本文選題：視網(wǎng)膜電圖 + 震蕩電位　； 參考：《重慶醫(yī)科大學(xué)》2012年碩士論文

【摘要】：目的：探討非增生性糖尿病視網(wǎng)膜病變視網(wǎng)膜電圖的特征及其臨床應(yīng)用價(jià)值。 方法：選取2010年9月至2011年3月于我病區(qū)門診就診的連續(xù)39例2型糖尿病患者，根據(jù)眼科檢查結(jié)果將其分為糖尿病無視網(wǎng)膜病變（no diabetic retinopathy,NDR）組（23例46眼）,非增生性糖尿病視網(wǎng)膜病變(non-proliferative diabetic retinopathy,NPDR)組（16例32眼），另納入年齡匹配的15例健康體檢者為對照組（30眼）。按ISCEV標(biāo)準(zhǔn)行全視野閃光視網(wǎng)膜電圖（flash Electroretinogram，f-ERG）檢查。濾波去除振蕩電位（oscillatory potentials，OPs）對a-、b-波的影響后，測量暗適應(yīng)0.01、暗適應(yīng)和明適應(yīng)3.0ERG的a-、b-波隱含期、振幅、b/a振幅比值。確定視桿和視錐系統(tǒng)OPs的頻譜范圍后，用快速傅里葉轉(zhuǎn)換分別提取視桿細(xì)胞系統(tǒng)和視錐細(xì)胞系統(tǒng)OPs并測量峰頻率、振幅、隱含期和振幅能量。用ANOVA輔以Bonferroni后矯正行統(tǒng)計(jì)分析。P0.05表示有統(tǒng)計(jì)學(xué)意義。 結(jié)果：暗適應(yīng)反應(yīng)變化明顯的是0.01反應(yīng)中b-波的隱含期延長及振幅下降（P＜0.05）；暗適應(yīng)3.0反應(yīng)中NPDR組a-波及b-波振幅較NDR組下降（P＜0.05）；明適應(yīng)反應(yīng)中,與對照組相比, NDR組及NPDR組a-波隱含期延長（P＜0.01和P＜0.001）；與對照組相比，NDR組及NPDR組視錐細(xì)胞系統(tǒng)Ops隱含期延長有統(tǒng)計(jì)學(xué)意義（P＜0.05），而視桿細(xì)胞系統(tǒng)Ops各項(xiàng)指標(biāo)改變無統(tǒng)計(jì)學(xué)意義。NPDR組與對照組、NDR組比較，視錐細(xì)胞系統(tǒng)Ops峰頻率增高有統(tǒng)計(jì)學(xué)意義（P＜0.05和P＜0.01）。 結(jié)論： 1、暗適應(yīng)0.01ERG b-波隱含期及振幅、明適應(yīng)3.0ERGa-波隱含期及視錐細(xì)胞系統(tǒng)Ops隱含期可作為早期了解糖尿病視網(wǎng)膜功能的穩(wěn)定客觀指標(biāo)。 2、隨著NPDR癥狀加重，，功能障礙同時(shí)累及視錐和視桿系統(tǒng),并且視桿系統(tǒng)功能的受損程度大于視錐系統(tǒng)。 3、NPDR對視網(wǎng)膜的功能損害可能源自光感受器的損害,視細(xì)胞層及視網(wǎng)膜內(nèi)層均出現(xiàn)功能障礙。 4、ERG各指標(biāo)中隱含期變異系數(shù)較小，振幅能量變異系數(shù)較大。 5、DR的視網(wǎng)膜神經(jīng)元功能改變早于臨床可見的視網(wǎng)膜血管病變。
[Abstract]:Objective: to investigate the characteristics and clinical value of electroretinogram in non-proliferative diabetic retinopathy. Methods: from September 2010 to March 2011, 39 consecutive patients with type 2 diabetes mellitus were selected. According to the results of ophthalmologic examination, the patients were divided into 23 cases (46 eyes) with no diabetic retinopathy, 16 cases (32 eyes) with non-proliferative diabetic retinopathy (NPDR) with non-proliferative diabetic retinopathy, and 30 eyes (30 eyes) with age matched 15 healthy controls. Flash electroretinogram (flash Electroretinogramgramma f-ERG) was performed according to ISCEV standard. After removing the effect of oscillatory potentials on a-b- wave, the dark adaptation (0.01), dark adaptation (dark adaptation) and bright adaptation (3.0ERG) are measured, and the amplitude ratio of b / a is measured. After determining the spectrum range of OPs in rod and cone system, the OPs of rod cell system and cone cell system were extracted by fast Fourier transform, and the peak frequency, amplitude, implicit period and amplitude energy were measured. Statistical analysis with ANOVA plus Bonferroni after correction. P05 indicated that there was statistical significance. Results: the obvious change of dark adaptation response was the prolongation of the implicit period and the decrease of the amplitude of b- wave in 0.01 response (P < 0.05), the amplitude of a- wave and b- wave in NPDR group was lower than that in NDR group (P < 0.05), and in the light adaptation reaction, the amplitude of a-wave and b-wave in NPDR group was lower than that in NDR group (P < 0.05). Compared with the control group, the a- wave implicit period was prolonged in NDR group and NPDR group (P < 0. 01 and P < 0. 001), and the prolongation of Ops implicit period in NDR group and NPDR group was statistically significant (P < 0. 05), but there was no significant change in Ops index of rod cell system. Significance: the NPDR group was compared with the control group in NDR group, The frequency of Ops peak in cone cell system increased significantly (P < 0. 05) and P < 0. 01 (P < 0. 01). Conclusion: 1. Dark adaptation to 0.01ERG b-wave implicit period and amplitude, explicit adaptation to 3.0 ERGa-wave implicit period and cone-cell system Ops implicit period can be used as an objective and stable index for early understanding of diabetic retinal function. 2. With the exacerbation of NPDR symptoms, the dysfunction involved both the visual cone and the rod system, and the damage degree of the rod system was greater than that of the cone system. 3The functional damage of retina caused by NPDR may be due to the damage of photoreceptor, and both the optic cell layer and the inner layer of retina have dysfunction. (4) the coefficient of variation of implied period and the coefficient of variation of amplitude energy are smaller in each index of ERG. The changes of retinal neuron function in Dr group were earlier than that in clinical retinopathy.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2012
【分類號】：R774.1

【參考文獻(xiàn)】

相關(guān)期刊論文 前1條

1 銀娟萍;雷博;彭惠;王雋;付校楠;;人類視網(wǎng)膜電圖暗適應(yīng)及明適應(yīng)震蕩電位的參數(shù)特征[J];南方醫(yī)科大學(xué)學(xué)報(bào);2011年12期

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