甲襞微循环检测在糖尿病视网膜病变筛查中的应用研究

目的 研究甲襞微循环与糖尿病视网膜病变(DR)的相关性,评价甲襞微循环检测作为DR筛查新方法的敏感度和特异度.方法 选择在我院就诊的2型糖尿病患者80例,对患者进行直接检眼镜、45°眼底照相、眼底荧光素血管造影(FFA)和甲襞微循环状态检查,评价以上筛查方法与DR分期的相关性、敏感度和特异度.结果 甲襞微循环加权积分值重度异常组合并DR者明显高于轻、中度异常组,有差异性(P＜0.05);中度异常组合并DR者高于轻度异常组,但无差异性(P＞0.05).非增殖性糖尿病视网膜病变患者(NPDR)甲襞微循环各项积分值,除形态积分无差异外(P＞0.05),微血管的血液流态和襻周状态积分增殖性糖尿病视网膜病变(PDR)均高于NPDR(P＜0.05),并且PDR组细胞聚集度,襻周渗出和襻周出血均与NPDR组有差异性(P＜0.05).结论 DR与甲襞微循环改变显著相关,甲襞微循环检测是一个很实用的筛查新方法.

Research of Nailfold Microcirculation for Diabetic Retinopathy Screening

Objective To study the correlation of nailfold microcirculation and diabetic retinopathy(DR),and to evaluate the sensitivity and specificity of nailfold microcirculation examination as the new screening method. Methods 80 patients with type 2 diabetes were selected as the research objects.They were examined by the direct ophthalmoscopy,45°fundus photography,FFA and nailfold microcirculation.With FFA as the gold standard,the DR staging correlation,the sensitivity and specificity of every screening method were evaluated. Results By comparing the nailfold mocrocirculation of the two groups,PDR was significantly higher than NPDR(P<0.05).Except for the morphological integral value,there was no significant difference among the other integral values(P>0.05).PDR was significantly higher than NPDR of microvascular blood fluid states and loop circuit states(P<0.05).The blood flow speed of PDR group was significantly slower than that of PDR group(P<0.05);cell aggregation and loop circuit exudation of PDR group were higher than those of NPDR group and there was significant difference(P<0.05);bleeding value of vascular loop circuit in PDR group was also higher than that of NPDR group,but there was no significant difference(P>0.05). Conclusion There is significant difference with DR screening and nailfold microcirculation.It is a new and applicable screening method.