彩色多普勒血流显像对Ⅱ型糖尿病患者眼球后血流动力学的研究

目的　探讨Ⅱ型糖尿病患者眼球后血流动力学变化与视网膜病变的发生、发展之间的关系。方法　应用彩色多普勒血流显像检测 80例Ⅱ型糖尿病患者的眼球后血流动力学改变 ,包括眼动脉 (OA)、视网膜中央动脉 (CRA)的各项参数。结果　在糖尿病视网膜病变 (DRP)发生过程的极早期阶段 ,眼底荧光造影尚未发现明显病变时 ,CRA血流速度较对照组增高 (P <0 .0 5 ) ,DRP早期阶段接近对照组 (P >0 .0 5 ) ,增殖前期、增殖期低于对照组 (P <0 .0 5 )并伴有OA舒张末期血流速度下降及阻力指数增高 ;Ⅱ型糖尿病不伴DRP或DRP早期者CRA血流速度与空腹血糖水平呈正相关 ,视网膜病变越重 ,血糖对CRA血流速度的影响越小。结论　Ⅱ型糖尿病患者的眼部血流动力学变化与DRP发生、发展之间的关系复杂 ,它反映了视网膜微循环对高血糖等全身与局部代谢异常的代偿与失代偿变化。视网膜血流供应不足在DRP的发生发展中起着重要作用

Hemodynamics of retrobulbar arteries in Patients with Type 2 Diabetes Mellitus

Objective To investigate the hemodynamic changes of retrobulbar arteries in the pathogenesis of diabetic retinopathy in type 2 diabetes mellitus. Methods The hemodynamics of ophthalmic artery (OA) and central retinal artery (CRA) were acquired by color Doppler flow imaging (CDFI) in 80 diabetes. Results In the beginning of diabetic retinopathy (DRP), even no change in fundus fluorescein angiography, the CRA velocities increased significantly higher than that of the control group (P<0.05). While in background diabetic retinopathy stage, the CRA velocities were as high as that in the control group (P>0.05). In pre-proliferate and proliferate diabetic retinopathy stages, the flow velocities decreased and became lower than that of the control group (P<0.05), together with a drop in OA diastolic velocity and a higher OA resistance index (RI).In the diabetes mellitus without DRP or with early DRP, the CRA blood velocity was related to fasting blood sugar (FBS) positively. However, the less the CRA blood velocity was influenced by the FBS level, the more severity of the DRP. Conclusion The ocular hemodynamics changes in diabetes were highly related to the onset and developing of the DRP, this reflects the influence of the metabolic compensated or decompensated disorder of the hyperglycemia on the retinal microcirculation. The insufficiency of retinal blood flow is one of the important factors in the development of DRP.