国际眼科杂志
國際眼科雜誌
국제안과잡지
International Eye Science
2015年
11期
1938-1941
,共4页
STCA%球后动脉%彩色多普勒超声%血流动力学%糖尿病视网膜病变%相关因素
STCA%毬後動脈%綵色多普勒超聲%血流動力學%糖尿病視網膜病變%相關因素
STCA%구후동맥%채색다보륵초성%혈류동역학%당뇨병시망막병변%상관인소
supratrochlear artery%posterior ball related artery%color Doppler ultrasound%hemodynamics%diabetic retinopathy%related factors
目的：利用彩色多普勒超声检测2型糖尿病视网膜病变( diabetic retinopathy, DR )患者的滑车上动脉( supratrochlear artery,STCA)与球后相关动脉的血流动力学变化,并分析影响2型糖尿病DR发生发展的因素,以为糖尿病患者早期发现DR发病趋势、预防DR发生、采取有效干预措施阻止DR进展提供依据。方法：选取2型糖尿病患者106例106眼,区分为糖尿病视网膜病变组( DR组)56例56眼右眼、糖尿病无视网膜病变组( NDR组)50例50眼右眼,选取同期于我院门诊体检的健康志愿者40例40眼右眼作为对照组( HC组)；彩色多普勒超声检测所有研究对象的STCA、视网膜中央动脉( central retinal artery, CRA )、睫状后动脉( posterior ciliary artery,PCA)的血流动力学变化,观察糖尿病患者血流频谱形态与血流动力学参数收缩期峰值血流速( peak systolic blood flow velocity,PSV)、舒张末期血流速度( end diastolic blood flow velocity, EDV )与血管阻力指数( vascular resistance index,RI)的改变情况；检测所有研究对象空腹血糖( fasting blood glucose,FBG)、血清总胆固醇( total cholesterol,TC)、甘油三酯( Triglyceride,TG)、低密度脂蛋白胆固醇(low density lipoprotein-cholesterol,LDL-C)、高密度脂蛋白胆固醇( high density lipoprotein-cholesterol, HDL-C )；记录DR组与NDR组的糖尿病病程、体重指数( body mass index,BMI)、既往病史(高血压、糖尿病、高血脂等)、家族遗传病史、吸烟饮酒史,对相关因素做非条件Logistic多因素回归分析。结果：在血流频谱形态方面, DR组与NDR组均发生了较明显的频谱形态改变；在血流动力学参数方面, STCA、CRA、PCA的 PSV、EDV 在 CH组、NDR 组、DR 组依次下降,RI依次上升；NDR组、DR组眼部动脉各血流参数值与HC组相比差异均有统计学意义(P<0.05),DR组STCA、CRA、PCA的PSV、EDV、RI与NDR组相比较,差异有统计学意义(P<0.05)；在DR发生发展相关因素方面,DR组与NDR组相比较,糖尿病病程、高血压病史与高血脂病史例数、舒张压、FBG、TG、LDL-C的差异有统计学意义( P<0.05)。结论：对于糖尿病患者,超声检测血流动力学可作为早期预防DR、早期发现DR的主要手段,视网膜发生明显病变之前眼部血管血流动力学即可发生异常改变,且其改变程度与视网膜病变程度呈正相关, DR的发生发展与血糖、血压、血脂水平以及糖尿病病程等相关因素有密切关系。
目的：利用綵色多普勒超聲檢測2型糖尿病視網膜病變( diabetic retinopathy, DR )患者的滑車上動脈( supratrochlear artery,STCA)與毬後相關動脈的血流動力學變化,併分析影響2型糖尿病DR髮生髮展的因素,以為糖尿病患者早期髮現DR髮病趨勢、預防DR髮生、採取有效榦預措施阻止DR進展提供依據。方法：選取2型糖尿病患者106例106眼,區分為糖尿病視網膜病變組( DR組)56例56眼右眼、糖尿病無視網膜病變組( NDR組)50例50眼右眼,選取同期于我院門診體檢的健康誌願者40例40眼右眼作為對照組( HC組)；綵色多普勒超聲檢測所有研究對象的STCA、視網膜中央動脈( central retinal artery, CRA )、睫狀後動脈( posterior ciliary artery,PCA)的血流動力學變化,觀察糖尿病患者血流頻譜形態與血流動力學參數收縮期峰值血流速( peak systolic blood flow velocity,PSV)、舒張末期血流速度( end diastolic blood flow velocity, EDV )與血管阻力指數( vascular resistance index,RI)的改變情況；檢測所有研究對象空腹血糖( fasting blood glucose,FBG)、血清總膽固醇( total cholesterol,TC)、甘油三酯( Triglyceride,TG)、低密度脂蛋白膽固醇(low density lipoprotein-cholesterol,LDL-C)、高密度脂蛋白膽固醇( high density lipoprotein-cholesterol, HDL-C )；記錄DR組與NDR組的糖尿病病程、體重指數( body mass index,BMI)、既往病史(高血壓、糖尿病、高血脂等)、傢族遺傳病史、吸煙飲酒史,對相關因素做非條件Logistic多因素迴歸分析。