PRP对DR患者视网膜血液循环时间及血流动力学的影响

Effect of PRP on retinal blood circulation time and hemodynamics in patients with DR

目的:分析全视网膜激光光凝(PRP)手术对糖尿病视网膜病变(DR)患者视网膜动静脉循环时间及血流动力学的影响,为临床治疗提供参考。方法:选取2013-05/2018-02期间在本院接受PRP治疗的DR患者80例80眼。分别于治疗前和治疗后3mo使用眼底荧光造影系统记录视网膜静脉分支主干发生层流时间和全部充盈时间(V1和V2)、视网膜动脉分支主干显影时间和全部充盈时间(A1和A2),并计算视网膜动静脉经过时间(V2-A1)、视网膜动脉经过时间(A2-A1)、视网膜静脉经过时间(V2-V1)及视网膜毛细血管经过时间(V1-A2);使用全自动生化分析仪检测红细胞聚集指数、血细胞压积、血浆粘度、全血粘度高切及全血粘度低切;使用彩色多普勒超声诊断仪记录眼动脉阻力指数(RI)、收缩期最大血流速度(PSV)和舒张末期血流速度(EDV)。结果:治疗后3mo,本组患者V1-A2时间较治疗前显著延长,红细胞聚集指数、血细胞压积、血浆粘度、全血粘度高切及全血粘度低切较治疗前显著降低,RI较治疗前显著降低,EDV、PSV较治疗前显著升高,差异均有统计学意义(P<0. 05)。结论:PRP手术对DR患者视网膜动静脉循环时间及血流动力学均会产生一定的影响,对视网膜毛细血管经过时间的影响较明显。

AIM： To analyze the effect of pan - retinalphotocoagulation （PRP） surgery on retinal arteriovenouscirculation time and hemodynamics in patients withdiabetic retinopathy （ DR）, and provide reference forclinical treatment.METHODS： Eighty patients with DR who underwentPRP treatment in our hospital during May 2013 toFebruary 2018 were selected for 80 eyes. The fundusfluorescein angiography system was used to recordlaminar flow time and total filling time （ V1 and V2 ）,retinal artery branch trunk development time and totalfilling time （A1 and A2）, respectively, before and aftertreatment. Retinal arteriovenous passage time （V2-A1）,retinal artery transit time （ A2 - A1 ）, retinal vein transit time （V2-V1） and retinal capillary passage time （V1-A2）were recorded; we used automatic biochemical analyzerto detect red blood cells aggregation index, hematocrit,plasma viscosity, whole blood viscosity, high shear andlow shear viscosity of whole blood; color Dopplerultrasound was used to record ophthalmic arteryresistance index （ the RI）, peak systolic velocity （ PSV）and diastolic the end of the flow velocity （EDV）.RESULTS： At 3mo after treatment, the V1 -A2 time ofthis group was significantly longer than that beforetreatment. The red blood cell aggregation index,hematocrit, plasma viscosity, high blood viscosity andlow blood viscosity were significantly lower than beforetreatment. RI was significantly lower than beforetreatment. EDV and PSV were significantly higher thanbefore treatment, and the difference was statisticallysignificant （P〈0. 05）.CONCLUSION： PRP surgery has a certain effect on theretinal arteriovenous circulation time and hemodynamicsin patients with DR, and has a significant effect on thetransit time of retinal capillaries.