糖尿病视网膜病变的彩色多普勒研究

本文应用彩色多普勒技术检测72例Ⅱ型糖尿病（DM）患者的球后血流动力学改变，包括眼动脉（OA）、视网膜中央动脉（CRA）。结果显示在糖尿病性视网膜病变（DR）发生过程的极早期阶段、眼底荧光造影尚未发现明显病变时，CRA血流速度较对照组增高（P＜0．05），背景型DR早期阶段接近对照组（p＞0．05），增殖前期、增殖期低于对照组（p＜0．05）并伴有OA舒张未期血流速度下降及阻力指数增高；DM不伴DR者或DR早期CRA血流速度与空腹血糖水平呈正相关，视网膜病变越重血糖水平对CRA血流速度的影响越小。提示DM患者的眼部血流动力学变化与DR发生、发展之间的关系是相当复杂的；它反映了视网膜微循环对高血糖等全身与局部代谢异常的代偿与失代偿变化。

A CDFI Research of the Diabetic Retinopathy

The ophthalmic artery's (OA) and central retinal artery's (CRA) hemodynamics were studied with CDFI technique in 72 diabetes mellitus cases. In the very early stage of the course of diabetic retinopathy(DR) even no slight pathological change was able to be observed by the fundus fluorescein angiography, the blood flow of CRA was already increased, higher than that in the control group (p<0. 05), while in back ground diabetic retinopathy stage, the blood flow velocity of CRA was almost as high as that in the control group(p>0. 05), but in pre-proliferative and proliferative diabetic retinopathy stages the blood flow was lower than that in the control group (p<0. 05), accompanied by the lower OA Vmin and a higher OA RI. In the DM patients without DR or with early DR the blood flow of CRA was correlated to fasting blood sugar (FBS) positively. At this stage the severe the DR is, the less is the level of FBS influenced the blood flow velocity in CRA. These implied that the relationship of the change in ocular hemodynamics in the DM patients and the onset and developing of the DR were quite complex, and revealed that the metabolic disorder of the hyperglycemia was compensated and decompensated by the retinal microcirculation.