本文選題：2型糖尿病 + 瞳孔直徑��； 參考：《山東大學(xué)》2012年碩士論文

【摘要】：目的： 探討2型糖尿病患者的瞳孔功能性改變與糖尿病病程,糖尿病視網(wǎng)膜病變,糖尿病自主神經(jīng)神經(jīng)病變的關(guān)系。 方法： 按WHO制定診斷標(biāo)準(zhǔn),將已確診為2型糖尿病的住院患者80例80眼(均為右眼),作為2型糖尿病組,其中病程1-8年者27例,9-16年者26例,17-25年以上者27例,根據(jù)眼底檢查或眼底熒光造影結(jié)果將2型糖尿病組分為：無糖尿病視網(wǎng)膜病變(NO-DR),單純期視網(wǎng)膜病變(PPDR)與增殖性糖尿病視網(wǎng)膜病變(PDR)。使用丹麥維迪公司Keypoint型肌電圖誘發(fā)電位儀對2型糖尿病組進(jìn)行交感神經(jīng)皮膚反應(yīng)(SSR)測定,根據(jù)有無糖尿病自主神經(jīng)系統(tǒng)損傷,將2型糖尿病組分為有自主神經(jīng)病變與無自主神經(jīng)兩組。隨機(jī)抽取我院眼科門診就診的50例50眼非糖尿病患者作為對照組。用C2514手提式瞳孔測量儀在暗室環(huán)境中測量出2型糖尿病組與對照組光刺激前、光刺激后及散瞳后瞳孔直徑,采用SPSS13.0對相關(guān)數(shù)據(jù)進(jìn)行統(tǒng)計學(xué)分析。 結(jié)果： 1、對照組,不同病程2型糖尿病患者瞳孔直徑比較 對照組光刺激前瞳孔直徑為5.13±0.28mm,光刺激后瞳孔直徑為3.10±0.35mm,散瞳后瞳孔直徑為7.09±0.34mm,病程1-8年組光刺激前瞳孔直徑為4.83±0.26mm,光刺激后瞳孔直徑為3.30±0.18mm,散瞳后瞳孔直徑為6.77±0.73mm,病程9-16年組光刺激前瞳孔直徑為3.80±0.18mm,光刺激后瞳孔直徑為6.77±0.73mm,病程9-16年組光刺激前瞳孔直徑為3.80±0.18mm,光刺激后瞳孔直徑為2.82±0.56mm,散瞳后瞳孔直徑為5.42±0.33mm,病程17-25年以上組光刺激前瞳孔直徑為3.00±0.24mm,光刺激后瞳孔直徑為2.90±0.41mm,,散瞳后瞳孔直徑為5.08±0.41mm。對照組與2型糖尿病患者在光照前與散瞳后瞳孔直徑相比較,均具有統(tǒng)計學(xué)意義(P0.05)；病程17-25年的糖尿病患者在光照前與光照后瞳孔直徑相比無明顯變化(P0.05)；在光照前與散瞳后,正常組與病程1-8年組瞳孔直徑比較均無統(tǒng)計學(xué)意義(P0.05),正常組與病程9-16年組及病程17-25年組瞳孔直徑差值比較有統(tǒng)計學(xué)意義(P＜0.05) 2、對照組,NO-DR、 PPDR、 PDR患者瞳孔直徑比較 對照組光刺激前瞳孔直徑為5.13±0.28mm,光刺激后瞳孔直徑為3.10±0.35mm,散瞳后瞳孔直徑為7.09±0.34mm,不伴有糖尿病性視網(wǎng)膜病變的糖尿病患者光刺激前瞳孔直徑為5.03±0.29mm,光刺激后瞳孔直徑為3.12±0.48mm散瞳后瞳孔直徑為7.00±0.66mm,單純期糖尿病性視網(wǎng)膜病變光刺激前瞳孔直徑組為4.90±0.28mm,,光刺激后瞳孔直徑為2.03±0.16mm,,散瞳后瞳孔直徑為5.91±0.23mm,增殖期糖尿病性視網(wǎng)膜病變光刺激前瞳孔直徑為3.60±0.16mm,光刺激后瞳孔直徑為2.52±0.32mm,散瞳后瞳孔直徑為5.73±0.41mm。對照組與2型糖尿病組在光照前與散瞳后瞳孔直徑相比較,均具有統(tǒng)計學(xué)意義(P0.05)；增殖期糖尿病患者瞳孔直徑在光刺激前與光刺激后相比,無明顯統(tǒng)計學(xué)意義(P0.05);光刺激前,對照組與無糖尿病性視網(wǎng)膜病變和單純糖尿病性視網(wǎng)膜病變患者瞳孔直徑相比無明顯統(tǒng)計學(xué)意義(PO.05),對照組與增殖期糖尿病性視網(wǎng)膜病變患者瞳孔直徑相比均具有統(tǒng)計學(xué)意義(P0.05)；散瞳后,對照組與無糖尿病性視網(wǎng)膜病變患者瞳孔直徑無明顯統(tǒng)計學(xué)意義,與單純期和增殖期糖尿病性視網(wǎng)膜病變患者瞳孔直徑相比有統(tǒng)計學(xué)意義(P0.05) 3、對照組,2型糖尿病組有無自主神經(jīng)病變患者瞳孔直徑比較 對照組光刺激前瞳孔直徑為5.13±0.28mm,光刺激后瞳孔直徑為3.10±0.35mm,,散瞳后瞳孔直徑為7.09±0.34mm,無自主神經(jīng)病變患者光刺激前瞳孔直徑為4.98±0.29mm,光刺激后瞳孔直徑為3.03±0.23mm,散瞳后瞳孔直徑為6.12±0.53mm,自主神經(jīng)病變患者患者光刺激前瞳孔直徑為3.32±0.16mm,患者,光刺激后瞳孔直徑為2.95±0.46mm,散瞳后瞳孔直徑為5.01±0.40mm。伴有自主神經(jīng)病變的糖尿病患者與不伴自主神經(jīng)病變的糖尿病患者瞳孔直徑在散瞳前與光刺激前相比均具有統(tǒng)計學(xué)意義(P0.05)；伴有自主神經(jīng)病變患者的瞳孔直徑在光刺激前與光刺激后無明顯變化(P0.05)；對照組與無自主神經(jīng)病變患者瞳孔直徑相比光刺激前無統(tǒng)計學(xué)意義(P0.05),但是在散瞳后具有統(tǒng)計學(xué)意義(P0.05) 結(jié)論： 1、2型糖尿病病程越長對瞳孔功能的影響越大 2、糖尿病性視網(wǎng)膜病變可能先于瞳孔功能異常 3、無自主神經(jīng)病變的糖尿病患者也同樣可以存在瞳孔功能的異常,有自主神經(jīng)病變者瞳孔更難散開,并且對光反射遲純。
[Abstract]:Purpose :

