摘要
目的 观察不同时期2型糖尿病肾病（diabetic nephropathy,DN）患者眼部血流动力学变化及其与尿微量白蛋白排泄率（urinarg albumin excretion rate,UAER）的关系,探讨DM患者眼部血流动力学变化与DN的相关性.方法 168例2型糖尿病住院患者,根据UAER水平分为3组：无蛋白尿组63例,微量白蛋白组60例和蛋白尿组45例,另选择30例健康体检者作为对照组.彩色多普勒显像技术（color Doppler flow imaging,CDFI）检测其眼动脉（ophthalmic artery,OA）、和睫状后动脉（posterior ciliary artery,PCA）的收缩期峰值血流速度（peak systolic velocities,PSV）、舒张末期血流速度（end diastolic velocities,EDV）及阻力指数（resistive index,RI）,分析不同临床分期DN患者与对照组间脉络膜血流动力学参数的差异.结果 DM患者OA和PCA的PSV、EDV均显著低于对照组,RI均显著高于对照组（P＜0.05）差异均有统计学意义.微量蛋白组和蛋白尿组OA和PCA的PSV、EDV均显著低于无蛋白尿组,差异均有统计学意义,RI显著高于无蛋白尿组（P＜0.05）差异均有统计学意义.蛋白尿组OA和PCA的EDV均显著低于微量蛋白组,差异均有统计学意义,RI显著高于微量蛋白尿组（P＜0.05）差异均有统计学意义.糖尿病患者24 h UAER与OA和PCA的RI呈正相关（r =0.521,0.642,P＜0.01）,与EDV呈现负相关（r=-0.628,-0.637,P＜0.01）.结论 糖尿病患者眼部循环障碍随DN的进展而加重,提示眼部微血管病变与DN存在相关性.
Objective To investigate the change of ocular hemodynamics and its relationship with urine albumin excretion ratio in patients with type 2 diabetic nephropathy and to discuss the correlation of ocular microangiopathy with diabetic nephropathy.Methods A total of 168 hospitalized patients with type 2 diabetes were divided into three groups according to urine albumin excretion ratio：normal albuminuria group （n =63）,microalbuminuria group （n =60） and proteinuria group （n =45）,and 30 cases of healthy physical examination were chosen as control group.Color Doppler flow imaging was used to quantitate peak systolic velocity （PSV）,end diastolic velocity （EDV） and resistance index （RI） of the ophthalmic artery （OA）,the posterior ciliary artery （PCA） in the control group and all diabetic patients.Statistic software was used to analyze the hemodynamic parameters.Results Compared with the control group,PSV,EDV of OA and PCA were decreased and RI were increased in diabetic patients （P 〈0.05）.PSV,EDV of OA and PCA were decreased and RI were increased in microalbuminuria group and proteinuria group than no proteinuria group （P 〈0.05）.EDV of OA and PCA were decreased and RI were increased in proteinuria group than microalbuminuria group （P 〈0.05）.UAER were positively correlated with RI of OA and PCA （r =0.521,0.642,0.625;P 〈0.01） and negatively correlated EDV in diabetic patients （r =-0.628,-0.637,P 〈0.01）.Conclusions The ocular hemodynamics is aggravating with the pathological progress of diabetic nephropathy,suggesting the correlation between diabetic choroidopathy and diabetic nephropathy.
作者
高丽芬
路晖
Gao Lifen;Lu Hui(Department of Ophthalmology,Zibo Central Hospital,Zibo 255000,China)
出处
《中国实用眼科杂志》
2017年第8期764-766,共3页
Chinese Journal of Practical Ophthalmology
