彩色多普勒超声对糖尿病眼球后血管血流动力学的研究

摘要

目的：探讨彩色多普勒超声对糖尿病眼球后血管血流动力学改变的作用。　　方法：选取2010-06/2013-05我院收治的2型糖尿病眼病患者80例160眼作为研究组，通过眼底照相和直接检眼镜检查将研究组分为糖尿病无视网膜病变组(DNR 组)、糖尿病视网膜病变非增殖期组(NPDR 组)、糖尿病视网膜病变增殖期组(PDR 组)，选取同期眼部正常者60例120眼作为对照组，通过彩色多普勒超声对各组间视网膜中央动脉(CRA)、睫状后动脉(PCA)及眼动脉(OA)的多普勒血流参数指标进行分析。　　结果：研究组与对照组在 CRA、PCA 和 OA 的血流参数上存在显著差异(P<0.05)；DNR 组、NPDR 组和 PDR 组在CRA、PCA 和 OA 的收缩期峰值流速(PSV)、舒张末期血流速度(EDV)、阻力指数(RI)与对照组存在显著差异(P<0.05)，且 PDR 组与 DNR 组、NPDR 组也存在显著差异(P<0.05)。　　结论：通过彩色多普勒超声动态监测视网膜血流状态并对血流频谱形态进行分析，根据血流变化可以对 DR 病变程度进行判定，从而为治疗和预后提供参考价值。%To explore the changes of retrobulbar hemodynamics in diabetes via color doppler ultrasound. ●METHODS: Totally 80 patients ( 160 eyes ) with eye diseases in type 2 diabetes from June 2010 to May 2013 in our hospital were enrolled as research group. By fundus photography and direct ophthalmoscopy, patients were assigned to diabetes without retinopathy group ( DNR subgroup), non- proliferative diabetic retinopathy group (NPDR subgroup) and proliferative diabetic retinopathy group (PDR subgroup). Of 60 healthy patients (120 eyes) over the same period were chosen as control group. The doppler parameters of central retinal artery ( CRA ), posterior ciliary artery (PCA) and ophthalmic artery (OA) were measured. ●RESULTS: There were significant differences on circulatory parameters of CRA, PCA and OA between both groups ( P < 0. 05 ). Significant differences were also observed on peak systolic velocity ( PSV), end diastolic velocity ( EDV) and resistance index ( Rl) of CRA, PCA and OA among DNR subgroup, NPDR subgroup and PDR subgroup ( P < 0. 05). The EDV, Rl and PSV of control group differed from those of DNR subgroup, NPDR subgroup and PDR subgroup (P<0. 05). ●CONCLUSlON: The monitoring of retinal blood flow and analysis of blood spectrum morphology via color doppler ultrasound can effectively evaluate the degree of diabetic retinopathy lesions, especially before DR vascular disease. Early detection can reveal the hemodynamic change pattern of DR, facilitating the prevention of diabetic eye complications and improvement of the quality of life.