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肾上腺素对糖尿病性白内障患者角膜内皮细胞的影响
引用本文:刘婕,赵娴,邵丽静,左建霞,王姝蕊,马新玲. 肾上腺素对糖尿病性白内障患者角膜内皮细胞的影响[J]. 河北医药, 2014, 0(3): 336-338
作者姓名:刘婕  赵娴  邵丽静  左建霞  王姝蕊  马新玲
作者单位:河北省石家庄市第一眼科医院,050011
摘    要:
目的:观察不同浓度肾上腺素对糖尿病并发白内障患者行超声乳化白内障吸除术后角膜内皮细胞的影响,探讨术中应用肾上腺素的合理浓度。方法选取2013年1至6月糖尿病性白内障患者90例(90眼),随机分为3组,每组30眼,分别于灌注液中加入0.1 ml、0.2 ml及0.5 ml肾上腺素,均行白内障超声乳化吸除联合人工晶体植入手术,于术前及术后1周采用非接触型角膜内皮显微镜行角膜内皮细胞密度及六角形细胞比例检查。结果3组术前角膜内皮细胞密度及六角形细胞比例比较,差异无统计学意义( P >0.05)。3组术后1周角膜内皮细胞密度分别为(2494±177;286)/mm 2,(2428±177;353)/mm 2,(2380±177;375)/mm 2,六角形细胞比例分别为(49±177;13)/mm 2,(45±177;13)/mm 2,(43±177;14)/mm 2。3组术后角膜内皮细胞密度及六角形细胞比例均较术前减少,其差异均有统计学意义( P<0.05)。术后3组间比较,随加入肾上腺素浓度增加,角膜内皮细胞密度及六角形细胞比例逐渐下降,但差异无统计学意义( P >0.05)。结论糖尿病性白内障患者角膜内皮细胞对手术损伤及肾上腺素毒性损害的耐受性降低,在有效维持术中瞳孔散大状态的同时,选用浓度较低的肾上腺素,以减少对角膜内皮细胞的损害。

关 键 词:白内障  糖尿病  超声乳化手术  角膜内皮细胞  肾上腺素

Effects of adrenalin on corneal endothelium in patients with diabetic cataract
Affiliation:LIU Jie,ZHAO Xian,SHAO Lijing,et al.The First Hospital of Shijiazhuang City, Shijiazhuang 050011, China
Abstract:
Objective To investigate the effects of adrenalin on corneal endothelium after phacoemulsification in patients with diabetic cataract and to explore the clinical suitable concentration of adrenalin during the operation .Methods Ninety patients with diabetic cataract (90 eyes) who were enrolled in our hospital from January 2013 to June 2013 were randomly divided into three groups,with 30 eyes in each group.These patients received phacoemulsification after the irrigation solution was added with different concentrations of adrenalin (0.1ml,0.2ml,0.5ml).At 1 week before and after the operation the corneal endothelial density and the percentage of hexagonal cells were detected by non -contact corneal endothelium microscope.Results There were no significant differences in the preoperative corneal endothelial cell density and percentage of hexagonal cells among the three groups ( P >0.05).However one week after surgery ,the cell densities in 0.1ml group, 0 .2 ml group and 0.5 ml group were (2493.52 ±285.32)/mm 2 ,(2428.14 ±353.53)/mm 2 ,(2379.51 ±375.13)/mm 2 , respectively,and the percentage of hexagonal cells was (48.88 ±13.13)/mm 2 , (44.77 ±12.67 )/mm 2 , ( 43.44 ± 13.99)/mm 2 ,respectively.Both cell density and percentage of hexagonal cells one week after surgery were significantly lower than those before operation, there were significant differences among three groups ( P <0.05).After operation the two detection parameters in three groups were gradually decreased with the increase of adrenalin concentration ,but there were no significant differences among three groups ( P >0.05).Conclusion The tolerance of corneal endothelial cell to surgery injure and adrenalin toxicity is decreased in patients with diabetic cataract .The lower concentration of adrenalin should be used in phacoemulsification so as to reduce the damage to corneal endothelial cell during maintaining mydriasis state .
Keywords:cataract  diabetes mellitus  phacoemulsification  corneal endothelium  epinephrine
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