彩色多普勒对糖尿病视网膜病变球后动脉血流动力学变化的研究

目的研究2型糖尿病患者视网膜中央动脉（CRA）、睫状后动脉（PCA）的血流动力学改变以及CRA、PCA血流参数与糖化血红蛋白（GHb）及伴随疾病高血压间的相关性。方法收集58例2型糖尿病病人的GHb及并发症等相关危险因素资料,彩色多谱勒检查病人及30例健康对照者的视网膜中央动脉（CRA）、睫状后动脉（PCA）的收缩期血流峰值速度（PSV）、舒张末期血流速度（EDV）、阻力指数（RI）,比较分析各因素与糖尿病眼底动脉病变的相关性。结果随患者视网膜病变程度的加重,CRA、PCA的PSV、EDV呈进行性下降趋势,RI呈进行性升高趋势。与健康对照组相比,糖尿病无视网膜病变组CRA的血流参数已出现改变,且组间差异有统计学意义,而PCA的PSV的组间差异也有统计学意义。相关性分析显示：CRA、PCA的EDV与GHb呈显著负相关,RI与GHb呈显著正相关;CRA的PSV、EDV以及PCA的EDV与收缩压显著负相关,PCA的RI值与收缩压显著正相关。结论糖尿病患者球后动脉血流动力学改变早于眼底检出确诊视网膜病变的出现。CRA、PCA的血流动力学参数与患者GHb及高血压伴随疾病相关。彩色多普勒超声检测球后动脉血流动力学改变是评价糖尿病视网膜及脉络膜早期病变的有效方法。

Analysis of Hemodynamic Changes of Retrobulbar Artery in Diabetic Patients by Color Doppler Flow Imaging

Objective To examine the hemodynamic changes of the central retinal artery(CRA)and short posterior ciliary artery(PCA)in patients with diabetic retinopathy(DR)by color Doppler imaging.Method Hemodynamic parameters of CRA and PCA,including peak systolic velocity(PSV),end diastolic velocity(EDV)and resistance index(RI),were examined in 30 healthy volunteers and 58 diabetic patients at different stage of diabetic retinopathy(DR)by color Doppler flow imaging(CDFI).Result Comparing with the healthy control group,blood flow velocity parameters of CRA and PCA decreased significantly and the resistance index(RI)increased significantly in diabetic patients(without or with DR).There was a negative correlation between PSV and EDV of CRA and glycosylated hemoglobin(GHb),and a positive correlation between RI and GHb.The blood pressure was negatively correlated with PSV and EDV of CRA,but positively correlated with RI of PCA.Conclusion Changes of hemodynamic parameters of CRA and PCA can be detected by color Doppler imaging.Furthermore,the hemodynamic changes correlate with the progression of DR.Detection of hemodynamic change by color Doppler is useful in the early monitoring of pathogenesis of DR.