糖尿病视网膜病变患者血管紧张素Ⅱ与眼血流关系的临床研究

A clinical study of relationship between AngⅡ and ophthalmic blood flow in the patients with diabetic retinopathy

目的 测定服药前后血浆的血管紧张素 (Ang )水平 ,并应用彩色多普勒血流显像 (color Dopplerflow im aging,CDFI)检测服药前后眼部循环的血流动力学变化 ,探讨血管紧张素转换酶抑制剂 (ACEI)对糖尿病患者眼部血流的影响。方法 检测视网膜中央动脉 (central retinal artery,CRA)、鼻侧和颞侧睫状后动脉 (posteriorcilliary arteries,PCAs)及眼动脉 (ophthalmic artery,OA)血流的收缩期峰速 (peak systolic velocity,PSV)、舒张末期流速 (end- diastolic velocity,EDV)和阻力指数 (resistance index,RI)。结果 服药前 DR组与正常组 Ang 含量比较有非常显著性差异 (P <0 .0 1) ;正常组服药前后 Ang 含量、OA、CRA及 PCAs血流速度差异无显著性。 DR组服药前后 Ang 含量比较差异有显著性 (P <0 .0 5 )。DR组患者服药后 OA血流速度较服药前略有提高 ,达不到正常标准 ,统计学处理差异无显著性 (P >0 .0 5 ) ;DR组 CRA及 PCAs血流速度服药后较服药前提高 ,统计学处理差异有显著性 (P <0 .0 5 )。结论 血管紧张素转换酶抑制剂 (ACEI)

Objective To study the effect of angiotensin converting enzyme inhibitor(ACEI) on the ophthalmic blood flow in the patients with diabetic retinopathy(DR).Methods Before and after entry,serum concentration of AngⅡ and the blood flow in the patients with diabetic retinopathy was determined with color Doppler flow imaging;Various clinical parameters including:PSV (peak systolic velocity),EDV (end-diastolic velocity),RI (resistance index) in CRA (central retinal artery),PCAs (posterior cilliary arteries) and OA (ophthalmic artery) was measured before and after entry.Results Before entry,there was significant difference in serum concentration of AngⅡ between DR group and normal group (P<0.01).There was no statistical significane for serum concentration of AngⅡ and the blood flow in normal group before and after entry.There was statistical significance for serum concentration of AngⅡ in the pre-and post-treatment in DR group (P<0.05).The blood flow velocity of the ophthalmic artery (OA) increased a little after entry,it shows no significant difference (P>0.05).The blood flow velocity of the central retinal artery (CRA) and posterior cilliary arteries (PCAs) were increased difinitely,it shows significant difference (P<0.05).Conclusion ACEI could improve the ophtholmic blood flow in the patients with diabetic retinopathy.