPDR group（54.2%,26/48） and the PDR group（66.7%,28/42） as compared with the control group（10.0%,4/40）（all P〈0.01）.There were a significant decreases in blood velocity in CCA,ICA,OA,CRA and CRV in the carotid atherosclerosis group compared with the non-carotid atherosclerosis group（all P〈0.05）.Conclusions The increased trend of the detection rate of carotid atherosclerosis is present accompanying the exacerbation of the diabetic retinopathy.The blood velocity is decreased resulting from the carotid atherosclerosis in the ipsilateral eye.