不同时期糖尿病视网膜病变中血栓弹力图的分析

Analysis of thrombelastogram in different degrees of diabetic retinopathy

目的观察在不同程度糖尿病视网膜病变(DR)的血栓弹力图(TEG)指标变化及意义。方法回顾性病例研究。收集90例2型糖尿病患者,按照DR严重程度分为无视网膜病变组(NDR组)、非增生期组(NPDR组)和增生期组(PDR组),每组30例;另收集30例单纯孔源性视网膜脱离患者作为对照组;比较各组患者血栓弹力图指标R值、K值、MA值和Angle值。结果随DR严重程度加重,R值逐渐降低(F=4.168,P=0.008),但对照组与NDR组差异无统计学意义(t=0.893,P=0.608),对照组与NPDR组差异也无统计学意义(t=1.497,P=0.358);随DR严重程度加重,K值也逐渐降低(H=33.954,P<0.001),但对照组与NDR组差异无统计学意义(q=1.076,P>0.05),NPDR组与PDR组差异无统计学意义(q=1.890,P>0.05);随DR严重程度加重,MA值逐渐增高(F=6.659,P<0.001),但对照组与NDR组差异无统计学意义(t=0.107,P=0.915),NPDR组与PDR组差异无统计学意义(t=0.912,P=0.595);随DR严重程度加重,Angle值也逐渐增高(F=7.517,P<0.001),但对照组与NDR组差异无统计学意义(t=1.112,P=0.456),NPDR组与PDR组差异无统计学意义(t=0.678.P=0.499)。结论血栓弹力图可反应DR的病情严重程度及凝血状态,血液高凝状态可能是DR病情加重的原因。

Objective To observe the changes and significance of thrombelastogram(TEG)in diabetic retinopathy(DR).Methods Retrospective study.Ninety patients with type 2 diabetes were collected and divided into non-retinopathy group(NDR group),non-proliferative retinopathy group(NPDR group)and proliferative retinopathy group(PDR group)according to the severity of retinopathy,with 30 patients in each group.Another 30 rhegmatogenous retinal detachment patients were collected as the control group.The R value,K value,MA value and Angle value of TEG in each group were compared.Results With the aggravation of DR severity,R value decreased gradually(F=4.168,P=0.008),but there was no significant difference between the control group and NDR group(t=0.893,P=0.608),and there was no significant difference between the control group and NPDR group(t=1.497,P=0.358);With the aggravation of DR severity,K value also decreased gradually(H=33.954,P<0.001),but there was no significant difference between the control group and NDR group(q=1.076,P>0.05),and there was no significant difference between NPDR group and PDR group(q=1.890,P>0.05).With the aggravation of DR severity,Ma value gradually increased(F=6.659,P<0.001),but there was no significant difference between control group and NDR group(t=0.107,P=0.915),and there was no significant difference between NPDR group and PDR group(t=0.912,P=0.595).With the aggravation of DR severity,the angle value also increased gradually(F=7.517,P<0.001),but there was no significant difference between the control group and NDR group(t=1.112,P=0.456),and there was no significant difference between NPDR group and PDR group(t=0.678,P=0.499).conclusions Thromboelasmogram can reflect the severity and coagulation state of diabetic retinopathy,and the high blood coagulation state may be the reason for the aggravation of diabetic retinopathy.