本文選題：糖尿病性視網(wǎng)膜病變 + 視網(wǎng)膜神經(jīng)纖維層�。� 參考：《吉林大學》2012年碩士論文

【摘要】：目的：分析眼底正常的2型糖尿病患者與正常人視網(wǎng)膜神經(jīng)纖維層厚度的差異，探討病程、血糖、糖化血紅蛋白、尿微量白蛋白、空腹C肽等全身因素與糖尿病患者視網(wǎng)膜神經(jīng)纖維層厚度的相關(guān)性。 方法：選擇2011年1月-2012年2月收治于我院內(nèi)分泌科的2型糖尿病患者，該組患者統(tǒng)一行眼底檢查，均為眼底正常的糖尿病患者共30例60眼，為糖尿病組，，年齡25-73歲，平均52.67±10.11歲，屈光范圍在-2.0~+2.5D。正常人對照組共31例62眼，年齡30-68歲，平均51.16±8.90歲，屈光范圍在-2.0~+2.5D。之間糖尿病組與對照組均行視力、眼壓、眼底檢查，采用光學相干斷層掃描儀-OCT（Spectralis OCT）檢測視網(wǎng)膜神經(jīng)纖維層（RNFL）厚度，糖尿病組住院期間均進行空腹血糖、餐后2小時血糖、糖化血紅蛋白、尿微量白蛋白、空腹C肽值等全身指標測定。將所得結(jié)果用SPSS16.0統(tǒng)計軟件包進行統(tǒng)計分析，糖尿病組與正常對照組RNFL厚度的比較采用t檢驗，糖尿病組和正常對照組RNFL厚度與年齡的相關(guān)分析采用Spearsman相關(guān)檢驗，糖尿病組RNFL厚度與全身因素的相關(guān)分析采用pearson相關(guān)檢驗，以P＜0.05為有統(tǒng)計學意義。 結(jié)果：1、糖尿病組與正常對照組RNFL5項檢測指標相比較：發(fā)現(xiàn)糖尿病組全周平均RNFL厚度（G）變薄，差異有統(tǒng)計學意義(P＜0.05)；糖尿病組上方RNFL厚度（S）變薄，差異有統(tǒng)計學意義(P＜0.05)；將上方區(qū)域RNFL厚度與下方區(qū)域RNFL厚度進一步劃分相比較，發(fā)現(xiàn)糖尿病組鼻上方RNFL厚度（NS）變薄，差異有統(tǒng)計學意義(P＜0.05)；糖尿病組與正常組之間的顳側(cè)（T）、下方（I）、鼻側(cè)（N）RNFL厚度相比較，差異無統(tǒng)計學意義（P0.05）。2、將年齡與糖尿病組及正常對照組RNFL厚度5項檢測指標做相關(guān)分析：年齡與糖尿病組RNFL厚度中的顳側(cè)RNFL厚度（T）、全周平均RNFL厚度（G）呈負相關(guān)(P＜0.05)，年齡與正常對照組RNFL厚度中的上方RNFL厚度（S）、全周平均RNFL厚度（G）呈負相關(guān)(P＜0.05)。3、糖尿病組RNFL厚度測定的五項指標與全身指標做相關(guān)性分析，發(fā)現(xiàn)餐后2小時血糖與上方RNFL厚度（S）存在負相關(guān)(P＜0.05)，糖化血紅蛋白與上方RNFL厚度（S）、全周RNFL平均厚度（G）都存在負相關(guān)(P＜0.05)。而空腹血糖、病程、尿微量白蛋白、空腹C肽等與RNFL厚度之間無相關(guān)性（P0.05）。 結(jié)論：1、糖尿病患者眼底未開始出現(xiàn)改變時就已經(jīng)發(fā)生了視網(wǎng)膜神經(jīng)病變； OCT可用于檢測眼底正常的2型糖尿病患者是否存在早期糖尿病性視網(wǎng)膜神經(jīng)病變。2、年齡與糖尿病病人及正常人視網(wǎng)膜RNFL厚度都有明顯相關(guān)性。3、餐后2小時血糖、糖化血紅蛋白與RNFL厚度檢測值存在負相關(guān)，病程、空腹血糖值、空腹C肽值、尿微量白蛋白等與RNFL厚度檢測值無明顯相關(guān)性。
[Abstract]:Objective: to analyze the difference of retinal nerve fiber layer thickness between normal fundus type 2 diabetic patients and normal people, and to explore the relationship between the whole body factors such as course of disease, blood sugar, glycated hemoglobin, urine microalbuminuria, fasting C peptide and the thickness of retinal nerve fiber layer in diabetic patients.
Methods: the patients with type 2 diabetes admitted in our hospital department of Endocrinology, January 2011 -2012, were treated in our hospital. The patients were treated with a unified line of fundus examination, all 30 cases of diabetic patients with normal fundus and 60 eyes, the diabetic group, the age of 25-73 years and the average 52.67 + 10.11 years old. The refractive range was 62 eyes of 31 cases in the normal control group of -2.0~+2.5D. and the age 30-68 years old. The average 51.16 + 8.90 years of age, the refractive range of the diabetic group and the control group of -2.0~+2.5D. between the visual acuity, intraocular pressure, fundus examination, optical coherence tomography -OCT (Spectralis OCT) detection of retinal nerve fiber layer (RNFL) thickness, diabetes group during the hospitalization of fasting blood glucose, 2 hours postprandial blood glucose, glycated hemoglobin, urine micro Total body indexes such as volume albumin and C peptide value were measured. The results were statistically analyzed by SPSS16.0 software package. T test was used in the comparison of the thickness of RNFL between the diabetic group and the normal control group. The correlation analysis of the thickness of RNFL with the age in the diabetic group and the normal control group was examined by Spearsman correlation, the thickness of RNFL in the diabetic group and the general cause of the whole body. Pearson correlation test was used for correlation analysis, and P < 0.05 was statistically significant.
Results 1: 1, the diabetic group was compared with the normal control group. The average RNFL thickness (G) in the diabetic group was thinner (P < 0.05). The thickness of RNFL (S) above the diabetic group was thinner, and the difference was statistically significant (P < 0.05); the thickness of the upper region RNFL and the RNFL thickness of the lower region were further delimit. It was found that the RNFL thickness (NS) in the upper nose of the diabetic group was thinner (P < 0.05), and there was no statistical difference between the diabetic group and the normal group (T), the lower (I) and the nasal (N) RNFL thickness, and the correlation analysis was made between the age and the diabetes group and the normal control group of the 5 items of RNFL thickness. The temporal RNFL thickness (T) and total week mean RNFL thickness (G) in the thickness of RNFL were negatively correlated (P < 0.05). The thickness of the upper RNFL (S) in the age and the normal control group RNFL thickness (S), the G RNFL thickness (G) had a negative correlation (P < 0.05). The correlation analysis of the five indexes of the thickness measurement of the diabetic group was related to the whole body index. There was a negative correlation between blood glucose and RNFL thickness (S) above (P < 0.05) after 2 hours of present meal. There was a negative correlation between glycated hemoglobin and the thickness of RNFL above (S), and all week RNFL mean thickness (P < 0.05). There was no correlation between the fasting blood glucose, the course of the disease, the urinary microalbumin, the fasting C peptide and RNFL thickness (P0.05).
Conclusions: 1, retinal neuropathy has occurred when the fundus of diabetic patients have not begun to change; OCT can be used to detect the presence of early diabetic retinopathy.2 in patients with normal fundus type 2 diabetes. Age has a significant correlation with RNFL thickness in diabetic patients and normal retina, and 2 hours postprandial. There was a negative correlation between glycemic, glycated hemoglobin and RNFL thickness detection value. The course of disease, fasting blood glucose, fasting C peptide value, urine microalbumin and so on had no significant correlation with the RNFL thickness detection value.
【學位授予單位】：吉林大學
【學位級別】：碩士
【學位授予年份】：2012
【分類號】：R774.1

