视网膜分支静脉阻塞及高度近视与非对称性糖尿病视网膜病变关系

发布时间：2019-01-05 20:56

【摘要】：目的：分析视网膜分支静脉阻塞和高度近视眼与非对称性糖尿病视网膜病变关系,明确促进及抑制糖尿病视网膜病变的相关因素。方法：回顾性分析2007年1月-2010年12月86例2型糖尿病患者资料,其中32例为一眼患有视网膜分支静脉阻塞而对侧为无视网膜分支静脉阻塞的非增生性糖尿病视网膜病变眼,以及22例一眼6.00D以上高度近视而对侧为正视的糖尿病视网膜病变眼,另外32例双眼无视网膜静脉阻塞的糖尿病患者为对照组,其年龄、性别、糖尿病病程与32例单眼视网膜分支静脉阻塞糖尿病患者相匹配。分析视网膜分支静脉阻塞及高度近视与非对称性糖尿病视网膜病变的关系；高度近视不同屈光度与糖尿病视网膜病变的关系；视网膜分支静脉阻塞的发生与全身情况的关系。结果： 32例2型糖尿病患者视网膜分支静脉阻塞眼,糖尿病视网膜病变程度较对侧眼加重,其中16只眼发生增生性糖尿病视网膜病变,有3只眼并发牵引性视网膜脱离,另外16只眼中,轻度NPDR3只眼,中度NPDR5只眼,重度NPDR8只眼,对侧无视网膜静脉阻塞眼中,无明显DR3只眼,轻度NPDR9只眼,中度NPDR12只眼,重度NPDR8只眼；22例患有单眼高度近视2型糖尿病患者中,其糖尿病视网膜病变程度均较对侧正视眼明显减轻,表现为未出现糖尿病视网膜病变(DR)或只出现非增生性糖尿病网膜病变(NPDR),而无一例出现增生性糖尿病网膜病变(PDR)。其中无明显DR10只眼,轻度NPDR7只眼,中度NPDR3只眼,重度NPDR2只眼；而对侧正视眼中,无明显视网膜病变1只眼,轻度NPDR3只眼,中度NPDR5只眼,重度NPDR5只眼,PDR8只眼,PDR中2只眼并发牵引性视网膜脱离。高度近视屈光度数越高,糖尿病视网膜病变越轻微。32例单眼BRVO的糖尿病患者中,有高血压的21例,高血脂19例,血糖控制不良的23例。对照组32例双眼无视网膜静脉阻塞的糖尿病患者中,有高血压的12例,高血脂的13例,血糖控制不良的12例。结论：视网膜分支静脉阻塞可能是促进增生型糖尿病视网膜病变形成的眼内危险性因素之一,而高度近视可能是抑制糖尿病视网膜病变加重保护性因素之一,且随着近视度数的加深,这种保护作用越明显；伴有高血压、高血脂、血糖控制不良的糖尿病患者更易发生视网膜分支静脉阻塞。
[Abstract]:Aim: to analyze the relationship between retinal branch vein occlusion (RVO) and high myopia and asymmetric diabetic retinopathy (ADM), and to determine the factors related to the promotion and inhibition of diabetic retinopathy. Methods: the data of 86 patients with type 2 diabetes mellitus from January 2007 to December 2010 were retrospectively analyzed. 32 of them were non-proliferative diabetic retinopathy with retinal branch vein occlusion and contralateral non-proliferative diabetic retinopathy with retinal branch vein occlusion. And 22 eyes of diabetic retinopathy with high myopia above 6.00D but opposite side emmetropia, and 32 patients with diabetes without retinal vein occlusion were used as control group, their age and sex were used as control group. The course of diabetes was matched with 32 patients with monocular retinal branch vein occlusion. To analyze the relationship between retinal branch vein occlusion and high myopia and asymmetric diabetic retinopathy, the relationship between different diopters of high myopia and diabetic retinopathy, and the relationship between the occurrence of retinal branch vein occlusion and the whole body condition. Results: in 32 patients with type 2 diabetes mellitus, the degree of diabetic retinopathy was more serious than that of the contralateral eyes. 16 eyes developed proliferative diabetic retinopathy, 3 eyes complicated with traction retinal detachment. In the other 16 eyes, mild NPDR3 eyes, moderate NPDR5 eyes, severe NPDR8 eyes, contralateral retinal vein occlusion eyes, no obvious DR3 eyes, mild NPDR9 eyes, moderate NPDR12 eyes, severe NPDR8 eyes; In 22 patients with type 2 diabetes with monocular high myopia, the degree of diabetic retinopathy was significantly less than that of contralateral positive vision. No diabetic retinopathy (DR) or only non-proliferative diabetic omentopathy (NPDR), and no proliferative diabetic retinopathy (PDR). There was no obvious DR10 in eyes, mild NPDR7 in eyes, moderate NPDR3 in eyes and severe NPDR2 in eyes. In the contralateral emmetropia, there was no obvious retinopathy in 1 eye, mild NPDR3 in 1 eye, moderate NPDR5 in the eyes, severe NPDR5 in the eyes, PDR8 in the eyes, and 2 eyes in the PDR complicated with traction retinal detachment. The higher the diopter of high myopia, the more slight the diabetic retinopathy. Among 32 patients with monocular BRVO, 21 had hypertension, 19 had hyperlipidemia and 23 had poor blood glucose control. In the control group, there were 12 cases of hypertension, 13 cases of hyperlipidemia and 12 cases of poor blood glucose control. Conclusion: retinal branch vein occlusion may be one of the intraocular risk factors to promote the formation of proliferative diabetic retinopathy, and high myopia may be one of the protective factors to inhibit the exacerbation of diabetic retinopathy. And with the deepening of myopia, this protective effect is more obvious; Diabetic patients with hypertension, hyperlipidemia and poor blood glucose control are more likely to develop retinal branch vein occlusion.
【学位授予单位】：南昌大学
【学位级别】：硕士
【学位授予年份】：2011
【分类号】：R774.1

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