Hearing loss in patients with diabetic retinopathy

With use of standard audiometric procedures, the hearing thresholds of patients with known diabetic retinopathy did not differ significantly from those of a control population group. However, use of a more subtle psychoacoustic tool--a filtered speech task--showed a definite difference in hearing acuity between the two groups.     

晚期糖尿病视网膜病变的玻璃体视网膜手术治疗预后

目的 评价玻璃体视网膜手术治疗晚期糖尿病性视网膜病变（PDR）伴黄斑脱离的临床效果。方法 回顾分析接受玻璃体视网膜手术治疗的60例6期（视网膜全脱离）PDR患者72眼的临床资料。手术方式为玻璃体切割联合或不联合晶状体摘除,术中均注入惰性气体或硅油。视网膜解剖复位的标准以黄斑复位为视网膜复位成功,黄斑未复位为复位失败。手术后行黄斑区OCT检查并随访1年。结果 手术后42眼一次性视网膜复位成功,占58.33%;30眼视网膜复位失败,占41.67%。手术后视力为无光感者3眼,占4.17%,较术前增加3眼;光感者18眼,占25.00%,较术前减少24眼;手动者26眼,占36.11%,较术前增加5眼;数指/10?cm～0.1者20眼,占27.78%,较术前增加11眼;≥0.1者5眼,占6.94%,较术前增加5眼。结论 晚期PDR伴黄斑区脱离的患者行玻璃体视网膜手术难度较大,术后解剖复位率较高,但视功能恢复较差。     

糖尿病视网膜病变的机制和细胞模型研究进展

糖尿病视网膜病变是成年人低视力和致盲的主要原因。一个合理的体外模型不仅能模拟疾病的发生发展机制,而且能减少经济投入,因此筛选和构建合适的体外模型是研究的关键。论文围绕糖尿病视网膜病变探讨了炎症反应、细胞凋亡、血管功能障碍和神经血管单元的破坏等相关机制,总结了内皮细胞、周细胞、视网膜色素上皮细胞、神经胶质细胞等建立的几种模型,以期为糖尿病视网膜病变机制研究及相应的药物研发提供有益的参考。     

The predictive value of auditory brainstem responses for diabetic retinopathy

OBJECTIVE: The purpose was to find out whether there is a relationship between the central nervous system involvement and retinopathy in diabetes mellitus. STUDY DESIGN: In a multidisciplinary clinical study, diabetic patients with and without retinopathy were examined utilising auditory brainstem response (ABR) testing, and the results were interpreted from clinical and pathophysiological point of view. PATIENTS AND METHODS: Thirty-three diabetic patients with retinopathy (study group) and 20 diabetic patients without retinopathy (control group) were included. Audiometry and ABR testing were made. The results of both groups were compared for ABR parameters. RESULTS: Audimetric results of the study and control groups were similar. In the study group, ABR testing revealed prolonged absolute and interpeak latency of the waves. The difference was significant for I-III interval (P<0.01). The amplitudes of the waves were similar in both groups and wave V amplitude was significantly diminished in the study group. Abnormal waveforms were recorded by 40 and 12.5% in the study and control groups, respectively. CONCLUSION: Retinopathy is accompanied with lower brainstem disintegration. Microangiopathy is the possible mechanism that is involved in the occurrence of retinopathy and brainstem neuropathy. ABR can help diagnose retinopathy. Better understanding the role of ABR in diagnosis and early detection of retinopathy in diabetic patients needs further study.     

糖尿病性盲患者玻璃体手术后的脱盲率及未脱盲原因分析

目的 分析因增殖性糖尿病视网膜病变(PDR)致盲行玻璃体手术后脱盲率及未脱盲的原因。方法 对110例(142眼)符合盲标准并行玻璃体手术的糖尿病视网膜病变患者的临床资料进行分析,观察术后的脱盲率并分析未脱盲的原因。结果 研究所纳入的142只盲眼中,术后脱盲91眼,脱盲率为64.1%。未脱盲的主要原因包括术前牵拉性视网膜脱离、视网膜血管严重闭塞、视神经病变、弥漫性黄斑水肿和新生血管性青光眼等。结论 玻璃体手术可以使部分糖尿病性盲的患者脱盲,而未脱盲的原因较复杂,避免糖尿病性盲的关键在于早期预防和早期治疗。     

