眼轴长对非增殖性糖尿病视网膜病变眼部血流动力学影响
안축장대비증식성당뇨병시망막병변안부혈류동역학영향
Effects to the hemodynamic of eye that Axial length of non-proliferative diabetic retinopathy
  • 万方数据
    中国实用眼科杂志 중국실용안과잡지
    Chinese Journal of Practical Ophthalmology
    2015年 7期 760-764 ,共5页

    薛尚才%王秀兰%李惠荣%孙建玲

    설상재%왕수란%리혜영%손건령

    糖尿病视网膜病变%眼轴长%血流动力学 糖尿病視網膜病變%眼軸長%血流動力學
    당뇨병시망막병변%안축장%혈류동역학
    Diabetic retinopathy%Axial length%Hemodynamic
    目的 观察眼轴轴长对非增殖性糖尿病视网膜病变(NPDR)眼部血流动力学的影响.方法 前瞻性临床研究.对2012年1月至2013年12月在甘肃省第二人民医院眼科及内分泌科住院的糖尿病及DR患者248例(248只眼)纳入研究.所有患者均行荧光素眼底血管造影(FFA))和光相干断层扫描(OCT)检查.排除中心视网膜有明显水肿、出血、渗出的其它眼底病变者.采用眼科A、B超测量眼球轴长,将眼轴长分为三组:22～24 mm组(正常组),24～26 mm组(长眼轴组),26 mm以上组(超长眼轴组).各组病例均进行眼部彩色多普勒血流成像技术(CDFI)指标及FFA眼底血管充盈指标的检查并对各项指标进行比对,观察不同眼轴轴长患者的血流动力学指标的差异性.结果 正常眼轴组与长眼轴组比较,长眼轴组眼动脉(OA)的收缩期峰值速度(PSV) (cm/s)无明显变化(F=1.265,P=0.20)、视网膜中央动脉(CRA)的PSV (cm/s)较低(F=4.289,P=0.02),睫状后短动脉(PCA)的PSV (cm/s)较高(F =4.595,P=0.01),搏动指数(PI) (F =4.258、4.682、4.596,P =0.02、0.01、0.01)及阻力指数(RI)F=4.196、4.658、3.652,P=0.02、0.01、0.03)相对较低,差异均有统计学意义(P＜0.05).正常眼轴组与超长眼轴组比较,超长眼轴组OA、CRA及PCA的PSV (F =7.589、9.574、8.365,P=0.00、0.00、0.00)高;RI (F =11.982、13.584、10.983,P=0.00、0.00、0.00) PI (F =13.654、14.652、12.368,P=0.00、0.00、0.00)低,差异有统计学意义(P ＜0.005).长眼轴组与超长眼轴组比较,超长眼轴组组OA的PSV (cm/s)较快,但两者比较无统计学意义(F =2.184,P=0.07)、CRA的PSV (cm/s)较低(F =4.679,P=0.01),PCA的PSV (cm/s)较高(F =3.452,P=0.04)、PI (F =3.886、3.952、12.362,P=0.03、0.03、0.00)及RI相对较低(F=4.686、4.359、4.685,P=0.01、0.02、0.01),差异均有统计学意义(P＜0.05).眼轴正常组臂-视网膜循环时间平均为(12.94±0.46)s,视网膜A-V荧光充盈期平均为(13.56±2.04)s;长眼轴组臂-视网膜循环时间平均为(10.42±0.51)s,视网膜A-V荧光充盈期平均为(9.15±1.36)s;超长眼轴组臂-视网膜循环时间平均为(10.36±0.64)s,视网膜A-V荧光充盈期平均为(6.36±1.15)s.三组数据比较并经统计学处理,臂-视网膜循环时间三组间差异无统计学意义(F=1.289,P=0.252);长眼轴组与眼轴正常组比较眼底血管充盈时间变快但差异无统计学意义(F =3.897,P=0.056);超长眼轴组与眼轴正常组比较眼底血管充盈时间变快(F =108.863,P=0.000),超长眼轴组与长眼轴组比较眼底血管充盈时间变快(F=175.516,P=0.000),差异均有统计学意义.结论 糖尿病视网膜病变眼轴长度与眼部血流动力学指标有着明显的相关性.
    목적 관찰안축축장대비증식성당뇨병시망막병변(NPDR)안부혈류동역학적영향.방법 전첨성림상연구.대2012년1월지2013년12월재감숙성제이인민의원안과급내분비과주원적당뇨병급DR환자248례(248지안)납입연구.소유환자균행형광소안저혈관조영(FFA))화광상간단층소묘(OCT)검사.배제중심시망막유명현수종、출혈、삼출적기타안저병변자.채용안과A、B초측량안구축장,장안축장분위삼조:22～24 mm조(정상조),24～26 mm조(장안축조),26 mm이상조(초장안축조).각조병례균진행안부채색다보륵혈류성상기술(CDFI)지표급FFA안저혈관충영지표적검사병대각항지표진행비대,관찰불동안축축장환자적혈류동역학지표적차이성.결과 정상안축조여장안축조비교,장안축조안동맥(OA)적수축기봉치속도(PSV) (cm/s)무명현변화(F=1.265,P=0.20)、시망막중앙동맥(CRA)적PSV (cm/s)교저(F=4.289,P=0.02),첩상후단동맥(PCA)적PSV (cm/s)교고(F =4.595,P=0.01),박동지수(PI) (F =4.258、4.682、4.596,P =0.02、0.01、0.01)급조력지수(RI)F=4.196、4.658、3.652,P=0.02、0.01、0.03)상대교저,차이균유통계학의의(P＜0.05).정상안축조여초장안축조비교,초장안축조OA、CRA급PCA적PSV (F =7.589、9.574、8.365,P=0.00、0.00、0.00)고;RI (F =11.982、13.584、10.983,P=0.00、0.00、0.00) PI (F =13.654、14.652、12.368,P=0.00、0.00、0.00)저,차이유통계학의의(P ＜0.005).장안축조여초장안축조비교,초장안축조조OA적PSV (cm/s)교쾌,단량자비교무통계학의의(F =2.184,P=0.07)、CRA적PSV (cm/s)교저(F =4.679,P=0.01),PCA적PSV (cm/s)교고(F =3.452,P=0.04)、PI (F =3.886、3.952、12.362,P=0.03、0.03、0.00)급RI상대교저(F=4.686、4.359、4.685,P=0.01、0.02、0.01),차이균유통계학의의(P＜0.05).안축정상조비-시망막순배시간평균위(12.94±0.46)s,시망막A-V형광충영기평균위(13.56±2.04)s;장안축조비-시망막순배시간평균위(10.42±0.51)s,시망막A-V형광충영기평균위(9.15±1.36)s;초장안축조비-시망막순배시간평균위(10.36±0.64)s,시망막A-V형광충영기평균위(6.36±1.15)s.삼조수거비교병경통계학처리,비-시망막순배시간삼조간차이무통계학의의(F=1.289,P=0.252);장안축조여안축정상조비교안저혈관충영시간변쾌단차이무통계학의의(F =3.897,P=0.056);초장안축조여안축정상조비교안저혈관충영시간변쾌(F =108.863,P=0.000),초장안축조여장안축조비교안저혈관충영시간변쾌(F=175.516,P=0.000),차이균유통계학의의.결론 당뇨병시망막병변안축장도여안부혈류동역학지표유착명현적상관성.
