基于角膜共焦激光显微镜检测的角膜基底神经变化与2型糖尿病视网膜微血管病变的相关性研究

发布时间：2018-07-06 16:32

  本文选题：角膜共焦激光显微镜 + 角膜神经　； 参考：《眼科新进展》2017年09期

【摘要】：目的探讨角膜共焦激光显微镜检测的角膜基底神经变化与2型糖尿病(type 2 diabetes mellitus,T2DM)视网膜微血管病变的相关性。方法选取2016年2月至2017年2月在我院治疗的T2DM患者118例,其中合并糖尿病视网膜病变(diabetic retinopathy,DR)患者57例(DR组),无DR患者61例(NDR组),同时选取健康志愿者60人作为对照组,所有研究对象采用角膜共焦激光显微镜检查,分析角膜神经形态参数与临床指标的关系。结果 DR组角膜神经纤维密度、角膜神经分支密度和角膜神经长度分别为(20.03±4.22)条·mm-2、(22.01±7.05)条·mm-2和(9.50±1.76)mm·mm-2,明显小于对照组和NDR组(均为P0.05),而角膜神经纤维弯曲度为0.30±0.03,明显高于对照组和NDR组(均为P0.05);DR患者中,Ⅲ期患者角膜神经纤维密度、角膜神经分支密度和角膜神经长度明显小于Ⅰ期和Ⅱ期DR患者(均为P0.05),而角膜神经纤维弯曲度明显高于Ⅰ期和Ⅱ期DR患者(均为P0.05)。DR组病程为(12.04±2.48)a,明显高于NDR组(P0.05),而空腹C肽和空腹胰岛素分别为(1.41±0.58)μg·L-1和(20.05±7.91)m U·L-1,明显低于NDR组(均为P0.05)。T2DM患者病程与角膜神经分支密度及角膜神经纤维长度呈负相关(r=-0.322、-0.317,均为P0.05);空腹C肽与角膜神经分支密度呈正相关(r=0.298,P0.05),与角膜神经弯曲度呈负相关(r=-0.311,P0.05)。结论 T2DM视网膜微血管病变患者角膜神经形态参数异常,对病程较长或空腹C肽水平低的T2DM患者应用角膜共激光显微镜检测有助于早期发现微血管病变。
[Abstract]:Objective to investigate the correlation between corneal basal nerve changes and type 2 diabetes mellitus (type 2 diabetes mellitus T2DM) by confocal laser microscopy. Methods from February 2016 to February 2017, 118 patients with T2DM were selected, including 57 patients with diabetic retinopathy Dr (Dr group), 61 patients without Dr (NDRgroup), and 60 healthy volunteers as control group. Corneal confocal laser microscopy was used to analyze the relationship between corneal nerve morphology and clinical parameters. Results the density of corneal nerve fibers in Dr group, The corneal nerve branching density and corneal nerve length were (20.03 卤4.22) mm ~ (-2), (22.01 卤7.05) mm-2 and (9.50 卤1.76) mm m ~ (-2), respectively, which were significantly lower than those in the control group and the mm-2 group (P0.05), while the corneal nerve fiber curvature was 0.30 卤0.03, which was significantly higher than that in the control group and the mm-2 group (P0.05). The density of corneal nerve fibers in stage 鈪，

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