高海拔对糖尿病视网膜病变患者眼部多普勒血液流变学参数的影响

Impact of high altitude on ocular CDFI parameters in patients with diabetic retinopathy

目的观察在不同糖化血红蛋白(Hb A1c)水平下,高海拔对糖尿病视网膜病变(DR)患者眼部多普勒血液流变学参数(CDFI)的影响。方法选择2015年1月至2020年12甘肃省第二人民医院(西北民族大学附属医院)及甘南藏族自治州人民医院眼科及内分泌科非增生性DR患者220例(220只眼),将高海拔组[高原藏族居民,110例(110只眼)]和低海拔组[中低海拔居民,110例(110只眼)]再依据Hb A1c水平的不同分别分为观察组和对照组,每组各55例(55只眼),观察组Hb A1c≥8.0 mmol/L及以上,对照组Hb A1c<8.0 mmol/L,观察不同海拔对DR患者眼部CDFI的影响。结果高海拔观察组与对照组比较,视网膜中央动脉(CRA)、眼动脉(OA)及睫状后短动脉(PCA)的收缩峰值血流速度(PSV)相对较低,搏动指数(PI)及阻力指数(RI)有所增加,差异有统计学意义(P<0.05);低海拔观察组与对照组比较,CRA、OA的PSV较低,PCA的PSV较高,而PI及RI均相对较低,差异均有统计学意义(P<0.05);高海拔观察组与低海拔观察组比较CRA、OA及PCA的PSV较低,PI及RI较高,差异有统计学意义(P<0.05)。结论当机体高海拔暴露且Hb A1c≥8.0 mmol/L时,DR患者的眼部CDFI有显著的异常。

Objective To observe the impact of high altitude on ocular color Doppler flow imaging(CDFI)parameters in patients with diabetic retinopathy(DR)at different glycosylated hemoglobin A1c(HbA1c)levels.Methods A total of 220 patients(220 eyes)with non-proliferative DR from the Departments of Ophthalmology and Endocrine of the Second Provincial People’s Hospital of Gansu(Affiliated Hospital of Northwest Minzu University)from January 2015 to December 2020 were selected as study subjects.The high altitude groups(highland Tibetan residents,110 patients[110 eyes])and low altitude groups(low-middle altitude residents,110 patients[110 eyes])were further divided into the observation group(HbA1c≥8.0 mmol/L)and the control group(HbA1c<8.0 mmol/L)based on the difference in HbA1c levels,with 55 patients(55 eyes)in each group.The impacts of different altitudes on the ocular CDFI parameters of DR patients were observed.Results The peak systolic velocity(PSV)of the central retinal artery(CRA),ophthalmic artery(OA)and posterior ciliary artery(PCA)were relatively lower,while the pulsatility index(PI)and resistance index(RI)were higher in the high-altitude observation group than in the high-altitude control group,with statistically significant differences(P<0.05).The PSV of the CRA and OA,and PI and RI were lower,while the PSV of the PCA was higher in the low-altitude observation group than in the lowaltitude control group,with statistically significant differences(P<0.05).The PSV of the CRA,OA and PCA were lower,while the PI and RI were higher in the high-altitude observation group than in the low-altitude observation group,with statistically significant differences(P<0.05).Conclusion Ocular CDFI parameters are obviously abnormal in DR patients with exposure to high altitude and HbA1c≥8.0 mmol/L.