CAJ | 학술논문

目的观察早期糖尿病患者视乳头和黄斑区视网膜神经纤维层厚度的改变.方法本试验为病例对照研究.收集2011年8月至2012年1月于安贞医院眼科就诊的2型糖尿病患者157例和健康对照者40名,按照彩色眼底像视网膜病变程度分组,利用光相干断层扫描(OCT)测量患者右眼视乳头、黄斑区视网膜神经纤维层厚度以及黄斑区视网膜厚度.各测量数据间的比较采用x2检验、One-Way ANOVA及(LSD)检验.结果糖尿病视网膜改变(NDR)组视乳头上方RNFL相较对照组变薄,但两组间差异无统计学意义(P=0.195),miNPDR组、moNPDR和sNPDR与对照组和NDR组间差异有统计学意义(P=0.13,0.02,0.00).moNPDR和sNPDR组黄斑中心厚度厚于对照组间,且差异有统计学意义(P =0.003,0.001).NDR组、miNPDR、moNPDR和sNPDR组黄斑区上方RNFL均显著薄于对照组(P＜0.01).结论在早期糖尿病患者,无论视乳头还是黄斑区均出现视网膜神经纤维层变薄,且其变化早于视网膜微血管病变.
목적 관찰조기당뇨병환자시유두화황반구시망막신경섬유층후도적개변.방법 본시험위병례대조연구.수집2011년8월지2012년1월우안정의원안과취진적2형당뇨병환자157례화건강대조자40명,안조채색안저상시망막병변정도분조,이용광상간단층소묘(OCT)측량환자우안시유두、황반구시망막신경섬유층후도이급황반구시망막후도.각측량수거간적비교채용x2검험、One-Way ANOVA급(LSD)검험.결과 당뇨병시망막개변(NDR)조시유두상방RNFL상교대조조변박,단량조간차이무통계학의의(P=0.195),miNPDR조、moNPDR화sNPDR여대조조화NDR조간차이유통계학의의(P=0.13,0.02,0.00).moNPDR화sNPDR조황반중심후도후우대조조간,차차이유통계학의의(P =0.003,0.001).NDR조、miNPDR、moNPDR화sNPDR조황반구상방RNFL균현저박우대조조(P＜0.01).결론 재조기당뇨병환자,무론시유두환시황반구균출현시망막신경섬유층변박,차기변화조우시망막미혈관병변.
Objective To observe the change of the retinal fiber layer thickness in patients at early stage of diabetes.Methods A case-control study.A total of 157 patients with diabetes,who were divided into four groups according to the degree of diabetic retinopathy in fudus photos,and 40 normal patients were examined by optical coherence tomography (OCT).The difference among the group was assessed by x2 test,One-Way ANOVA test and LSD test.Results The superior RNFL around optic nerve was not statistically thinner in NDR group than normal group (P =0.195).The superior RNFL around optic nerve was statistically thinner in miNPDR group,moNPDR group and sNPDR group (P =0.13,0.02,0.00).The thickness of fovea in both moNPDR group and sNPDR group were thicker than normal (P =0.003,0.001).In fovea,the superior RNFL was thinner in all diabetic groups (P ＜0.01).Conclusion In early stage of diabetes,the RNFL both in optic nerve and fovea were thinner,which would precede the microvascular changes.