糖化血红蛋白及视觉电生理检测在糖尿病视网膜病变早期诊断的价值

目的:研究糖尿病性视网膜病变(diabetic retinopathy,DR)时糖化血红蛋白(hemoglobin A1c,HbA1c)及视网膜振荡电位(oscillatory potentials,Op)的动态变化。方法:对确诊的2型糖尿病患者用检眼镜检查进行筛选,以眼底荧光素血管造影(fundus fluorescein angiography,FFA)进行明确分期,对各期患者在3a内定期行HbA1c测定6次,行Op检查2次,最后1次检测配合FFA检查,统计分析结果。结果:HbA1c水平控制在4.99%±0.58%为预防DR发生发展的安全参考值;HbA1c水平持续在9.77%±1.57%时,DR进展明显加快;Op总波幅下降副度<10.6±4.9μV可作为预测视网膜病变未进展的参考值;Op总波幅下降幅度>31.6±9.7μV,则可作为预测2型糖尿病患者发生DR或DR发生进展的依据。结论:HbA1c,OP结合,能预测DR的发展。

Glycosylated hemoglobin and visual electrophysiological testing in early diagnosis of diabetic retinopathy and prediction of disease progression

AIM:To study dynamic changes of glycosylated hemoglobin and retinal oscillatory potentials in diabetic retinopathy(DR) .·METHODS:Ophthalmoscope examination was used to screen patients with typeⅡ diabetes. In this study,clear phases was limited by fundus fluorescein angiography(FFA) . Each patient of three-year period regularly measured glycosylated hemoglobin six times and the retinae potentials two times. The final tests were combined with FFA,and the results were analyzed.·RESULTS:When HbA1c level was controlled between 4.99%±0.58%,it could be used as the safety reference value for prevention of occurrence and development of retinopathy;HbA1c level continued in 9.77%±1.57%,the progress of DR speeded up significantly;the total amplitude of retinal oscillatory potentials(Op) decrease <10.6±4.9μV might be taken as stable reference value;amplitude of Op overall decrease >31.6±9.7μV might be used to predict the occurrence of DR or DR progression.·CONCLUSION:Combination of HbA1c and Op can predict the development of DR.