眼底正常的2型糖尿病患者视网膜神经纤维层厚度分析

发布时间：2018-06-22 07:09

本文选题：糖尿病性视网膜病变 + 视网膜神经纤维层　；参考：《吉林大学》2012年硕士论文

【摘要】：目的：分析眼底正常的2型糖尿病患者与正常人视网膜神经纤维层厚度的差异，探讨病程、血糖、糖化血红蛋白、尿微量白蛋白、空腹C肽等全身因素与糖尿病患者视网膜神经纤维层厚度的相关性。方法：选择2011年1月-2012年2月收治于我院内分泌科的2型糖尿病患者，该组患者统一行眼底检查，均为眼底正常的糖尿病患者共30例60眼，为糖尿病组，，年龄25-73岁，平均52.67±10.11岁，屈光范围在-2.0~+2.5D。正常人对照组共31例62眼，年龄30-68岁，平均51.16±8.90岁，屈光范围在-2.0~+2.5D。之间糖尿病组与对照组均行视力、眼压、眼底检查，采用光学相干断层扫描仪-OCT（Spectralis OCT）检测视网膜神经纤维层（RNFL）厚度，糖尿病组住院期间均进行空腹血糖、餐后2小时血糖、糖化血红蛋白、尿微量白蛋白、空腹C肽值等全身指标测定。将所得结果用SPSS16.0统计软件包进行统计分析，糖尿病组与正常对照组RNFL厚度的比较采用t检验，糖尿病组和正常对照组RNFL厚度与年龄的相关分析采用Spearsman相关检验，糖尿病组RNFL厚度与全身因素的相关分析采用pearson相关检验，以P＜0.05为有统计学意义。结果：1、糖尿病组与正常对照组RNFL5项检测指标相比较：发现糖尿病组全周平均RNFL厚度（G）变薄，差异有统计学意义(P＜0.05)；糖尿病组上方RNFL厚度（S）变薄，差异有统计学意义(P＜0.05)；将上方区域RNFL厚度与下方区域RNFL厚度进一步划分相比较，发现糖尿病组鼻上方RNFL厚度（NS）变薄，差异有统计学意义(P＜0.05)；糖尿病组与正常组之间的颞侧（T）、下方（I）、鼻侧（N）RNFL厚度相比较，差异无统计学意义（P0.05）。2、将年龄与糖尿病组及正常对照组RNFL厚度5项检测指标做相关分析：年龄与糖尿病组RNFL厚度中的颞侧RNFL厚度（T）、全周平均RNFL厚度（G）呈负相关(P＜0.05)，年龄与正常对照组RNFL厚度中的上方RNFL厚度（S）、全周平均RNFL厚度（G）呈负相关(P＜0.05)。3、糖尿病组RNFL厚度测定的五项指标与全身指标做相关性分析，发现餐后2小时血糖与上方RNFL厚度（S）存在负相关(P＜0.05)，糖化血红蛋白与上方RNFL厚度（S）、全周RNFL平均厚度（G）都存在负相关(P＜0.05)。而空腹血糖、病程、尿微量白蛋白、空腹C肽等与RNFL厚度之间无相关性（P0.05）。结论：1、糖尿病患者眼底未开始出现改变时就已经发生了视网膜神经病变； OCT可用于检测眼底正常的2型糖尿病患者是否存在早期糖尿病性视网膜神经病变。2、年龄与糖尿病病人及正常人视网膜RNFL厚度都有明显相关性。3、餐后2小时血糖、糖化血红蛋白与RNFL厚度检测值存在负相关，病程、空腹血糖值、空腹C肽值、尿微量白蛋白等与RNFL厚度检测值无明显相关性。
[Abstract]:Objective: to analyze the difference of retinal nerve fiber layer thickness between normal fundus type 2 diabetic patients and normal people, and to explore the relationship between the whole body factors such as course of disease, blood sugar, glycated hemoglobin, urine microalbuminuria, fasting C peptide and the thickness of retinal nerve fiber layer in diabetic patients.
Methods: the patients with type 2 diabetes admitted in our hospital department of Endocrinology, January 2011 -2012, were treated in our hospital. The patients were treated with a unified line of fundus examination, all 30 cases of diabetic patients with normal fundus and 60 eyes, the diabetic group, the age of 25-73 years and the average 52.67 + 10.11 years old. The refractive range was 62 eyes of 31 cases in the normal control group of -2.0~+2.5D. and the age 30-68 years old. The average 51.16 + 8.90 years of age, the refractive range of the diabetic group and the control group of -2.0~+2.5D. between the visual acuity, intraocular pressure, fundus examination, optical coherence tomography -OCT (Spectralis OCT) detection of retinal nerve fiber layer (RNFL) thickness, diabetes group during the hospitalization of fasting blood glucose, 2 hours postprandial blood glucose, glycated hemoglobin, urine micro Total body indexes such as volume albumin and C peptide value were measured. The results were statistically analyzed by SPSS16.0 software package. T test was used in the comparison of the thickness of RNFL between the diabetic group and the normal control group. The correlation analysis of the thickness of RNFL with the age in the diabetic group and the normal control group was examined by Spearsman correlation, the thickness of RNFL in the diabetic group and the general cause of the whole body. Pearson correlation test was used for correlation analysis, and P < 0.05 was statistically significant.
Results 1: 1, the diabetic group was compared with the normal control group. The average RNFL thickness (G) in the diabetic group was thinner (P < 0.05). The thickness of RNFL (S) above the diabetic group was thinner, and the difference was statistically significant (P < 0.05); the thickness of the upper region RNFL and the RNFL thickness of the lower region were further delimit. It was found that the RNFL thickness (NS) in the upper nose of the diabetic group was thinner (P < 0.05), and there was no statistical difference between the diabetic group and the normal group (T), the lower (I) and the nasal (N) RNFL thickness, and the correlation analysis was made between the age and the diabetes group and the normal control group of the 5 items of RNFL thickness. The temporal RNFL thickness (T) and total week mean RNFL thickness (G) in the thickness of RNFL were negatively correlated (P < 0.05). The thickness of the upper RNFL (S) in the age and the normal control group RNFL thickness (S), the G RNFL thickness (G) had a negative correlation (P < 0.05). The correlation analysis of the five indexes of the thickness measurement of the diabetic group was related to the whole body index. There was a negative correlation between blood glucose and RNFL thickness (S) above (P < 0.05) after 2 hours of present meal. There was a negative correlation between glycated hemoglobin and the thickness of RNFL above (S), and all week RNFL mean thickness (P < 0.05). There was no correlation between the fasting blood glucose, the course of the disease, the urinary microalbumin, the fasting C peptide and RNFL thickness (P0.05).
Conclusions: 1, retinal neuropathy has occurred when the fundus of diabetic patients have not begun to change; OCT can be used to detect the presence of early diabetic retinopathy.2 in patients with normal fundus type 2 diabetes. Age has a significant correlation with RNFL thickness in diabetic patients and normal retina, and 2 hours postprandial. There was a negative correlation between glycemic, glycated hemoglobin and RNFL thickness detection value. The course of disease, fasting blood glucose, fasting C peptide value, urine microalbumin and so on had no significant correlation with the RNFL thickness detection value.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R774.1

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