糖尿病患者HbA1c水平与白内障术后黄斑中心凹视网膜厚度的相关性研究

Correlation between HbA1c and macular foveal retinal thickness in diabetic patients after cataract surgery

目的:探讨糖尿病患者糖化血红蛋白(HbA1c)水平与白内障术后黄斑中心凹视网膜厚度的相关性。方法:回顾性分析2013-09/2016-06在我院眼科行白内障手术的糖尿病视网膜病变患者119例119眼,根据术前HbA1c水平将患者分为低HbA1c组(HbA1c≤7.0%,60例60眼)和高HbA1c组(7.0%<HbA1c≤9.0%,59例59眼)。所有患者均行白内障超声乳化摘除联合后房型人工晶状体植入术。采用光学相干断层扫描(OCT)技术检测手术前后黄斑中心凹视网膜厚度,并分析其与术前HbA1c水平的相关性。结果:术前1d,高HbA1c组和低HbA1c组患者的HbA1c水平分别为8.29%±2.19%和5.38%±1.49%,差异有统计学意义(P<0.05),高HbA1c组患者5个区域黄斑中心凹视网膜厚度均显著高于低HbA1c组(P<0.05)。术后7d,两组患者5个区域黄斑中心凹视网膜厚度均高于术前1d(P<0.05),且高HbA1c组显著高于低HbA1c组(P<0.05)。直线回归分析显示,术前1d、术后7d CSF及A1～A4 5个区域黄斑中心凹视网膜厚度与术前HbA1c水平均呈显著正相关(P<0.05)。结论:糖尿病患者术前HbA1c水平与白内障术前、术后黄斑中心凹视网膜厚度均有显著相关性,对于监测白内障术后黄斑水肿的发生发展有重要的临床意义。

AIM： To investigate the correlation between glycosylated hemoglobin（ HbA1c） level and macular fovea retinal thickness after cataract surgery in diabetic patients.METHODS： By a randomized sampling and retrospective study,from September 2013 to June 2016,a total of 119 cases（ 119 eyes） of diabetic retinopathy in our hospital were selected and divided into low HbA1c group（ HbA1c≤7. 0%） of 60 cases（ 60 eyes） and high HbA1c group（ 7. 0% HbA1c≤9. 0%） of 59 cases（ 59 eyes）according to preoperative HbA1c levels. All patients underwent phacoemulsification and posterior chamber intraocular lens implantation. Optical coherence tomography（ OCT） was used to detect the retinal thickness of the fovea before and after surgery,and its correlation with preoperative HbA1c levels was analyzed.RESULTS： At preoperative 1 d,HbA1c in the high HbA1c group and the low HbA1c group were 8. 29%±2. 19% and5. 38%±1. 49% respectively,and the differences between two groups were statistically significant（ P〈0. 05）;macular foveal retinal thickness in the 5 regions of high HbA1c group were significantly higher than that in the low HbA1c group（ P〈0. 05）. At postoperative 7 d of macular fovea retinal thickness in the 5 regions of the two groups was higher than that at postoperative 1 d（ P〈0. 05）,and the high HbA1c group was also significantly higher than that of the low HbA1c group（ P〈0. 05）. Linear regression analysis showed that preoperative 1 d HbA1c were significant positive correlation with preoperative 1 d,postoperative 7 d of macular foveal retinal thickness in 5 regions（ P〈0. 05）.CONCLUSION： HbA1c levels in diabetic patients are significantly correlated with preoperative and postoperative macular foveal retinal thickness. It has important clinical significance for monitoring the occurrence and development of macular edema after cataract surgery.