糖尿病视网膜病变筛查方式探讨.pdfVIP

DOC格式论文，方便您的复制修改删减 糖尿病视网膜病变筛查方式探讨 （作者:___________单位: ___________邮编: ___________） 作者：张蕾,许维强,谭荣强,刘姣,林绮敏 【摘要】 目的：通过对散瞳直接眼底镜检查、免散瞳数码眼底 照相及眼底荧光造影 3 种检查方法对可疑糖尿病视网膜病变患者进 行检查和评估 比较 ，优化检查程序和方法 。方法 ：对 2007 01/2009 01 就诊我院门诊和住院确诊的264 例糖尿病患者进 行散瞳直接眼底镜检查、免散瞳数码眼底照相及眼底荧光造影检查。 眼底病专科医师阅片进行诊断，以眼底血管荧光造影诊断为标准。主 要指标散瞳直接眼底镜检查、免散瞳数码眼底照相方法进行筛查诊断 的敏感性、特异性及与眼底血管荧光造影诊断结果的一致性。结果： 以糖尿病视网膜病变Ⅰ期为筛查阈值时直接眼底镜检查和免散瞳眼 底 照 相 的 敏 感 度 分 别 是 63.4%,86.8%, 特 异 度 分 别 是 76.9%,92.3%,Youden 指数分别是 41.1%,79.1%,Kappa 检验的一致性 分别是 41. 9%,80.7%。以糖尿病视网膜病变2 期为筛查阈值时，直 接眼底镜检查和免散瞳眼底照相的敏感性分别是 65.5%,93.1%,特异 性分别是94.7%,97.4%,Youden 指数分别是60.3%,90.5%,Kappa 检验 的一致性分别是39.1%,61.2%。结论：免散瞳数码眼底彩色照相可作 DOC格式论文，方便您的复制修改删减 为糖尿病视网膜病变Ⅱ期以上糖尿病视网膜病变优化筛查诊断方法。 【关键词】糖尿病视网膜病变；筛查；数码眼底照相；荧光素眼底 血管造影 Abstract AIM: To evaluate the ability of digital fundus photography and direct funduscopy to detect diabetic retinopathy(DR) in patients with diabetic mellitus(DM) compared with fundus fluorescein angiography(FFA).METHODS: All 264 cases with diabetes underwent non mydriatic digital fundus photography,FFA, and direct funduscopy with dilation of their pupils. Then statistics contrast study of direct funduscopy and FFA, non mydriatic digital fundus photography and FFA were carried out respectively. RESULTS: In comparison with FFA, mild nonproliferative DR being taken as referable DR, direct funduscopy with dilation of pupils gave a sensitivity of 63.4% ，a specificity of 76.9% ，and a Kappa statistic of 41.9%,a Youden of 41.1%, digital fundus photography gave a sensitivity of 86.8% ，a specificity of 92.3% ，and a Kappa statistic of 80.7%,a Youden of 79.1%; moderate nonproliferative DR being taken as referable DR, direct funduscopy with dilation of pupils gave a sensitivity of 65.5%， a specificity of 94.7%，and a Kappa statistic of 39.1%,a Youden of 60.3%