糖尿病性白内障患者超声乳化联合人工晶状体植入术后黄斑水肿发生的影响因素

Influencing factors for the occurrence of macular edema after phacoemulsification combined with implantation of artificial lens in patients with diabetic cataract

目的探讨糖尿病性白内障患者超声乳化联合人工晶状体植入术后黄斑水肿(ME)发生的影响因素。方法选取80例行超声乳化联合人工晶状体植入术治疗的糖尿病性白内障患者,根据术后ME发生情况进行分组,收集两组患者的基线资料,检测血清总胆固醇(TC)、甘油三酯(TG)、糖化血红蛋白(HbA1c)、血管内皮生长因子(VEGF)以及房水中白细胞介素-6(IL-6)水平,分析糖尿病性白内障患者超声乳化联合人工晶状体植入术后ME发生的影响因素。结果80例行经超声乳化联合人工晶状体植入术的糖尿病性白内障患者中,共23例(28.75%)术后发生ME(发生组),未发生ME 57例(71.25%,未发生组)。发生组HbA1c、VEGF、IL-6水平均高于未发生组(均P<0.05);两组患者的性别、年龄、糖尿病病程、高血压、TC、TG比较,差异无统计学意义(均P>0.05)。多因素Logistic回归分析结果显示,HbA1c、VEGF、IL-6高表达是导致糖尿病性白内障患者超声乳化联合人工晶状体植入术后发生ME的独立危险因素(均P<0.05)。结论糖尿病性白内障患者超声乳化联合人工晶状体植入术后发生ME受HbA1c、VEGF、IL-6水平的影响。

Objective To investigate the influencing factors for the occurrence of macular edema(ME)in patients with diabetic cataract after phacoemulsification combined with implantation of artificial lens.Methods A total of 80 patients with diabetic cataract who underwent phacoemulsification combined with implantation of artificial lens were selected,and they were assigned to groups based on the occurrence of ME after surgery.The baseline information were collected,and the levels of serum total cholesterol(TC),triglyceride(TG),glycosylated hemoglobin(HbA1c),vascular endothelial growth factor(VEGF),as well as the interleukin-6(IL-6)in aqueous humor were detected in both groups.The influencing factors for the occurrence of ME after phacoemulsification combined with implantation of artificial lens in patients with diabetic cataract were analyzed.Results Among 80 patients with diabetic cataract after phacoemulsification combined with implantation of artificial lens,23 cases(28.75%)occurred ME(the occurrence group)after surgery,whereas 57 cases(71.25%)did not occur ME(the non-occurrence group).The levels of HbA1c,VEGF and IL-6 in the occurrence group were higher than those in the non-occurrence group(all P<0.05).There were no statistically significant differences in gender,age,duration of diabetes,hypertension,TC,and TG between the two groups(all P>0.05).Multivariate logistic regression analysis showed that high expressions of HbA1c,VEGF and IL-6 were the independent risk factors for the occurrence of ME after phacoemulsification combined with implantation of artificial lens in patients with diabetic cataract(all P<0.05).Conclusion The occurrence of ME after phacoemulsification combined with implantation of artificial lens in patients with diabetic cataract is influenced by the levels of HbA1c,VEGF and IL-6.