糖尿病合并视网膜分支静脉阻塞患者继发黄斑水肿后视力损伤程度及危险因素

发布时间：2018-01-25 10:17

本文关键词： 视网膜分支静脉阻塞视力损伤黄斑水肿糖尿病危险因素　出处：《眼科新进展》2017年12期 　论文类型：期刊论文

【摘要】：目的对比分析糖尿病和非糖尿病视网膜分支静脉阻塞(branch retinal vein occlusion,BRVO)继发黄斑水肿后患者视力损伤程度,并探讨视力损伤的危险因素。方法回顾性分析就诊于我院的BRVO患者87例92眼,其中糖尿病组38例40眼,非糖尿病组49例52眼,患者均伴有不同程度黄斑水肿。分别记录患者的性别、年龄、病史及BRVO发病的高危因素,包括体质量指数、高血压病史、血脂水平、糖化血红蛋白水平、缺血性心脏病等,记录两组患者入院时及治疗后随访1个月、3个月、6个月视力、眼压、黄斑中心凹厚度(central macular thickness,CMT),并进行对比分析,利用Logistic回归分析确认与视力损伤相关的危险因素。结果两组患者治疗前最佳矫正视力差异无统计学意义(P0.05),治疗后随访至1个月时,非糖尿病组患者视力较糖尿病组改善明显,差异有统计学意义(t=2.22,P0.05)。治疗后随访至3个月和6个月时,两组视力差异均无统计学意义(均为P0.05)。以"远视力0.5 log MAR"为因变量,各危险因素为自变量进行单因素Logistic回归分析,结果提示:糖尿病(P=0.000)、高血脂(P=0.000)、体质量指数(P=0.000)、眼轴长度(P=0.000)均与BRVO发生后的视力损伤显著相关。多因素Logistic回归分析结果提示:糖尿病(OR=8.222,P=0.014)、高血脂(OR=25.247,P=0.002),体质量增加(OR=1.388,P=0.014)的患者发生BRVO后最终远视力下降的风险显著增加,然而随着眼轴增长(OR=0.213,P=0.000)其最终视力损伤程度则减轻。结论糖尿病患者发生BRVO后,视力损伤程度较非糖尿病患者更加严重,严格控制体质量、血糖和血脂是减轻视网膜静脉阻塞引起的视力损伤的重要措施。
[Abstract]:Objective to compare and analyze branch retinal vein occlusion of branch retinal vein occlusion in diabetic and non-diabetic patients. The degree of visual impairment and the risk factors of visual impairment in patients with macular edema after macular edema were analyzed retrospectively in 87 cases (92 eyes) of BRVO in our hospital. There were 38 cases (40 eyes) of diabetes mellitus group and 49 cases (52 eyes) of non-diabetic group. All the patients were accompanied with macular edema of different degrees. The sex, age, history and high risk factors of BRVO were recorded. Body mass index (BMI), history of hypertension, blood lipid level, glycosylated hemoglobin level, ischemic heart disease and so on were recorded. The patients were followed up for 1 month, 3 months and 6 months after treatment. The thickness of central foveal fovea of macular is central macular thicknessen. Logistic regression analysis was used to identify the risk factors associated with visual impairment. Results there was no significant difference in the best corrected visual acuity (BCVA) between the two groups before treatment (P 0.05). The visual acuity of the non-diabetic group was significantly improved than that of the diabetic group at 1 month after treatment, and the difference was statistically significant. The follow-up period was 3 months and 6 months after treatment. There was no significant difference in visual acuity between the two groups (P 0.05). "far vision 0.5 log MAR" was taken as dependent variable. All risk factors were analyzed by univariate Logistic regression analysis. The results showed that diabetes mellitus was 0.000 and hyperlipidemia was 0.000). The body mass index was 0.000). Visual acuity after BRVO was significantly correlated with axial length (P < 0. 000). Multivariate Logistic regression analysis showed that diabetes mellitus was 8. 222. P0. 014, high blood lipids, 25. 247, P0. 002, body weight increased OR1. 388. There was a significant increase in the risk of ultimate distant visual acuity decline in patients with BRVO, however, with the increase of the axial axis of the eye, OR0.213. Conclusion the degree of visual impairment in diabetic patients with BRVO is more serious than that in non-diabetic patients, and body mass is strictly controlled. Blood glucose and lipids are important measures to reduce visual impairment caused by retinal vein occlusion.
【作者单位】：陕西省人民医院眼科;西安交通大学基础医学院药理学系;西安交通大学第二附属医院眼科;
【基金】：陕西省科技厅社会发展攻关计划(No:2017SF-249)~~
【分类号】：R587.2;R774
【正文快照】： 视网膜分支静脉阻塞(branch retinal vein occlu-后随访1个月、3个月、6个月视力、眼压、黄斑中心sion,BRVO)是常见的眼部血管性疾病,常因继发黄凹厚度(central macular thickness,CMT),并进行对斑水肿而导致不同程度的视力下降,已成为全球范比分析。其中将国际标准视力表测量

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