眼轴长度对NPDR眼部彩色多普勒血流动力学的影响

Effects of axial length on color Doppler hemodynamics of nonproliferative diabetic retinopathy

目的：观察眼轴长度对非增殖期糖尿病视网膜病变（ nonproliferative diabetic retinopathy,NPDR）眼部彩色多普勒血流动力学的影响。方法：前瞻性比较病例系例。自2012-01／2013-12间我院眼科及内分泌科住院的糖尿病视网膜病变患者，排除中心视网膜有明显的水肿、出血、渗出及有明显的其它眼底病变者，依据眼科A／B超测量眼球轴长并根据眼轴长度将患者归类为眼轴长度正常组（22～〈24mm）、长眼轴组（24～〈26mm）及超长眼轴组（26mm及以上），所有患者进行眼部彩色多普勒血流动力学指标测定，对有完整研究资料的患者248例248眼的研究指标进行统计学分析，观察眼轴长度与眼部彩色多普勒血流动力学指标的相关性。结果：正常眼轴组与长眼轴组比较，长眼轴组OA的PSV（cm／s）无明显变化（t=1．362，P=0．20）、CRA的PSV（cm／s）较高（t=-2．335，P=0．02），PCA的PSV（cm／s）较高（t=2，756，P=0．01），PI（t=-2．371，-2．585，-2．67；P=0．02，0．01，0．01）及RI（t=2．348，2．462，2．293：P=0．02，0．01，0．03）相对较低，差异均有统计学意义（P〈0．05）。正常眼轴组与超长眼轴组比较，超长眼轴组OA的PSV较低（t=3．290，P=0．00），CRA及PCA的PSV（t=-5．520，-4．900；P=0．00，0．00）高；PI（t=4．970，6．160，5．990；P=0．00，0．00，0．00）；RI（t=-4．310，-5．230，-4．390；P=0．00，0．00，0．00）低，差异有统计学意义（P〈0．01）。长眼轴组与超长眼轴组比较，超长眼轴组OA的PSV（cm／s）较慢，但两者比较无统计学意义（t=1．967，P=0．07）、CRA的PSV（cm／s）较低（t=-2．543，P=0．01），PCA的PSV（cm／s）较高（t=-2．198，P=0．04），PI（t=-2．331，-2．135，-4．191；P=0．03，0．03，0．00）及m（t=2．570，2．360，2．490；P=0．01，0．02，O．01）相对较低，差异均有统计学意义（P〈0．05）。结论：糖尿病视网膜病变患者的眼轴长度与眼部彩色多普勒血流动力学指标有着明显的相关性。

AIM： To observe the effect of axial length on color Doppler hemodynamic of nonproliferative diabetic retinopathy （NPDR） eye. METHODS： This is a prospective comparative case series study. The hospitalized patients with diabetic retinopathy from January 2012 to December 2013 in Department of Ophthalmology and Endocrinology of our hospital were included, those with central retinal significant edema, hemorrhage, exudation and significant other fundus lesions were excluded. According to ocular axial length measured by ophthalmologic A/B ultrasound scanner and axial length, the patients were divided into normal axial group （22-〈24mm）, long axial group （24 - 〈26mm） and super-long axial group （26mm or above）. Color Doppler hemodynamic parameters of all patients were measured. Totally, 248 cases （248 eyes） with complete research data were statistically analyzed and were observed the correlation between axial length and eye color Doppler hemodynamics. RESULTS： Compared with normal axial group, OA PSV （cm/s） of long axial group did not change significantly （t= 1.362, P=0.20）, CRA PSV （crn/s） was high （t=-2.335, P= 0.02）, PCA PSV （cm/s） was higher （t=2.756, P=0.01）, PI （t=-2.371, -2. 585, -2.67; P=0.02, 0.01, 0.01） and RI （ t= 2. 348, 2. 462, 2. 293 ; P= 0.02, 0.01, 0.03） is relatively lower, there were statistically significant differences （P〈 0.05）. When compared with super-long axial group, ultra long shaft section OA（ t= 3. 290, P= 0.00） low, CRA and PCA PSV of normal axial group was higher （ t= 3. 290, -5.520, -4.900; P=0.00, 0.00, 0.00）, PI （t=4.970,6.160, 5.990; P=0.00, 0.00, 0.00） and RI （t=-4.310, -5.230, -4. 390; P= 0. 00, 0. 00, 0. 00） was lower, there was statistically significant differences （ P 〈 0. 005 ）. When compared with long axial group, OA in PSV （cm/s） of super-long axial group was more slower, but with no statistical significance （t=1.967, P=0.07）, CRA PSV （cm/s） was lower （t=-2.543, P=0.01）, PCA PSV （crn/s） was higher （t=-2.198, P=0.04）, PI （t=-2.331,-2.135, -4.191; P=0.03, 0.03, 0.00） and RI （t=2.570, 2.360, 2.490; P=0.01, 0.02, 0. 01 ） was relatively lower, there were significant differences （P〈0.05）. CONCLUSION： There is a clear correlation between axial length in diabetic retinopathy and ocular hemodynamics with color Doppler index.