监测糖化血红蛋白在糖尿病患者白内障术后的应用价值

Application value of monitoring glycosylated hemoglobin after cataract surgery in diabetic patients

目的:探讨糖化血红蛋白(HbA1c)在糖尿病患者白内障术后的应用价值。方法:选取2014-05/2016-05在我院眼科行白内障手术患者120例158眼,分为糖尿病组80例110眼和正常对照组40例48眼,根据Hb A1c水平将糖尿病组分为高HbA1c组(HbA1c>7.0%,39例54眼)和低HbA1c组(HbA1c≤7.0%,41例56眼),观察上述三组白内障患者术前、术后1mo的黄斑总容积及黄斑中心视网膜厚度。结果:术前黄斑区中心凹视网膜厚度比较糖尿病组患者较对照组厚,差异有统计学意义(P<0.05);术前、术后1mo黄斑总容积、黄斑区中心凹视网膜厚度高HbA1c组高于低HbA1c组与对照组,差异有统计学意义(P<0.05),低HbA1c组上述指标稍大于正常对照组,差异无统计学意义(P>0.05)。结论:HbA1c与白内障术后黄斑区视网膜厚度呈正相关,且其可用于监测术后黄斑水肿的发生发展。术前HbA1c高于7.0%者,应积极采取干预措施,保护视功能。

AIM：To explore the application value of glycosylated hemoglobin after cataract surgery in diabetic patients.METHODS：Selected 120 patients with cataract surgery from May 2014 to May 2016 in ophthalmology department of our hospital,were divided into diabetic group（80 patients with 110 eyes） and control group（40 patients with 48 eyes）.According to the HbA1c levels,diabetic group was divided into high HbA1c group（HbA1c 7.0%） and low HbA1c group（HbA1c≤7%）.The total macular volume and central retinal thickness were observed before and at 1mo after the cataract operation in the three groups.RESULTS：The central retinal thickness of the macular area in the diabetic group was significantly higher than that in the control group（P0.05）.The total volume of macular foveal retinal thickness before and at 1mo after the operation in the high HbA1c group were significantly higher than those of low HbA1c group and the control group（P0.05）.The indexes of preoperative and 1mo postoperative of low HbA1c group were slightly higher than those of the normal control group（P0.05）.CONCLUSION：HbA1c is positively correlated with macular retinal thickness after cataract surgery,and it can be used for monitoring the occurrence and development of macular edema after cataract surgery.For patients whose preoperative HbA1c is higher than7%,the application of active intervention is needed to protect the visual function.