結果：在血流頻譜形態方麵, DR組與NDR組均髮生瞭較明顯的頻譜形態改變；在血流動力學參數方麵, STCA、CRA、PCA的 PSV、EDV 在 CH組、NDR 組、DR 組依次下降,RI依次上升；NDR組、DR組眼部動脈各血流參數值與HC組相比差異均有統計學意義(P<0.05),DR組STCA、CRA、PCA的PSV、EDV、RI與NDR組相比較,差異有統計學意義(P<0.05)；在DR髮生髮展相關因素方麵,DR組與NDR組相比較,糖尿病病程、高血壓病史與高血脂病史例數、舒張壓、FBG、TG、LDL-C的差異有統計學意義( P<0.05)。結論：對于糖尿病患者,超聲檢測血流動力學可作為早期預防DR、早期髮現DR的主要手段,視網膜髮生明顯病變之前眼部血管血流動力學即可髮生異常改變,且其改變程度與視網膜病變程度呈正相關, DR的髮生髮展與血糖、血壓、血脂水平以及糖尿病病程等相關因素有密切關繫。
목적：이용채색다보륵초성검측2형당뇨병시망막병변( diabetic retinopathy, DR )환자적활차상동맥( supratrochlear artery,STCA)여구후상관동맥적혈류동역학변화,병분석영향2형당뇨병DR발생발전적인소,이위당뇨병환자조기발현DR발병추세、예방DR발생、채취유효간예조시조지DR진전제공의거。방법：선취2형당뇨병환자106례106안,구분위당뇨병시망막병변조( DR조)56례56안우안、당뇨병무시망막병변조( NDR조)50례50안우안,선취동기우아원문진체검적건강지원자40례40안우안작위대조조( HC조)；채색다보륵초성검측소유연구대상적STCA、시망막중앙동맥( central retinal artery, CRA )、첩상후동맥( posterior ciliary artery,PCA)적혈류동역학변화,관찰당뇨병환자혈류빈보형태여혈류동역학삼수수축기봉치혈류속( peak systolic blood flow velocity,PSV)、서장말기혈류속도( end diastolic blood flow velocity, EDV )여혈관조력지수( vascular resistance index,RI)적개변정황；검측소유연구대상공복혈당( fasting blood glucose,FBG)、혈청총담고순( total cholesterol,TC)、감유삼지( Triglyceride,TG)、저밀도지단백담고순(low density lipoprotein-cholesterol,LDL-C)、고밀도지단백담고순( high density lipoprotein-cholesterol, HDL-C )；기록DR조여NDR조적당뇨병병정、체중지수( body mass index,BMI)、기왕병사(고혈압、당뇨병、고혈지등)、가족유전병사、흡연음주사,대상관인소주비조건Logistic다인소회귀분석。결과：재혈류빈보형태방면, DR조여NDR조균발생료교명현적빈보형태개변；재혈류동역학삼수방면, STCA、CRA、PCA적 PSV、EDV 재 CH조、NDR 조、DR 조의차하강,RI의차상승；NDR조、DR조안부동맥각혈류삼수치여HC조상비차이균유통계학의의(P<0.05),DR조STCA、CRA、PCA적PSV、EDV、RI여NDR조상비교,차이유통계학의의(P<0.05)；재DR발생발전상관인소방면,DR조여NDR조상비교,당뇨병병정、고혈압병사여고혈지병사례수、서장압、FBG、TG、LDL-C적차이유통계학의의( P<0.05)。결론：대우당뇨병환자,초성검측혈류동역학가작위조기예방DR、조기발현DR적주요수단,시망막발생명현병변지전안부혈관혈류동역학즉가발생이상개변,차기개변정도여시망막병변정도정정상관, DR적발생발전여혈당、혈압、혈지수평이급당뇨병병정등상관인소유밀절관계。
Abstract? AlM: To observe hemodynamic changes of supratrochlear artery ( STCA ) and posterior ball related artery in type 2 diabetic retinopathy ( DR ) by color Doppler ultrasound detection, analyze the occurrence and development of related factors, and provide the evidences to find the DR incidence trends at early stage, prevent the occurrence of DR and adopt effective interventions to prevent progression of DR.?METHODS:A total of 106 cases (106 eyes) with type 2 diabetes mellitus were divided into DR group ( 56 eyes of 56 cases ) , non-diabetic retinopathy group ( NDR group, 50 eyes of 50 cases) , healthy