【參考文獻】

相關(guān)期刊論文 前10條

1 黃天納;張卯年;;亞臨床期糖尿病視網(wǎng)膜病變的多焦視網(wǎng)膜電流圖[J];國際眼科雜志;2006年03期

2 王漫麗;張妍;張?zhí)K河;;2型糖尿病患者C肽與紅細胞膜Na~+-K~+ ATPase及血漿NOS活性的關(guān)系[J];中國實用神經(jīng)疾病雜志;2009年03期

3 孫桂軍;魏紹春;呂艷芬;元俊錄;馬坤;;隨機尿微量白蛋白與尿肌肝測定早期診斷糖尿病腎病[J];醫(yī)學檢驗與臨床;2006年01期

4 馬曉昀;徐格致;;年齡對正常成年人視網(wǎng)膜神經(jīng)纖維層厚度的影響(英文)[J];復旦學報(醫(yī)學版);2009年02期

5 馬曉昀;徐格致;;無糖尿病視網(wǎng)膜病變表現(xiàn)的糖尿病患者視網(wǎng)膜神經(jīng)纖維層厚度的研究(英文)[J];復旦學報(醫(yī)學版);2009年03期

6 何劍峰;杜娟;唐柳萍;李向榮;黃艷霞;;糖尿病大鼠視網(wǎng)膜細胞凋亡的影響因素[J];中國臨床康復;2005年39期

7 宋學英;齊紹文;胡長娥;陳曉凱;;近視眼神經(jīng)纖維層光學相干斷層掃描檢測的臨床研究[J];眼科新進展;2006年12期

8 熊小艷;毛新幫;王嬋嬋;趙菊蓮;游志鵬;陸瑩;;視網(wǎng)膜神經(jīng)纖維層厚度與糖尿病視網(wǎng)膜病變程度的相關(guān)性研究[J];眼科新進展;2011年05期

9 劉罡,段俊國,張富文,孫影,宋劍濤,孫崖濤;2型糖尿病病程與視網(wǎng)膜病變的相關(guān)性[J];現(xiàn)代醫(yī)藥衛(wèi)生;2004年02期

10 馬曉昀;徐格致;;糖尿病患者視網(wǎng)膜神經(jīng)纖維層厚度的測定及相關(guān)因素分析[J];眼科研究;2009年08期

本文編號：2052035