老年人糖尿病性眼肌麻痹的临床分析

Clinical analysis of ocular muscle paralysis of the aged with diabetes

目的：探讨老年人糖尿病性眼肌麻痹的临床特点和发病机制。方法：常规的眼科检查和眼肌专科检查，内科行全身检查及实验室血生化检查以确诊糖尿病；部分病例辅以影像学检查。结果：３９例老年人糖尿病患者多数为单眼患病；受累颅神经以动眼神经最多２１例２３只眼，以后依次为外展神经１２例，滑车神经和复合神经麻痹各３例。动眼神经麻痹中５例为伴随上睑下垂和瞳孔变化的完全性动眼神经麻痹。大多数患者合并有高血压，近半数患者有高血脂症。结论：老年人糖尿病患者易合并眼肌麻痹。

Clinical features and pathogenetic mechanism of ocular muscle paralysis of the aged with diabetes were studied in this article Besides routine ophthalmologic examination and ocular muscle examination,general check up and blood biochemical examination were also included Some cases with diabetes were diagnosed with the help of image processing. Monocular involvement happened in most of 39 aged cases with diabetes. 21 cases (23eyes) suffered oculomotor paralysis,of which 5 cases had blepharoptosis and platycoria;12 cases suffered abducens paralysis;3 cases had trochlear paralysis and another 3 cases compound nerve paralysis In addition,most cases had hypertension and almost half hyperlipemia Our results showed that ocular muscle paralysis was one of the most common complications among the elderly diabe tics and micrangium pathologic changes were the pathogenetic basis.