早期糖尿病视网膜病变视网膜血管管径变化的初步研究

Changes of retinal vascular caliber in early stages of diabetic retinopathy in type 2 diabetes

目的探讨2型糖尿病患者早期糖尿病视网膜病变(diabetic retinopathy,DR)视网膜血管管径的变化及其相关因素。设计病例对照研究。研究对象北京德胜社区糖尿病眼病随访研究的85例2型糖尿病患者(51~80岁)及年龄性别匹配的26例无糖尿病者(51~78岁)作为对照。方法85例2型糖尿病患者根据DR情况分成两组:无DR(NDR)组(51例)、轻中度非增生性糖尿病视网膜病变(Nonproliferative diabetic retinopathy,NPDR)组(34例),26例无糖尿病者为对照组。使用计算机软件测量视网膜中央动脉管径当量(CRAE)和视网膜中央静脉管径当量(CRVE)。使用光学断层成像技术测量黄斑中心凹视网膜厚度。同时记录最佳矫正视力(BCVA)、糖尿病病程、身高、体重、糖化血红蛋白等数据。比较三组间CRAE、CRVE的差异,并分析可能的相关因素。主要指标CRAE、CRVE。结果无糖尿病对照组右眼、NDR组右眼和NPDR组病变严重眼的CRAE分别为(151.91±13.65)μm、(156.73±11.53)μm、(154.08±9.82)μm(F=1.58,P=0.21);CRVE分别为(226.60±11.84)μm、(231.70±15.65)μm、(244.59±13.82)μm(F=13.43,P<0.01);NPDR组比无糖尿病对照组和NDR组CRVE均显著变宽(P均<0.01),而对照组和NDR组CRVE无统计学差异(P=0.42)。多因素线性回归分析显示,三组中CRVE与年龄均呈负相关(P均<0.01)。结论CRVE与年龄呈负相关;与正常对照及无DR的糖尿病患者相比,轻中度NPDR期患者的CRVE显著增宽。(眼科,2022,31:195-199)

Objective To assess the changes and associations of retinal vascular caliber in early stages of diabetic retinopathy(DR)in type 2 diabetic patients.Design Case-control study.Participants 85 patients with type 2 diabetes(51~80 years old)and 26 age-sex-matched subjects without diabetes(51~78 years old)from Beijing Desheng Community Diabetic Eye Disease Study were used as controls.Methods 85 patients with type 2 diabetes were divided into two groups according to DR:no DR(NDR)group(51 cases),and mild to moderate nonproliferative diabetic retinopathy(NPDR)group(34 cases),compared with 26 non-diabetic control subjects.Central retinal arterial equivalence(CRAE)and central retinal vein equivalence(CRVE)were measured using computer software.Central macular retinal thickness was measured using spectral domain optical coherence tomography(OCT).Best corrected visual acuity(BCVA),diabetes duration,height,weight,glycosylated hemoglobin and other data were recorded.The differences of CRAE and CRVE among the three groups were compared,and possible related factors were analyzed.Main Outcome Measures CRAE,CRVE.Results The CRAE of the right eye of the non-diabetic control group,the right eye of the NDR group and the severely diseased eye of the NPDR group were(151.91±13.65)μm,(156.73±11.53)μm,(154.08±9.82)μm(F=1.58,P=0.21);CRVE was(226.60±11.84)μm,(231.70±15.65)μm,(244.59±13.82)μm(F=13.43,P<0.01);CRVE in NPDR group was significantly wider than that in non-diabetic control group and NDR group(P<0.01 for both),while there was no statistical difference of CRVE between the control and NDR groups(P=0.42).Multivariate linear regression analysis showed that CRVE was negatively correlated with age in the three groups(P<0.01,all).Conclusion CRVE in the three groups of patients in this study was negatively correlated with age;CRVE in NPDR group was significantly wider compared with the control and NDR group.(Ophthalmol CHN,2022,31:195-199)