糖尿病患者白内障超声乳化术后黄斑中心凹脉络膜厚度的改变

发布时间：2018-04-27 18:17

本文选题：糖尿病 + 白内障超声乳化手术　；参考：《昆明医科大学》2017年硕士论文

【摘要】：[目的]研究糖尿病患者白内障超声乳化手术后黄斑中心凹脉络膜厚度(SFCT)的变化,探究白内障超声乳化手术对SFCT变化的影响,及术后SFCT变化与术前空腹血糖、糖化血红蛋白之间的关系。[方法]本研究纳入40例患者,20例为糖尿病白内障患者,20例为非糖尿病白内障患者。所有患者行白内障超声乳化摘除合并人工晶体植入术,患者术前抽血检测空腹血糖和糖化血红蛋白。用标准对数视力表检测术前、术后1周、1月、3月最佳矫正视力,采用Mann-Whitney U检验分析。应用EDI-OCT分别测量患者术前、术后1周、1月、3月SFCT值,采用重复测量方差分析及SNK-q检验对测量数据进行分析。多元线性回归分析患者术前及术后各时间点SFCT变化与年龄、糖尿病病程时间、空腹血糖、糖化血红蛋白的相关性。[结果]两组患者术前、术后1月、术后3月最佳矫正视力(BCVA)比较差异无统计学意义(P0.05),术后1周非糖尿病组的BCVA好于糖尿病组(P0.01)。糖尿病组术前、术后1周、1月、3月SFCT分别为(174.15 ± 37.65)μm、(188.58±42.42)μm、(197.07±45.54)μm、(194.11 ±44.83)μm。非糖尿病组术前、术后1周、1月、3月SFCT分别为(168.26± 36.59)μm、(181.50± 44.25)μm、(184.50± 44.38)μm、(183.13± 43.93)μm。糖尿病组与非糖尿病组患者术后SFCT值增加,术后1月时最厚,术后3月SFCT值相比较于术后1月有所回落,但仍大于术后1周测量值。两组患者术前、术后各时间点SFCT值两两比较差异均有统计学意义(P0.05)。多元线性回归分析结果显示糖尿病组患者术前、术后各时间点SFCT变化与术前空腹血糖呈正相关性,而与年龄、糖尿病病程时间、糖化血红蛋白无明显相关性。[结论]白内障超声乳化手术对患者术后黄斑中心凹脉络膜厚度变化存在影响,糖尿病患者术前血糖控制水平对白内障超声乳化术后黄斑中心凹脉络膜厚度变化存在影响,而年龄、糖尿病病程时间、近期血糖控制水平对术后黄斑中心凹脉络膜厚度变化影响不大。
[Abstract]:[objective] to study the changes of central foveal choroidal thickness (SFCT) after phacoemulsification in diabetic patients, and to explore the effect of phacoemulsification on the changes of SFCT, the changes of SFCT and fasting blood glucose before operation. The relationship between glycosylated hemoglobin. [methods] A total of 40 patients with diabetic cataract and 20 patients with non-diabetic cataract were included in this study. All patients were treated with phacoemulsification and intraocular lens implantation. Fasting blood glucose and glycosylated hemoglobin were measured before operation. Standard logarithmic visual acuity chart was used to detect the best corrected visual acuity before operation, 1 week, 1 month and 3 months after operation. Mann-Whitney U test was used. EDI-OCT was used to measure the SFCT values before operation, 1 week, 1 month and 3 months after operation, and repeated measurement variance analysis and SNK-q test were used to analyze the measured data. Multivariate linear regression analysis showed that SFCT changes were correlated with age, duration of diabetes, fasting blood glucose and glycosylated hemoglobin in patients before and after operation. [results] there was no significant difference in BCVA between the two groups before operation, one month after operation and three months after operation. The BCVA in the non-diabetic group was better than that in the diabetic group at 1 week after operation. Before operation, 1 week, 1 month and 3 months after operation, the SFCT in the diabetic group was 188.58 卤42.42 渭 m and 194.11 卤44.83 渭 m respectively. Before operation, 1 week, 1 month and 3 months after operation, the SFCT of non-diabetic group was 181.50 卤44.25 渭 m and 184.50 卤44.38 渭 m respectively, the SFCT was 183.13 卤43.93 渭 m. The SFCT value of diabetic group and non-diabetic group increased after operation, and the thickest one month after operation. The SFCT value of 3 months after operation was lower than that of 1 month after operation, but still larger than the measured value at 1 week after operation. There were significant differences in SFCT values before and after operation between the two groups (P 0.05). The results of multiple linear regression analysis showed that the changes of SFCT were positively correlated with fasting blood glucose before and after operation, but not with age, duration of diabetes, glycosylated hemoglobin. [conclusion] the effect of phacoemulsification on the choroidal thickness of macular central fovea after cataract phacoemulsification, and the effect of blood glucose control on the thickness of central foveal choroidal thickness after phacoemulsification in diabetic patients. However, age, duration of diabetes, and the level of blood glucose control had little effect on the thickness of central foveal choroid.
【学位授予单位】：昆明医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R587.2;R779.6

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