彩色多普勒超声对糖尿病眼底微循环障碍及其慢性并发症评估的临床意义

目的:探讨彩色多普勒超声对2型糖尿病患者视网膜及脉络膜的微循环改变评估的临床意义。方法:将我院2型糖尿病患者分为糖尿病不伴视网膜病变组(NDR组)、非增殖性视网膜病变组(NPR组)、增殖性视网膜病变组(PR组)和对照组。应用彩色多普勒和脉冲多普勒成像技术对视网膜睫状后短动脉(PCA)、中央动脉(CRA)的血流动力学情况进行监测,同时检测其空腹血糖、糖化血红蛋白等生化指标。结果:NDR组动脉频谱呈S1、S2、S3三峰双切迹,NPR组和PR组为S峰降低,波形圆钝呈半圆形,D峰低平、宽大;4组间CRA的收缩期峰值流速(PSV)、舒张末期血流速度(EDV)和RI差异有统计学意义(F=13.21,11.34,9.85,P<0.05);CRA的PSV、EDV与空腹血糖(FBG)、糖化血红蛋白(HbA1c)、胰岛素抵抗指数、24h尿蛋白呈正相关关系,CRA的RI与FBG、HbA1c、胰岛素抵抗指数、24h尿蛋白呈负相关关系(P<0.05)。结论:CDFI能监测眼底血流动力学参数的变化,评价眼底微循环的变化,早期发现糖尿病眼底病变。

The clinical significance of color Doppler in eye ground microcirculation and the chronic complications examination to patients with diabetes

Objective：To investigate clinical significance of color doppler examination to retina and choroidal microcirculation change in patients with type 2diabetes.Methods：The patients with type 2diabetes were divided into NDR group,NPR group,PR group and control group.The color doppler and pulse doppler imaging technology were applied to test dynamics condition of short artery of retinal after ciliary,central artery blood flow.The fasting blood glucose,glycosylated hemoglobin and biochemical indexes were tested.Results：There was three peak of S1,S2,S3and double incisure of NDR group by artery spectrum and there was reduced of S peak and waveform round blunt a semicircle of D peak of NPR group and PR group.The difference among the four groups of PSV,EDV and RI of CRA was significant（F=13.21,11.34,9.85,P〈0.05）.There were positive correlation between the PSV,EDV of CRA and FBG,HbA1c,insulin resistance index,24hurine protein.There were negative correlation between the RI and FBG,HbA1c,insulin resistance index,24hurine protein（P〈0.05）.Conclusion：The flow imaging by color doppler can get fundus hemodynamic parameters change effectively to observe the change of fundus microcirculation and can accurately reflect the possibility of various complications of diabetes.