观察糖尿病视网膜病变早期干预治疗效果

目的观察糖尿病视网膜病变早期干预治疗的效果。方法应用视网膜电流图多焦视网膜电流图技术进行对早期糖尿病视网膜病变观察感光细胞、双极细胞、神经节细胞及视网膜血管细胞的改变,应用羟苯磺酸钙、甲钴胺、促红细胞生成素进行早期干预治疗。结果尚未出现肉眼可见的Ⅰ期糖尿病视网膜病变时,通过ERG、多焦ERG可观察到a、b波幅降低,N1、P波传导延迟,提示糖尿病视网膜病变早期既存在神经元损伤和血管功能改变,且神经元损伤早于血管细胞损伤。早期进行干预性口服羟苯磺酸钙目的降低血浆内皮素,提高降钙素,降低血管的紧张性,减少5-羟色胺、缓激肽、前列腺素和血栓素B2的合成并抑制其作用,减少红细胞和内皮细胞内的山梨醇的形成,使毛细血管内皮细胞松弛,减少微血管栓形成。应用周围神经保护剂、促红细胞生成素,产生对视网膜神经元的保护治疗。可以起到有效早期预防糖尿病视网膜病变、神经细胞和微血管细胞的凋亡,并保护血-视网膜屏障完整性。结论应用电生理检查技术,早期发现隐匿的视网膜神经元,及视网膜血管细胞的损伤,提供早期干预治疗,达到控制糖尿病视网膜病变发展,延长视网膜并发症发生,达到保护视力的目的。

Study on effect of early intervention treatment on diabetic retinopathy

OBJECTIVE To observe the effect of early intervention treatment on diabetic retinopathy.METHODS Applied multifocal electroretinogram for early diabetic retinopathy to observe the changes of photoreceptor cell,bipolar cell,neurone cell and retinal vascular cell and used calcium dobesilate,mecobalamin,erythropoietin by oral as the early treatment.RESULTS No diabetic retinopathy was found in typeⅠdiabetes.It was observed that a,b wave decreased,N1 P wave delayed,which indicated damage of neurone cell and retinal vascular cell in early diabetic retinopathy.Early treatment with calcium dobesilate was to increase calcitonin and reduce plasma endothelin,hemal tension,serotonin meanwhile,prostaglandins peptide and thrombosis.It also reduced capillary thrombosis by decreaseing sorbitol from red cell and endothelial cell.Application of peripheral nerve cryoprotectants and erythropoietin was to protect retinal neurons.All the early treatment protected the integrity of blood-retinal barrier integrity.CONCLUSION Early intervention treatment has significant effect on diabetic retinopathy protecting photoreceptor cell,bipolar cell,neurone cell and retinal vascular cell of patient with diabetic retinopathy.