彩色多普勒超声观察2型糖尿病患者视网膜血流动力学变化

Retinal hemodynamic study using color Doppler flow imaging in patients with type 2 diabetes mellitus

目的观察2型糖尿病患者视网膜病变(DR)的血流动力学改变及其与DR发生、发展的关系。方法应用彩色多普勒超声检查36名正常对照者(NC组)和68例T2DM患者[单纯性糖尿病(DM组)33例,DR组35例]视网膜中央动脉(CRA)及视网膜中央静脉(CRV)的血流参数。结果 DR组CRA收缩期峰值流速慢于NC组及DM组(P<0.01或P<0.05);DR组CRV最大血流速度快于NC组及DM组(P<0.01或P<0.05);DR组阻力指数高于NC组(P<0.01)。结论糖尿病患者视网膜血管的血流动力学变化发生于视网膜形态学改变之前,与DR的发生、发展密切相关。

Objective To observe hemodynamic changes of central retinal artery（CRA）and central retinal vein （CRV）,and to investigate their relationship with the development of diabetic retinopathy（DR） in patients with type 2 diabetes mellitus. Methods The hemodynamic parameters of CRA and CRV were measured in 33 diabetic patients without diabetic retinopathy（NDR）, 35 diabetic patients with background diabetic retinopathy（BDR）, and 36 normal control （NC）subjects using color Doppler flow imaging. Results The peak systolic velocity（PSV）of CRA was lower in BDR group （7.31±1.59）cm/s than in NC groupE（10. 11±1.57）cm/s,P〈0.01] and in NDR group[（9.37± 1.62）cm/s,P〈0.05]. The maximum velocity （Vmax）of CRV was higher in BDR group（7.67±1.34）cm/s than in NC group[（5.68±1.07）cm/ s,P〈0.01]and in NDR group[（6.59±1.49）cm/s, P〈0.05]. The resistance index （RI）of CRV was higher in BDR group（0.47±0.12） than in NC group（0.33±0.14,P〈0.01）. Conclusions The retinal hemodynamic changes appear to occur before retinal pathologic changes in patients with type 2 diabetes mellitus, and are related to the development of DR.