【摘要】：目的本研究通過彩色多普勒超聲檢查視網(wǎng)膜中央動(dòng)脈(Central retinal artery,CRA)及頸內(nèi)動(dòng)脈(Internal carotid artery,ICA),研究糖尿病(Diabetes mellitus,DM)患者與健康志愿者的CRA與ICA的血流動(dòng)力學(xué)特征,并分析其差異,以探討超聲檢查在糖尿病視網(wǎng)膜病變(Diabetic retinopathy,DR)早期診斷中的應(yīng)用價(jià)值。方法選取DM患者62例(共124只眼)作為病例組,健康志愿者37例(共74只眼)作為對(duì)照組,根據(jù)眼底攝片結(jié)果將DM患者分為非糖尿病視網(wǎng)膜病變(Non-diabetic retinopathy,NDR)組及糖尿病視網(wǎng)膜病變(Diabetic retinopathy,DR)組,其中NDR組27例(共54只眼),DR組35例(共70只眼)。分別對(duì)健康志愿者及DM患者的視網(wǎng)膜中央動(dòng)脈及頸內(nèi)動(dòng)脈行超聲檢查,檢測(cè)并對(duì)比分析其收縮期峰值流速(Peak systolic velocity,PSV)、舒張末期流速(End-diastolic velocity,EDV)與阻力指數(shù)(Resistance index,RI)。結(jié)果DR組、NDR組與對(duì)照組視網(wǎng)膜中央動(dòng)脈的PSV分別為:7.93±1.60cm/s、10.65±2.07cm/s、11.53±2.07cm/s,EDV分別為2.71±0.57cm/s、4.14±0.83cm/s、4.72±1.07cm/s,RI分別為0.66±0.06、0.61±0.03、0.59±0.05;DR組、NDR組與對(duì)照組頸內(nèi)動(dòng)脈的PSV分別為:52.64±9.00cm/s、57.62±6.11cm/s、56.38±11.19cm/s,EDV分別為20.34±5.17cm/s、24.83±5.14cm/s、24.42±5.64cm/s,RI分別為0.62±0.08、0.57±0.07、0.57±0.06。NDR組與對(duì)照組的視網(wǎng)膜中央動(dòng)脈各血流動(dòng)力學(xué)參數(shù)比較,NDR組的PSV與EDV均下降,RI升高,差異均有統(tǒng)計(jì)學(xué)意義(PSVP0.05,EDV及RI P0.01)。DR組與NDR組、對(duì)照組的視網(wǎng)膜中央動(dòng)脈各血流動(dòng)力學(xué)參數(shù)比較,DR組的PSV與EDV均下降,RI升高,差異均有統(tǒng)計(jì)學(xué)意義(P0.01)。NDR組與對(duì)照組的頸內(nèi)動(dòng)脈PSV、EDV及RI比較,差異均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。DR組與NDR組、對(duì)照組的頸內(nèi)動(dòng)脈各血流動(dòng)力學(xué)參數(shù)比較,DR組PSV、EDV下降,RI升高,差異均有統(tǒng)計(jì)學(xué)意義(與NDR組比較,PSV、EDV及RI P0.01;與對(duì)照組比較,PSVP0.05,EDV及RI P0.01)。結(jié)論超聲檢查可顯示DM患者視網(wǎng)膜中央動(dòng)脈及頸內(nèi)動(dòng)脈的血流動(dòng)力學(xué)參數(shù)PSV、EDV及RI,其血流動(dòng)力學(xué)的改變(如PSV下降、EDV下降及RI升高等)均有助于早期診斷DR,可為臨床早期診斷及治療DR提供更多的診斷信息。
[Abstract]:Objective to study the hemodynamic characteristics of CRA and ICA in patients with diabetes mellitus (Diabetes mellitus,DM) and healthy volunteers by color Doppler ultrasound (CDFI) examination of central retinal artery (Central retinal artery,CRA) and internal carotid artery (Internal carotid artery,ICA). To explore the value of ultrasonography in the early diagnosis of diabetic retinopathy (Diabetic retinopathy,DR). Methods Sixty-two DM patients (124 eyes) were selected as the case group and 37 healthy volunteers (74 eyes) as the control group. According to the results of fundus radiography, the patients with DM were divided into non-diabetic retinopathy (Non-diabetic retinopathy,). NDR group and diabetic retinopathy (Diabetic retinopathy,DR) group, NDR group 27 cases (54 eyes), DR 35 cases (70 eyes). The central retinal artery and internal carotid artery of healthy volunteers and patients with DM were examined by ultrasound. The peak systolic velocity (Peak systolic velocity,PSV), end-diastolic velocity (End-diastolic velocity,EDV) and resistance index (Resistance index,) were detected and compared. RI). Results the PSV of central retinal artery in DR group, NDR group and control group were 7.93 鹵1.60 cm / s and 10.65 鹵2.07 cm / s respectively. The PSV of central retinal artery in DR group, NDR group and control group were 2.71 鹵0.57 cm / s, 4.14 鹵0.83 cm / s and 4.72 鹵1.07 cm / s, respectively. RI was 0.66 鹵0.06U 0.61 鹵0.03U 0.59 鹵0.05; The PSV of internal carotid artery in DR group, NDR group and control group were 52.64 鹵9.00 cm / s, 57.62 鹵6.11 cm / s, 56.38 鹵11.19 cm / s EDV, respectively, which were 20.34 鹵5.17 cm / s (24.83 鹵5.14 cm / s) and 24.42 鹵5.64 cm / s, respectively. The hemodynamic parameters of the central retinal artery in the RI group were 0.62 鹵0.08 and 0.57 鹵0.07 鹵0.57 鹵0.57 鹵0.06.NDR, respectively. The PSV and EDV in the NDR group were significantly lower than those in the control group (PSVP0.05,). The hemodynamic parameters of central retinal artery in EDV and RI P0.01). DR group and NDR group were lower than those in NDR group. PSV and EDV in DR group were decreased, RI was increased in DR group. There was no significant difference in PSV,EDV and RI between the). NDR group and the control group (P0.05 between the). DR group and the NDR group, and the comparison of the internal carotid artery hemodynamic parameters between the control group and the control group). PSV,EDV decreased and RI increased in DR group (compared with NDR group, PSV,EDV and RI P 0.01); Compared with the control group, PSVP0.05,EDV and RI P0.01). Conclusion Ultrasound can show the hemodynamic parameters of central retinal artery and internal carotid artery in patients with DM. The changes of hemodynamics in PSV,EDV and RI, (such as decreased PSV, decreased EDV and increased RI) are helpful for the early diagnosis of DR,. It can provide more diagnostic information for early diagnosis and treatment of DR.
【學(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R587.2;R774.1;R445.1

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