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目的探讨糖尿病患者各项生化指标对视网膜血管直径的影响,从而了解糖尿病血管并发症的发展程度。设计回顾性病例系列。研究对象不合并高血压的2型糖尿病患者72例。方法行散瞳彩色眼底照相,测量距离视盘中心1~1.5视盘直径范围的血管直径。行血生化检查。视网膜动脉、静脉直径分别与各生化指标进行相关分析和多元线性回归分析。主要指标视网膜动脉直径、视网膜静脉直径、血生化指标。结果血尿素值与视网膜动脉直径呈负线性相关关系(t=-4.994,P=0.000),回归方程为:视网膜动脉直径=68.714-2.964×血尿素值;糖化血红蛋白与视网膜静脉直径呈线性相关关系(t=2.537,P=0.014),回归方程为:视网膜静脉直径=74.318+1.402×糖化血红蛋白值。结论在2型糖尿病患者中,血糖控制不良,糖化血红蛋白升高,会影响视网膜静脉,造成视网膜静脉扩张。视网膜动脉改变提示患者肾功能有恶化的可能。
Objective To investigate the effects of various biochemical markers of diabetic patients on the diameter of retinal vessels so as to understand the development of diabetic vascular complications. Design retrospective case series. The study included 72 patients with type 2 diabetes without hypertension. Methods Mydriatic color fundus photography was performed to measure the diameter of the vessels in the range of 1 ~ 1.5 disc diameter from the center of the disc. Blood biochemical examination. Retinal artery and vein diameter were correlated with biochemical indexes and multivariate linear regression analysis respectively. The main indicators of retinal artery diameter, retinal vein diameter, blood biochemical indicators. Results There was a negative linear correlation between blood urea and retinal artery diameter (t = -4.994, P = 0.000). The regression equation was: the diameter of retinal artery was 68.714-2.964 × blood urea, and the linear relationship between HbA1c and retinal vein diameter (t = 2.537, P = 0.014). The regression equation was: Retinal vein diameter = 74.318 + 1.402 × HbA1c. Conclusions In patients with type 2 diabetes, poor glycemic control and elevated glycated hemoglobin can affect retinal veins and cause retinal vein dilatation. Retinal artery changes suggest that patients may have deteriorated renal function.