Objective To investigate the relationship between the changes of pupil function and diabetic history , diabetic retinopathy and diabetic autonomic neuropathy in patients with type 2 diabetes mellitus .

Method :

According to the WHO standard of diagnosis , 80 patients with type 2 diabetes mellitus were diagnosed as type 2 diabetes mellitus ( 80 eyes ) ( right eye ) . Among them , 27 patients with type 2 diabetes mellitus , 27 patients with diabetic retinopathy ( PDR ) and 27 patients with proliferative diabetic retinopathy ( PDR ) were randomly selected according to fundus examination or fundus fluorescein angiography . All 50 patients with type 2 diabetes were randomly selected to be treated with diabetic retinopathy ( NO - DR ) , simple retinal disease ( PPDR ) and proliferative diabetic retinopathy ( PDR ) .

Results :

Comparison of pupil diameters in 1 , control group and 2 diabetic patients with different course of disease

The pupil diameter of pupil after light stimulation was 3.80 鹵 0.28mm , pupil diameter was 3.80 鹵 0.27mm , pupil diameter was 3.80 鹵 0.27mm , pupil diameter was 2.82 鹵 0.67mm , pupil diameter was 3.80 鹵 0.33mm , pupil diameter was 2.90 鹵 0.41 mm , pupil diameter was 5.08 鹵 0.41 mm , and the pupil diameter was 5.08 鹵 0.41 mm . The diameter of pupil was 5.08 鹵 0.41 mm .
There was no significant difference between the diameter of pupil and pupil diameter before illumination ( P0.05 ) .
There was no significant difference between normal group and pupil diameter in 1 - 8 years before and after illumination ( P < 0.05 ) .

2 . Comparison of pupil diameters in control group , NO - DR , PPDR and PDR patients

The pupil diameter of pupil after light stimulation was 5.03 鹵 0.28mm , pupil diameter was 3.60 鹵 0.28mm , pupil diameter was 3.60 鹵 0.23mm , pupil diameter was 2.52 鹵 0.32 mm and pupil diameter was 5.73 鹵 0.41 mm .
The pupil diameter of diabetic patients with proliferative phase was not statistically significant ( P0.05 ) before and after light stimulation ( P0.05 ) . The control group had no significant difference compared with the pupil diameter of diabetic retinopathy and simple diabetic retinopathy ( P0.05 ) .
There was no significant difference in pupil diameter between the control group and the non - diabetic retinopathy after mydriasis ( P0.05 ) .

Comparison of pupil diameter in 3 , control group and type 2 diabetic group with or without autonomic neuropathy

The pupil diameter of pupil in control group was 5.13 鹵 0.28mm , pupil diameter was 3.03 鹵 0.23mm , pupil diameter was 3.03 鹵 0.23mm , pupil diameter was 3.03 鹵 0.23mm , pupil diameter was 5.01 鹵 0.40 mm , pupil diameter was 5.01 鹵 0.40 mm .
The pupil diameter of patients with autonomic neuropathy did not change significantly before and after light stimulation ( P0.05 ) .
There was no statistical difference between the control group and the pupil diameter of the patients without autonomic neuropathy ( P0.05 ) , but there was statistical significance after mydriasis ( P0.05 ) .

Conclusion :

1 . The longer the duration of the type 2 diabetes , the greater the effect of the function of pupil .

2 . Diabetic retinopathy may be preceded by abnormal pupil function

3 . Patients with diabetes without autonomic neuropathy can also have abnormal pupil function , and the pupil of autonomic nervous lesion is more difficult to disperse and is late to reflect light .
【學(xué)位授予單位】：山東大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2012
【分類號】：R587.2;R774.1

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相關(guān)期刊論文 前2條

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本文編號：2091957