糖尿病患者的视网膜电图分析

The analysis of electroretinography in diabetes mellitus

目的 :分析糖尿病 (DR)患者视网膜电图 (F ERG)的振幅、峰潜时、OPS总和振幅及其与病程的相关性。方法 :将 5 3例 10 2眼糖尿病患者分为三组 (NDR、BDR、PDR) ,并采用美国UATA 2 0 0 0型视觉电生理仪对5 3DR例进行F ERG检查 ,主要分析其a、b波峰潜时、振幅、OPS总和振幅。结果 :随着DR病情的加重 ,ERG及OPS无波的情况所占比例增大。a波峰潜时BDR组和正常组比较差异有极显著性 (P <0 .0 1) ,BDR组和DM无DR组比较差异有显著性 (P <0 .0 5 ) ;a波振幅正常对照组与其他各组比较差异均有极显著性 (P <0 .0 1)。b波振幅正常对照组与BDR、PDR间以及DM无DR组与BDR、PDR组间均有极显著性差异 (P <0 .0 1)。OPS总和振幅除了BDR与PDR间外 ,其他各组比较差异均有极显著性 (P <0 .0 1)。结论 :OPS、ERG之a、b波振幅 ,尤其是b波振幅 ,可以作为早期诊断DR患者以及估计预后的敏感指标 ;良好的血糖控制 。

Objective:In order to have a better understanding of diabetic retinopathy (DR), we analyzed and evaluated the amplitude and latency of F ERG a wave and b wave as well as the total amplitudes of oscillatory potentials (OPS).Methods:We examined the 105 eyes (55 cases) by ophthalmoscope and fluorescing in angiography. The patients were divided into 3 groups: 22 eyes with DM but no DR (NDR), 56 eyes with background DR (BDR) and 27 eyes with proliferative DR (PDR). In addition, 30 eyes that were considered normal were the control group (NCG). We used the VATA 2000 electrophysiological instrument and the international standard for clinical ERG to automatically measure and record by computer.Results:①The number of eyes in which the a wave, b wave of F ERG and Ops were invisible increased proportionately with the development of DR.②There were significant differences (P<0.01) between NCG and BDR in the latency of the a wave, and there were statistically significance differences (P<0.05) between BDR and NDR. There were significant differences (P<0.01) in the amplitude of the b wave between NCG and BDR, NCG and PDR, NDR and BDR, and NDR and PDR.③The total amplitudes of Ops were progressively lower with the progression of DR. There were significant differences (P<0.01) in the total amplitudes of Ops between NCG and NDR, NCG and BDR, and NDR and BDR. There was a statistically significance difference (P<0.05) between NDR and PDR.Conclusion:The amplitude of the a wave and b wave as well as the total amplitudes are the targets for early diagnosis of DR. The combined analyses of the three indices of the ERG can determine the severity, the rate of cure, and the prognosis of the disease.