volunteers were selected in our hospital outpatient medical examination in 40 cases (40 eyes) as control group ( HC group). Color Doppler ultrasound was used to detect the hemodynamic changes of STCA, central retinal artery ( CRA ) , posterior ciliary artery ( PCA ) of all research subjects. The changes of blood spectrum morphology and hemodynamics parameters including peak systolic diastolic blood flow velocity ( PSV ) , end diastolic blood flow velocity ( EDV ) and vascular resistance index ( Rl ) in diabetics were observed. Fasting blood glucose ( FBG ) , serum total cholesterol ( TC ) , triglyceride ( TG ) , low density lipoprotein-cholesterol ( LDL-C) , high density lipoprotein-cholesterol ( HDL - C ) in all research subjects were detected. The duration of diabetes, body mass index ( BMl ) , past medical history ( hypertension, diabetes, hyperlipidemia, etc. ) , family genetic history, smoking and drinking history were recorded. Non - conditional Logistic regression analysis was used to analyze the related factors.?RESULTS: The results showed that the changes of blood spectrum morphology in DR and NDR group were significant. ln terms of hemodynamic parameters, STCA, CRA, PCA, PSV, EDV decreased sequentially and Rl increased sequentially in the CH and NDR, DR group. Compared the eye artery hemodynamic parameters of DR and NDR group with HC group, the differences were statistically significant ( P < 0. 05 ). The differences on STCA, CRA PCA, PSV, EDV, Rl between DR and NDR group had statistical significance (P<0. 05). ln aspect of the occurrence and development of related factors, diabetes duration, hypertension history, the number of cases with hyperlipidemia history, diastolic blood pressure, fasting blood glucose, triglyceride, and low density lipoprotein cholesterol of DR group were statistically different with NDR group (P<0. 05).? CONCLUSlON: For patients with diabetes, hemodynamics ultrasonic detection can be used as the principal means of early prevention and detection of DR. Hemodynamic ocular vascular abnormalities can occur before the retina obvious lesions, and its change degree is positively correlated with retinal lesions. Blood glucose, blood pressure, blood lipid level and duration of diabetes and other related factors are closely related to the occurrence and development of DR.