    Objective To observe the effects of the hemodynamic of eye for axial length of non-proliferative diabetic retinopathy.Methods A prospective study.Patients with Diabetes and DR of hospitalized 248 cases (248 eyes) in Department of Ophthalmology and Endocrinology were included in the study.All patients underwent Fluorescence Fundus Angiography (FFA) and optical coherence tomography (OCT) examination.Patients were excluded with central retinal edema,hemorrhage,retinal exudates,and other diseases.Eye axial length was measured using type A ultrasonic diagnostic apparatus,and were divided into three groups:22-24 mm group (normal group),24-26 mm group (group axial length),26 mm or more groups (long axial group).Each group of patients underwent eye color Doppler flow imaging (CDFI) check indicators and FFA retinal vascular filling indicators,the indicators for comparison,the different hemodynamic parameters in patients with axial shaft length differences were observed.Results Normal axial group were compared with the axial extension,OA group axial length of PSV (crn/s) no significant change (F =1.265,P =0.20),CRA 's PSV (cm/s) lower (F =4.289,P =0.02),PCA's PSV (cm/s) higher (F =4.595,P =0.01),PI(F =4.258,4.682,4.596,P =0.02,0.01,0.01) and RI(F =4.196,4.658,3.652,P =0.02,0.01,0.03) was relatively low,differences were statistically significant (P ＜0.05).Normal group with long axial group,Long axial group OA,CRA and PCA of PSV (F =7.589,9.574,8.365,P =0.00,0.00,0.00) High;RI(F =11.982,13.584,10.983,P =0.00,0.00,0.00) PI(F =13.654,14.652,12.368,P =0.00,0.00,0.00) was low,the difference was statistically significant (P ＜0.005).Often long axial group compared with long axial group,long axial group of OA PSV (cm/s) faster,but no significant difference between the two (F =2.184,P =0.07),CRA's PSV (crn/s) lower (F =4.679,P =0.01),PCA of PSV (cm/s) higher (F =3.452,P =0.04),PI (F =3.886,3.952,12.362,P =0.03,0.03,0.00) and RI(F =4.686,4.359,4.685,P =0.01,0.02,0.01) was relatively low,the differences were statistically significant (P ＜0.05).Axial normal arm-retinal circulation time averaged 12.94 ± 0.46s,retinal AV fluorescence filling for an average of 13.56 ± 2.04s;Long axial group arm-retinal circulation time averaged 10.42 ± 0.51s,retinal AV fluorescence filling for an average of 9.15 ± 1.36s;Long axial group arm-retinal circulation time averaged 10.36 ± 0.64s,retinal AV fluorescence filling for an average of 6.36 ± 1.15s.Comparison of the three groups and the statistical treatment,arm-retinal circulation time was no significant difference (F =1.289,P =0.252);axial length of vascular filling time faster than the normal group,showed no significant difference (F =3.897,P =0.056);vascular filling time of Long axial group faster than the normal group(F =108.863,P =0.000),vascular filling time of long axial group faster than length axial group (F =175.516,P =0.000).Conclusions There is a clear correlation between axial length and ocular hemodynamics in patients with diabetic retinopathy.
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