玻璃体切除术治疗增殖性糖尿病视网膜病变疗效观察

目的评价玻璃体切除术对增殖性糖尿病视网膜病变(PDR)的疗效。方法对在我院行玻璃体切割术的156例（198眼）PDR患者资料进行回顾性分析。结果198眼术后视力改善146眼(73.74％),其中Ⅳ～Ⅴ期116眼(79.45%),Ⅵ期30眼(20.55%);32眼(16.16％)视力不变,20眼(10.10％)视力下降。术中、术后主要并发症有视网膜脱离、高眼压、玻璃体出血。结论玻璃体切割术是治疗PDR的有效手段,大部分患者视力改善;减少术中、术后并发症对该病的预后非常关键。     

玻璃体手术治疗增殖性糖尿病视网膜病变的时机和疗效

目的 探讨玻璃体切割术治疗增殖性糖尿病视网膜病变的时机和疗效。方法 回顾186例（242眼）PDR患者资料,123眼行全视网膜光凝术,119眼行玻璃体切割术,对手术时机和治疗效果进行对比分析。术后随访6～40个月。结果 PDRⅣ期、Ⅴ期患者行玻璃体切割手术后视力改善的比例为78.4%,Ⅵ期患者为43.7%;PDRⅣ期患者行全视网膜光凝术治疗后有效率为80.8%,Ⅴ期患者为58.2%;未合并玻璃体出血的Ⅴ期PDR患者,PRP治疗有效率为58.2%,而玻璃体切割术后视力改善者占78.9%。术中并发症主要是医源性裂孔,术后并发症为玻璃体再出血、视网膜脱离、新生血管性青光眼。结论 正确把握PDR患者行全 视网膜光凝术和玻璃体切割术的时机,才能提高疗效,有效地改善PDR患者的视力。     

辛润通络法治疗糖尿病视网膜病变探析

辛润通络法是叶天士根据《金匮要略》中药物的配伍特点创立的通络治法之一。糖尿病视网膜病变(Diabetic retinopathy,DR)是神经血管病变中的一类,从中医角度来看,具有气血俱伤,瘀阻液亏的特点。现今中医理论研究常将“脉络(即血管系统)”受损作为DR病理改变的重点,并在此基础上制定治疗方法,而忽视了气络(即神经-内分泌-免疫网络)的重要性。辛润通络法既可调气通络,又可养血润燥,切合了DR的病因病机。笔者旨在将DR与气络-血络系统、辛润通络治法有机结合,丰富DR的诊疗方案。     

瑞舒伐他汀联合非诺贝特对老年糖尿病视网膜病变患者血管内皮功能的影响

目的 分析瑞舒伐他汀联合非诺贝特治疗老年糖尿病视网膜病变患者时,对血清单核细胞趋化因子-1(MCP-1)、基质金属蛋白酶-9(MMP-9)、血管内皮生长因子(VEGF)水平的影响。方法 选择糖尿病视网膜病变患者140例,按入院先后顺序,以随机数字表法将患者分为瑞舒伐他汀组(单药组)和瑞舒伐他汀与非诺贝特联合治疗组(联合组)各70例。二组患者性别、年龄、体质量、血脂、血压及糖化血红蛋白水平差异无统计学意义(P>0.05)。单药组给予瑞舒伐他汀钙10 mg/d,联合组在单药组基础上给予非诺贝特胶囊100 mg/次,3次/d,观察时间为3个月。治疗前与治疗后晨空腹抽取肘静脉血,酶联免疫吸附法检测血清单核细胞趋化因子-1(MCP-1)、基质金属蛋白酶-9(MMP-9)及血管内皮生长因子(VEGF)水平的变化。结果 单药组患者治疗后与治疗前比较, MCP-1[(2.59±0.38)比(3.23±0.61)μg/L,t=2.697]、MMP-9[(47.47±5.13)比(69.38±6.28)ng/L,t=2.868]、VEGF[(125.48±8.27)比(198.47±12.63)ng/L,t=2.846];联合组患者治疗后与治疗前比较, MCP-1[1.14±0.29)比(3.17±0.53)μg/L,t=3.217]、MMP-9[(34.18±4.29)比(71.05±7.36)ng/L,t=3.163]、VEGF[(87.39±10.27)比(195.28±11.49)ng/L,t=3.352],二组患者上述指标治疗后明显减少,差异有统计学意义(P<0.05)。其中,治疗后联合组MCP-1、MMP-9、VEGF水平较单纯组减少更为显著,差异有统计学意义(P<0.05)。结论 瑞舒伐他汀钙与非诺贝特联合治疗有助于维持老年糖尿病视网膜病变患者血管内皮细胞功能稳定。