成人肾病综合征患者黄斑区视网膜厚度与尿蛋白的相关性研究

Correlation between macular retinal thickness and urinary protein in adult patients with nephrotic syndrome

目的探讨成人肾病综合征患者黄斑区视网膜厚度与尿蛋白的相关性。方法选择内科收治的住院患者112例,按照尿蛋白检测结果分为正常尿蛋白组28例(56眼)、轻度异常尿蛋白组30例(58眼)、中度异常尿蛋白组27例(51眼)、肾病综合征组27例(53眼)。利用光学相干断层扫描仪(OCT)测量黄斑中央区(Center)、内环颞侧(InT)、内环上方(InS)、内环鼻侧(InN)、内环下方(InI)、外环颞侧(OutT)、外环上方(OutS)、外环下方(OutI)、外环鼻侧(OutN)9个区域视网膜平均厚度,采用相关比率E2对各组黄斑区视网膜平均厚度与尿蛋白分级进行相关性分析。结果轻度异常尿蛋白组黄斑区Center、InT、InN和InI视网膜平均厚度高于正常尿蛋白组,中度异常尿蛋白组黄斑区Center、InT、InS、InN、InI和OutN视网膜平均厚度低于轻度异常尿蛋白组,肾病综合征组黄斑区InT、InS、InN和InI视网膜平均厚度高于中度异常尿蛋白组(均P<0.05)。黄斑区InT、InS、InN、InI视网膜平均厚度与尿蛋白严重程度呈中度相关(0.06≤E2<0.16),Center、OutN视网膜平均厚度与尿蛋白严重程度的相关性较弱(E2<0.06)。结论黄斑区InT、InS、InN、InI视网膜平均厚度有可能成为成人肾病综合征早期病变的生物标志物。

Objective To investigate the correlation between retinal thickness in macular area and urinary protein in adult patients with nephrotic syndrome.Methods A total of 112 inpatients admitted to the internal medicine department were selected and divided into the normal urine protein group(28 cases,56 eyes),the mildly abnormal urine protein group(30 cases,58 eyes),the moderately abnormal urine protein group(27 cases,51 eyes)and the nephrotic syndrome group(27 cases,53 eyes)according to results of urine protein detection.Optical coherence tomography(OCT)was used to measure the average retinal thickness of the nine divisions in the macula regions,including the central region(Center),temporal side of the inner ring(InT),superior the inner ring(InS),nasal side of the inner ring(InN),inferior the inner ring(InI),temporal side of the outer ring(OutT),superior the outer ring(OutS),inferior the outer ring(OutI)and nasal side of the outer ring(OutN).The correlation ratio E2 was used to analyze the correlation between the mean retinal thickness of different macular regions and the grading of urinary protein in each group.Results The mean retinal thickness of Center,InT,InN and InI in the macular area was higher in the mildly abnormal urine protein group than that in the normal urine protein group.The mean retinal thickness of Center,InT,InS,InN,InI and OutN in the macular area was lower in the moderately abnormal urine protein group than that in the mildly abnormal urine protein group,and the mean retinal thickness of InT,InS,InN and InI in the macular area was higher in the nephrotic syndrome group than that in the moderately abnormal urinary protein group(All P<0.05).The mean retinal thickness of InT,InS,InN and InI in macular area was moderately correlated with the severity of urinary protein group(0.06≤E2<0.16),while the mean retinal thickness of Center and OutN in macular area was weakly correlated with the severity of urinary protein group(E2<0.06).Conclusion The mean retinal thickness of InT,InS,InN and InI in macular area may be biomarkers of early lesions of adult nephrotic syndrome.