彩色多普勒超声技术对糖尿病视网膜病变患者视网膜血流动力学的分析研究

目的：通过彩色多普勒超声技术观察糖尿病性视网膜病变(diabeticretinitis，DR)患者血流动力学的变化。

方法：选取2014-06/2017-05于我院就诊的糖尿病(diabetes mellitus，DM)患者96例96眼，根据眼底检查结果分为A、B、C三组，A组为单纯DM患者32例32眼； B组为糖尿病合并单纯性视网膜病变(NPDR)患者32例32眼； C组为糖尿病合并增殖性视网膜病变(PDR)患者32例32眼。同时选取健康志愿者30例30眼作为对照组。采用彩色多普勒超声技术检测患者眼部CRA(视网膜中央动脉)、PCA(睫状后动脉)、OA(眼动脉)血流动力学改变情况，并探讨糖尿病患者视网膜病变程度与糖化血红蛋白(HbA1c)、空腹血糖(FBG)、糖尿病病程的关系。

结果：各组CRA、PCA、OA血流动力学指标差异均有统计学意义(P<0.05)。A组与对照组CRA、PCA、OA的PSV比较，差异均无统计学意(P>0.05)； C组CRA、PCA、OA的PSV与EDV最低、RI最高，与A、B组比较差异均有统计学意义(P<0.05)。各组HbA1c、FBG比较，差异均有统计学意义(P<0.05)。病程仅A组与C组间比较，差异有统计学意义(P<0.05)。

结论：彩色多普勒超声监测DM患者CRA、PCA、OA血流动力学改变，可了解患者视网膜的血流变化，对DM患者视网膜病变的预防和治疗有重要价值。

Analysis of retinal hemodynamics in patients with diabetic retinopathy by color Doppler ultrasonography

AIM: To analyze the changes of retinal hemodynamics in patients with diabetic retinopathy(DR)by color Doppler ultrasonography.

METHODS: Totally 96 patients(96 eyes)with diabetes mellitus(DM)treated in our hospital from June 2014 to May 2017 were selected and divided into A, B, C three groups. Group A consisted of 32 DM patients(32 eyes), Group B with 32 cases(32 eyes)of non-proliferative diabetic retinopathy(NPDR), Group C 32 cases(32 eyes)of proliferative diabetic retinopathy(PDR), and 30 healthy volunteers(30 eyes)were set as control group. All patients'' the central retinal artery(CRA), posterior ciliary artery(PCA), ophthalmic artery(OA)hemodynamic changes were detected by color Doppler ultrasound. And the relation of HbA1c and FBG with diabetic lesion degree were studied.

RESULTS: The hemodynamic indexes of CRA, PCA and OA in each group were statistically significant(P<0.05). The difference of PSV of CRA, PCA and OA in Group A and control group was not statistically significant(P>0.05). The PSV and EDV of CRA, PCA and OA in Group C were the lowest, and the RI was the highest, which had a significant difference between Group A and B(P<0.05). HbA1c and FBG in each group showed statistical significance(P<0.05). Course of disease in Group A and Group C only showed significantly different(P<0.05).

CONCLUSION: Color Doppler ultrasound monitoring changes of CRA, PCA, OA hemodynamics in diabetic patients can bring us more understand in retinal blood flow, and play a vital role in prevention and treatment of diabetic retinopathy.