2型糖尿病患者角膜厚度和内皮细胞形态学的初步研究

目的　研究 2型糖尿病患者角膜厚度和内皮细胞形态学的变化。方法　采用角膜测厚仪和非接触式角膜内皮镜对 60例 ( 60眼 ) 2型糖尿病患者及 60例 ( 60眼 )健康志愿者的角膜厚度及内皮细胞形态进行比较研究 ;并采用逐步回归分析方法研究全身因素对角膜内皮细胞密度及角膜厚度的影响。结果　糖尿病患者较正常人角膜内皮细胞密度降低 ,细胞面积变异系数增加 ,差异有显著性 (P <0 .0 5 )。角膜厚度两组间差异无显著性。增殖性糖尿病视网膜病变患者较单纯性糖尿病视网膜病变患者角膜内皮细胞密度显著降低 (P <0 .0 5 )。糖尿病患者血浆糖化血红蛋白水平与角膜内皮细胞密度负相关 (r=-0 .761,P <0 .0 1)。无一全身因素与角膜厚度相关。结论　糖尿病患者角膜内皮细胞形态结构异常 ,且随糖尿病视网膜病变的加重而加重。糖尿病患者在内眼手术及眼外伤手术时应特别注意保护角膜内皮 ,防止角膜内皮功能失代偿。

Central corneal thickness and corneal endothelium morphology in type 2 diabetes mellitus

Objective To study the changes of central corneal thickness(CCT) and corneal endothelium morphology in type 2 diabetes mellitus. Methods The CCT and corneal endothelium morphology in 60 diabetic patients(60 eyes) and 60 healthy volunteers(60 eyes) as the age and gender matched control group were examined by pachymetry and non contact specular microscopy. Stepwise regression analysis was performed to assess the effects of systemic factors on CCT and the corneal endothelial cell density of diabetic patients. Results Compared with that in the control group, the endothelial cell density decreased, and the coefficient of variation of cell area increased significantly( P <0 05). No significance difference was found in CCT( P >0 05). Compared to patients with non proliferative diabetic retinopathy(NPDR), the patients with proliferative diabetic retinopathy(PDR) had a significant reduction in cell density( P <0 05). Stepwise regression analysis indicated that hemoglobin A(1c) value was significantly correlated with cell density, but no systemic factors were related to CCT. Conclusion There is abnormal corneal endothelium morphology in type 2 diabetes mellitus. The changes are in a severity dependent manner in PDR patients.