早期2型糖尿病视网膜病变患者周围神经传导速度与内层视网膜厚度的相关性研究

Relationship between peripheral nerve conduction velocity and inner retinal thickness in patients with early diabetic retinopathy

目的探讨早期2型糖尿病视网膜病变(DR)患者周围神经传导速度与内层视网膜厚度的相关性。方法纳入于2019年4月至2019年10月在绵阳市中心医院内分泌科就诊的81例2型糖尿病患者,所有患者行相干光层析成像术(OCT)检查测定内层视网膜厚度,并行周围神经传导速度(NCV)检查,行眼底荧光造影后按照2002年国际糖尿病视网膜病变分期标准,将患者分为无糖尿病视网膜病变组(NDR组,47例)和轻度非增生型糖尿病视网膜病变组(轻度NPDR组,34例),探讨周围神经传导速度与内层视网膜厚度的相关性。结果与NDR组相比,轻度NPDR组正中感觉神经传导速度(SCV)、正中运动神经传导速度(MCV)、腓总运动神经传导速度(MCV)、腓肠感觉神经传导速度(SCV)、胫运动神经传导速度(MCV)、黄斑区平均神经节细胞-内丛状层(GCL-IPL)厚度及视乳头平均神经纤维层(RNFL)厚度均降低(均P<0.05)。Pearson相关性分析结果,正中SCV、腓总MCV、腓肠SCV与黄斑平均GCL-IPL厚度呈正相关(r=0.428,r=0.386,r=0.434;均P<0.001),多因素Logistic回归分析显示腓肠SCV(OR=1.03,95%CI:0.78~3.13,P=0.011,B=-0.143,Walds=6.54)及黄斑区平均GCL-IPL厚度(OR=1.05,95%CI:0.76~0.91,P=0.003,B=-0.176,Walds=14.41)是2型糖尿病患者DR的独立危险因素。结论早期DR患者周围神经传导速度(正中SCV、正中MCV、腓总MCV、胫MCV及腓肠SCV)与黄斑区平均GCL-IPL厚度呈正相关,腓肠SCV降低可能是早期识别DR的潜在临床指标。

Objective To investigate the relationship between peripheral nerve conduction velocity and inner retinal thickness in patients with early diabetic retinopathy(DR).Methods Eighty-one patients with type 2 diabetes in the department of Endocrinology at Mianyang central hospital from April 2019 to October 2019 were enrolled.All patients underwent optical coherence tomography(OCT)to measure the inner retinal thickness,as well as peripheral nerve conduction velocity(NCV)measurement.According the 2002 International Standard for Diabetic Retinopathy Staging,participants were divided into two groups after fundus fluorescein angiography examination:no diabetic retinopathy(NDR,n=47)and mild non-proliferative diabetic retinopathy(mNPDR,n=34).Standard statistical methods were used to assess associations between the peripheral nerve conduction velocity and inner retinal thickness.Results The median sensory conduction velocity(SCV),median motor nerve conduction velocity(MCV),peroneal motor conduction velocity,sural sensory conduction velocity,tibial motor conduction velocity,macular average ganglion cell inner plexiform layer(GCL-IPL)thickness and optic nerve head average retinal nerve fiber layer(RNFL)thickness were significantly lower among patients with mNPDR than those in the NDR group(P<0.05).Pearson correlation analysis showed that median SCV,peroneal MCV,and sural SCV were positively correlated with macular average GCL-IPL thickness(r=0.428,r=0.386,r=0.434;P<0.001,respectively).Multiple logistic regression analysis showed that sural SCV(OR=1.03,95%CI:0.78~3.13,P=0.011,B=-0.143,Walds=6.54;OR=1.05,95%CI:0.76~0.91,P=0.003,B=-0.176,Walds=14.41)and macular average GCL-IPL thickness(OR=1.05,95%CI:0.76~0.91,P=0.003)were independent risk factors for DR in patients with type 2 diabetes.Conclusions The peripheral nerve conduction velocity(median SCV,median MCV,peroneal MCV,tibial MCV,sural SCV)was positively correlated with the average macular GCL-IPL thickness in patients with type 2 diabetes and early DR.The decrease in sural SCV may be a potential clinical indicator for early identification of DR.