角膜光密度、中央角膜厚度、角膜内皮细胞计数在评估糖尿病角膜病变中的作用

Roles of Corneal Optical Density,Central Corneal Thickness and Endothelial Cells Count in Evaluating Diabetic Keratopathy

目的：分析角膜光密度（corneal optical density,CD）、中央角膜厚度（central corneal thickness,CCT）、角膜内皮细胞计数（corneal endothelial cell count,CECC）在评估糖尿病角膜病变（diabetic keratopathy,DK）中的作用。方法：选取2012年3月至2013年3月于我院眼科就诊的糖尿病（diabetes mellitus,DM）患者180例180只眼,按病程分为〈5年组、5~10组与〉10年组,每组各60例60只眼,另选同期健康体检者60例60只眼作为健康对照组。用PTC（oculus pentacam,PTC）测量各组的CD、CCT。同时用角膜内皮镜检查角膜内皮细胞密度（endothelial cell density,ECD）。用偏相关系数控制年龄因素后,对DM组CD、ECD、CCT与病程长短做相关性分析;同时对DM组角膜中层、内层CD与CCT做相关性分析。结果：DM组CD比对照组增加;内层、中层CD、CCT与DM病程正相关;ECD与之无明显相关性;在DM患者中角膜中层、内层CD与CCT正相关。结论：中层、内层角膜光密度和CCT是反映早期糖尿病角膜病变的一个敏感指标。

Objective To explore the roles of corneal optical density （CD）, central corneal thickness （CCT） and corneal endothelial cell count（CECC） in＇ evaluating diabetic keratopathy（DK）. Methods From March 2012 to March 2013, 180 patients （180 eyes） with diabetes mellitus （DM） admitted to our hospital were selected. According to duration, the patients were divided into three groups （groupl ：duration low 5 years, group 2：duration from 5 to 10 years, group 3：duration over 10 years, 60 patients 50 eyes in each group）, another 60 volunteers （60 eyes） were selected as control group. The CD and CCT were detected by Pentacam and the density of corneal endothelial cells（ECD） were measure by specular microscope （EM-3000）. After the age errors were controlled by partial correlation coefficient, the correlation between duration and CD, ECD, CCT were analyzed and analysis about CD and ,CCT of mesocomea and inner cornea were conducted in DM groups.Results Compared with normal control group, the CD values increased in the DM group with a significant difference （P〈0.05）, the CD, CCT of mesocornea and inner cornea were positively correlated with duration, while ECD had no correlation; the CD and CCT of mesocomea and inner cornea were positively correlated. Conclusion The density of mesocornea and inner cornea and GGT play important roles in early diagnosis of diabetic keratopathy.