彩色多普勒超声对糖尿病患者视网膜中央动脉和睫状动脉血流动力学的研究

目的:研究糖尿病患者视网膜中央动脉(CRA)、睫状动脉(PCA)的血流变化规律以及视网膜中央动脉血流参数与糖化血红蛋白(GHb)间的相关性。材料与方法:彩色多普勒超声检测67例(67只右眼)糖尿病患者和40例正常对照者的CRA、PCA的收缩期血流峰值速度(PSV)、舒张末期血流速度(EDV)、阻力指数(RI),同时检测患者GHb水平,分析CRA血流参数与GHb的关系。结果:糖尿病各组随病情的加重,CRA、PCA的血流速度呈逐渐减低趋势,RI呈增高趋势;且在无视网膜病变时就存在眼血流动力学的异常,CRA改变明显于PCA;GHb与CRA血流速度呈负相关,与RI呈正相关。结论:在无视网膜病变时,糖尿病患者不仅视网膜而且脉络膜都表现出血流动力学的异常,GHb水平与CRA血流参数有密切的相关性。

Study the hemodynamics of central retinal artery and posterior ciliary artery in diabetic retinopathy with color Doppler ultrasonography

Objective: To study the hemodynamics of posterior ciliary artery(PCA) and central retinal artery(CRA) in diabetic retinopathy(DR) with color Doppler ultrasonography and the correlation between glycohemoglobin(GHb) and hemodynamics. Methods: We measured the peak systolic velocities(PSV), the end diastolic velocities(EDV), the resistive index(RI) of CRA and PCA with color Doppler ultrasonography and GHb in 67 patients with diabetes and 40 normal volunteers, the correlation between GHb and hemodynamics were analysed. Result: Reduced blood flow velocity and increased resistance of CRA and PCA was found in patients with diabetes and appeared to become further reduce in PSV, EDV and increase in RI with the progression of retinopathy. The alteration of CRA has statistically significance compared to PCA. The hemodynamic alteration of CRA and PCA appeared before retinopathy. The GHb has positive correlation with blood flow velocity and correlation with RI. Conclusion: Reduced blood flow velocity and increased resistance were the characteristics of ophthalmic hemodynamics in diabetic retinopathy. The alteration of CRA hemodynamics correlated with GHb significantly.