mfERG在糖尿病视网膜病变诊断中的价值研究

Diagnostic value of multifocal visual electrophysiology on diabetic retinopathy

目的探讨视觉多焦视网膜电图（multi-focal ERG,mfERG）在糖尿病视网膜病变中的诊断价值。方法选择2015年1月~2016年1月首都医科大学附属北京同仁医院眼科门诊就诊的2型糖尿病视网膜病变患者42例作为观察组,选择同时期就诊的无视网膜病变的糖尿病患者40例作为对照组。两组患者均接受多焦视觉电生理仪检查,记录两组患者的mfERG N1波,P1波的振幅及潜伏期变化,检测糖化血红蛋白、血脂等指标。应用SPSS 19.0统计软件,P〈0.05为差异有统计学意义。结果观察组患者的P1波振幅由环1~环5均降低（P〈0.01）,P1潜伏期则表现为环3~环5延迟,差异有统计学意义（P〈0.05）;与对照组相比,观察组患者的N1波的振幅环3（t=5.121,P〈0.01）和环4（t=4.601,P〈0.01）降低,差异有统计学意义,N1波潜伏期环5延迟,差异有统计学意义（t=3.214,P=0.031）。糖化血红蛋白（r=-0.708,P〈0.05）和总胆固醇（r=-0.771,P〈0.05）与糖尿病视网膜病变患者mfERG的P1振幅降低呈负相关。结论 mfERG是评估糖尿病视网膜病变视网膜功能的敏感检测方法,有效控制糖尿病患者的糖化血红蛋白和血脂水平,可以预防及延缓糖尿病视网膜病变的发生发展。

Objective To explore the diagnostic value and clinical significance of multifocal visual electrophysiology （mfERG） on diabetic retinopathy. Methods 42 outpatients with type 2 diabetic retinopathy were selected from the department of ophthalmology in Beijng Tongren Hospital from January 2015 to January 2016, and 40 diabetic patients with no retinopathy were chosen as controls. All subjects were tested for glycosylated hemoglobin and blood lipids, and received rnfERG examination. The amplitude and latency of P1 wave and N1 wave were recorded and analyzed. Data were processed using SPSS 19.0 statistical software. Results The amplitude of P1 wave in patients with diabetic retinopathy was significantly lower in the ring 1 to ring 5 （P〈 0.01）, and the latency of P1 was delayed in the ring 3 to ring 5 （P〈 0.05） compared with the controls. The amplitude of N1 wave in patients with diabetic retinopathy was also significantly lower in ring 3 （t=5. 121, P 〈0.01） and ring 4 （t=4. 601, P〈0.01）, and the latency of N1 wave was delayed in the ring 5 （t=3. 214, P =0.031） .Theglycosylated hemoglobin （r=-0.708, P〈0.05） and total cholesterol （r=-0.771, P〈 0.05） were negatively correlated with the Pl amplitude of mfERG in patients with diabetic retinopathy. Conclusions mfERG test is a sensitive method to evaluate the retinal function of diabetic retinopathy. The effective control of the levels of glycosylated hemoglobin and blood lipids of diabetic patients can help to prevent and de lay the occurrence and development of diabetic retinopathy.