糖尿病视网膜病变患者黄斑拱环结构变化及相关影响因素分析论文.docVIP

　　糖尿病视网膜病变患者黄斑拱环结构变化及相关影响因素分析论文 【摘要】目的 评价Ⅲ期、Ⅳ期糖尿病视网膜病变（Diabetic Retinopathy，DR）患者视网膜动脉、静脉及黄斑拱环结构的改变，探讨其对于理解视网膜病变严重程度的意义。方法 回顾分析80例眼底荧光素血管造影（Fundus fluorescein angiography，FFA）检查、眼底光学相干断层扫描(Optical coherence tomography, OCT）等临床资料，观察分析黄斑中心凹毛细血管拱环破坏程度。按DR严重程度及是否伴随高血压进行分组，利用海德堡激光扫描眼底荧光造影系统测量软件对视网膜血管和黄斑拱环直径进行统计学分析。结果 本组病例中，对于DR黄斑拱环结构研究发现，黄斑拱环结构破坏主要表现为：黄斑拱环直径缩小、黄斑拱环直径扩大、黄斑拱环结构完全破坏。拱环直径为0.43±0.048mm.freelonitoring in DR.Methods: 80 cases of diabetic retinopathy acular arch easuring softeter of retinal vessel and macular arch in these cases. Results: In these cases, the destruction of macular arch is the diameter expand and the total disruption. The diameter of macular arch is 0.43±0.048mm, and the superior temporal A/V is 0.59±0.12, the inferior temporal A/V is 0.61±0.11. In non HBP group, the stages of DR is relative to diameter of macular arch, irrespective of A/V. In addition, there is a significant difference in macular thickness betacular arch morphology demonstrate that the destroy factors included diameter,.freelicro-aneurysm in capillary bolism outsides the macular ring, large area of non-perfusion and hemorrhage patches. The above all mentioned is the important references for DR classification.Conclusions: Structure change of macular arch in diabetic retinopathy has many types, and has strong relationship ples study to determine acular arch can be classified as references standard of DR stages in our country. 【Key acular arch Fundus fluorescein angiography 糖尿病（Diabetes Mellitus, DM）是以糖代谢紊乱为主的全身常见病，致残率、致死率仅次于心、脑血管病及癌症，占第三位1。糖尿病的人群发病率逐年上升，并呈上升趋势。糖尿病视网膜病变(Diabetic Retinopathy，DR)是由其并发的以眼部微血管病变为特征的四大致盲眼病之一。常常累及末梢微血管，造成视网膜供血供氧不足，导致微血管瘤、眼底无灌注及新生血管的发生。视网膜的动脉和静脉是眼底可见的血管，对于理解眼底的血液循环具有重要意义。黄斑拱环是黄斑区域可见的重要的微循环结构，黄斑拱环结构在一定程度上可以反映黄斑微循环情况，该毛细血管结构改变对于理解DR的程度具有一定的意义2，本文拟针对黄斑拱环结构进行分析，并相应比较视网膜动脉和静脉的管径状况。 材料与方法 一、病例选择 选择2005至2010年间就诊于我院眼科的Ⅲ期、Ⅳ期的DR患者，经眼底镜检查和荧光素血管造影（Fundus fluorescein angiography，FFA）确诊。入选标准：年龄 18周岁，屈光间质清晰，眼底照相、FFA显示良好的患者80例，以右眼为主。排除标准：屈光间质混浊影响FFA显影观察，全身状况伴有妊娠的，心脏病