糖化血红蛋白水平对糖尿病患者白内障术后黄斑区视网膜厚度的影响

目的：：探讨糖化血红蛋白(HbA1c)水平对白内障术后黄斑区视网膜厚度的影响。方法：选取2013-01/2015-01在我院眼科行白内障手术的患者121例160眼,分为正常对照组40例50眼和糖尿病组81例110眼,其中糖尿病组分为低HbA1 c组( HbA1 c≤7.0％)和高HbA1 c组( HbA1 c>7.0％)。采用光学相干断层扫描仪( OCT )于白内障摘除术前、术后1 mo进行黄斑中心凹视网膜厚度、黄斑总容积的检查。分析 HbA1 c值与黄斑区视网膜厚度的关系。结果：糖尿病组患者白内障术前、术后1 mo黄斑中心凹视网膜厚度与正常组比较差异有统计学意义(P<0.05),且糖尿病组的厚。低 HbA1 c 组与高 HbA1 c 组术前、术后1 mo黄斑中心凹视网膜厚度及黄斑区总容积比较差异均有统计学意义( P<0.05)。低HbA1 c组术前、术后1 mo黄斑中心凹视网膜厚度均比正常组厚,但差异无统计学意义(P>0.05)。 HbA1c 与术前黄斑中心凹视网膜厚度(r=0.254,P<0.01)、术前黄斑区容积(r=0.276,P<0.01)、术后黄斑中心凹视网膜厚度(r=0.349,P<0.01)、术后黄斑总容积呈正相关(r=0.286,P<0.01)。结论：HbA1 c与糖尿病患者白内障术后黄斑区视网膜厚度呈正相关。术前HbA1 c高于7.0％的白内障患者,应积极随访黄斑区视网膜厚度,及时干预,保护患者视功能。

Effect of HbA1c for macular retinal thickness after phacoemulsification in diabetic patients

AIM: To investigate the infIuence of gIycosyIated hemogIobin ( HbA1c) IeveIs on macuIar retinaI thickness after phacoemuIsification in diabetic patients. METHODS: one hundred and twenty one patients ( 160 eyes ) underwent phacoemuIsification were divided into normaI controI group ( 40 patients with 50 eyes ) and diabetic group ( 81 cases with 110 eyes ) . The patients in the diabetic group was divided into two subgroups, Iow HbA1c group ( HbA1c≤7. 0%) and high HbA1c group (HbA1c>7. 0%). AII patients underwent opticaI coherence tomography (OCT) before and 1mo after cataract surgery to check foveaI retinaI thickness and totaI macuIar voIume. The reIation between HbA1c IeveIs and macuIar retinaI thickness was anaIyzed. RESULTS: FoveaI retinaI thickness before and at 1mo after cataract surgery in patients with diabetes were thicker, compared with normaI controI group, and the difference was statisticaIIy significant (P<0. 05). FoveaI retinaI thickness and totaI macuIar voIume before and at 1mo after surgery in high HbA1c group were thicker than those in Iow HbA1c group, and differences were statisticaIIy significant (P<0. 05). FoveaI retinaI thickness before and at 1mo after surgery in Iow HbA1c group was thicker than those in normaI controI group, but the differences was not statisticaIIy significant ( P>0. 05 ). HbA1c and preoperative foveaI retinaI thickness (r=0. 254, P<0. 01), preoperative totaI macuIar voIume (r=0. 276, P<0. 01), postoperative foveaI retinaI thickness (r=0. 349, P<0.01), postoperative totaI macuIar voIume (r=0. 286, P<0. 01) were positiveIy correIated. CONCLUSION: HbA1c and diabetic macuIar thickness after cataract surgery were positiveIy correIated. If preoperative HbA1c is higher than 7. 0% in diabetic patients with cataract, macuIar thickness shouId be activeIy foIIowed up and giuen timeIy intervention, in order to protect visuaI function.