中国实用眼科杂志
中國實用眼科雜誌
중국실용안과잡지
CHINESE JOURNAL OF PRACTICAL OPHTHALMOLOGY
2009年
9期
935-938
,共4页
刘红%谷万章%陶源%周丽霞%Zueva M.V.
劉紅%穀萬章%陶源%週麗霞%Zueva M.V.
류홍%곡만장%도원%주려하%Zueva M.V.
Muller细胞%增殖性糖尿病性视网膜病变
Muller細胞%增殖性糖尿病性視網膜病變
Muller세포%증식성당뇨병성시망막병변
Muller Cells%Retinal neovascularization
目的 评价Muller细胞在糖尿病性视网膜病变(DR)视网膜新生血管形成中的作用.方法 对239例(478只眼)非增殖期、增殖前期及早期增殖期DR病人进行了闪光视网膜电图(ERG)、局部ERG以及12、32、40赫兹闪烁光ERG检查,并计算纤维指数:闪光ERG的b波幅值/12赫兹闪烁光ERG幅值.此外,对37例增殖前期DR病人每间隔2～4个月进行动态电生理观察1～1.5年.结果 非增殖期DR的32、40赫兹闪烁光ERG b波幅值位于正常低限,闪光ERG的a波幅值中度降低,为(54±9.6)μv,b波幅值正常;12赫兹闪烁光ERG幅值明显降低,为(25.8±9.4)μv,纤维指数平均为(9.3±1.4)单位.增殖前期DR的所有视网膜电反应均中度下降,闪光ERG的b波幅值为(179±19)μv,12赫兹闪烁光ERG幅值为(13.0±6.4)μv,纤维指数为10～16单位,平均(13.8±1.3)单位,有极显著增高(P<0.001).早期增殖期DR的闪光视网膜电图的a波和32、40赫兹闪烁光视网膜电图幅值继续下降,分别为(30.0±12.2)μv、(8.8±2.7)μv和(4.o±2.1)μv,纤维指数平均为:(13.5±2.2),有极显著增高(P<0.001).动态观察表明,原来增高的纤维指数突然下降,说明近期出现视网膜新生血管的可能性极大.结论 纤维指数增高是视网膜缺血缺氧的共同特点,表明Muller细胞的代谢活性代偿性增高,证实其在视网膜新生血管形成中起重要作用.
目的 評價Muller細胞在糖尿病性視網膜病變(DR)視網膜新生血管形成中的作用.方法 對239例(478隻眼)非增殖期、增殖前期及早期增殖期DR病人進行瞭閃光視網膜電圖(ERG)、跼部ERG以及12、32、40赫玆閃爍光ERG檢查,併計算纖維指數:閃光ERG的b波幅值/12赫玆閃爍光ERG幅值.此外,對37例增殖前期DR病人每間隔2～4箇月進行動態電生理觀察1～1.5年.結果 非增殖期DR的32、40赫玆閃爍光ERG b波幅值位于正常低限,閃光ERG的a波幅值中度降低,為(54±9.6)μv,b波幅值正常;12赫玆閃爍光ERG幅值明顯降低,為(25.8±9.4)μv,纖維指數平均為(9.3±1.4)單位.增殖前期DR的所有視網膜電反應均中度下降,閃光ERG的b波幅值為(179±19)μv,12赫玆閃爍光ERG幅值為(13.0±6.4)μv,纖維指數為10～16單位,平均(13.8±1.3)單位,有極顯著增高(P<0.001).早期增殖期DR的閃光視網膜電圖的a波和32、40赫玆閃爍光視網膜電圖幅值繼續下降,分彆為(30.0±12.2)μv、(8.8±2.7)μv和(4.o±2.1)μv,纖維指數平均為:(13.5±2.2),有極顯著增高(P<0.001).動態觀察錶明,原來增高的纖維指數突然下降,說明近期齣現視網膜新生血管的可能性極大.結論 纖維指數增高是視網膜缺血缺氧的共同特點,錶明Muller細胞的代謝活性代償性增高,證實其在視網膜新生血管形成中起重要作用.
목적 평개Muller세포재당뇨병성시망막병변(DR)시망막신생혈관형성중적작용.방법 대239례(478지안)비증식기、증식전기급조기증식기DR병인진행료섬광시망막전도(ERG)、국부ERG이급12、32、40혁자섬삭광ERG검사,병계산섬유지수:섬광ERG적b파폭치/12혁자섬삭광ERG폭치.차외,대37례증식전기DR병인매간격2～4개월진행동태전생리관찰1～1.5년.결과 비증식기DR적32、40혁자섬삭광ERG b파폭치위우정상저한,섬광ERG적a파폭치중도강저,위(54±9.6)μv,b파폭치정상;12혁자섬삭광ERG폭치명현강저,위(25.8±9.4)μv,섬유지수평균위(9.3±1.4)단위.증식전기DR적소유시망막전반응균중도하강,섬광ERG적b파폭치위(179±19)μv,12혁자섬삭광ERG폭치위(13.0±6.4)μv,섬유지수위10～16단위,평균(13.8±1.3)단위,유겁현저증고(P<0.001).조기증식기DR적섬광시망막전도적a파화32、40혁자섬삭광시망막전도폭치계속하강,분별위(30.0±12.2)μv、(8.8±2.7)μv화(4.o±2.1)μv,섬유지수평균위:(13.5±2.2),유겁현저증고(P<0.001).동태관찰표명,원래증고적섬유지수돌연하강,설명근기출현시망막신생혈관적가능성겁대.결론 섬유지수증고시시망막결혈결양적공동특점,표명Muller세포적대사활성대상성증고,증실기재시망막신생혈관형성중기중요작용.
Objective To evaluate the muller cells' role in retinal neovascularization. Methods A total of 239 (478eyes)patients with NPDR, pre-PDR and PDR in the early stage were carried on BF-ERG, local electroretinogram and 12, 32, 40Hz flickerERG examination and fiber exponent: BF-ERG b-wave amplitude value/12Hz flicker ERG width value were calculated in addition, 37 patient with pre-PDR were carried on dynamic state electricity physiology observation for 1-1.5 years in 2-4 months intervals. Results IN propagate NPDR 32, 40Hz ficker ERG b-wave width value were at normal low limit, BF-ERG a-wave width value was lower in the degree, equaled to (54±9.6)μ v, b-wave width value was normal, 12Hz flicker ERG width value was significantly lower which was (25.8±9.4) μ v and fiber exponent equivalent to 9.3±1.4; while in pre-PDR all of retinal response were all in medium degree descend, BF-ERG b-wave width value was (179±19) μ v, 12Hz BF-ERG width value was equivalent to (13.0±6.4) μ v, fiber exponent was 10-16 units in average of 13.8±1.3, which improved significantly (p<0.001). In the early stage of PDR, BF-ERG a-wave and 32. 40Hz width value was kept on decrease obviously, equaled to (30.0±12.2) μ v, (8.8±2.7) μ v and (4.0±2.1)μ v, fiber exponent was equal to13.5±2.2, which was improved obviously (p<0.001). Dynamic observation indicated that the original higher value of fiber exponent suddenly descend showed greater possibility of the recent retinal neovascularization. Conclusions Higher fiber exponent are the common characteristics of retinal neovascularization and indicate the increases of muller cell's metabolic activity compensatory. That confirm muller cells play an important role in trigging of retinal NV.
