【摘要】：目的： 分析視網(wǎng)膜分支靜脈阻塞和高度近視眼與非對(duì)稱(chēng)性糖尿病視網(wǎng)膜病變關(guān)系,明確促進(jìn)及抑制糖尿病視網(wǎng)膜病變的相關(guān)因素。 方法： 回顧性分析2007年1月-2010年12月86例2型糖尿病患者資料,其中32例為一眼患有視網(wǎng)膜分支靜脈阻塞而對(duì)側(cè)為無(wú)視網(wǎng)膜分支靜脈阻塞的非增生性糖尿病視網(wǎng)膜病變眼,以及22例一眼6.00D以上高度近視而對(duì)側(cè)為正視的糖尿病視網(wǎng)膜病變眼,另外32例雙眼無(wú)視網(wǎng)膜靜脈阻塞的糖尿病患者為對(duì)照組,其年齡、性別、糖尿病病程與32例單眼視網(wǎng)膜分支靜脈阻塞糖尿病患者相匹配。分析視網(wǎng)膜分支靜脈阻塞及高度近視與非對(duì)稱(chēng)性糖尿病視網(wǎng)膜病變的關(guān)系；高度近視不同屈光度與糖尿病視網(wǎng)膜病變的關(guān)系；視網(wǎng)膜分支靜脈阻塞的發(fā)生與全身情況的關(guān)系。 結(jié)果： 32例2型糖尿病患者視網(wǎng)膜分支靜脈阻塞眼,糖尿病視網(wǎng)膜病變程度較對(duì)側(cè)眼加重,其中16只眼發(fā)生增生性糖尿病視網(wǎng)膜病變,有3只眼并發(fā)牽引性視網(wǎng)膜脫離,另外16只眼中,輕度NPDR3只眼,中度NPDR5只眼,重度NPDR8只眼,對(duì)側(cè)無(wú)視網(wǎng)膜靜脈阻塞眼中,無(wú)明顯DR3只眼,輕度NPDR9只眼,中度NPDR12只眼,重度NPDR8只眼；22例患有單眼高度近視2型糖尿病患者中,其糖尿病視網(wǎng)膜病變程度均較對(duì)側(cè)正視眼明顯減輕,表現(xiàn)為未出現(xiàn)糖尿病視網(wǎng)膜病變(DR)或只出現(xiàn)非增生性糖尿病網(wǎng)膜病變(NPDR),而無(wú)一例出現(xiàn)增生性糖尿病網(wǎng)膜病變(PDR)。其中無(wú)明顯DR10只眼,輕度NPDR7只眼,中度NPDR3只眼,重度NPDR2只眼；而對(duì)側(cè)正視眼中,無(wú)明顯視網(wǎng)膜病變1只眼,輕度NPDR3只眼,中度NPDR5只眼,重度NPDR5只眼,PDR8只眼,PDR中2只眼并發(fā)牽引性視網(wǎng)膜脫離。高度近視屈光度數(shù)越高,糖尿病視網(wǎng)膜病變?cè)捷p微。32例單眼BRVO的糖尿病患者中,有高血壓的21例,高血脂19例,血糖控制不良的23例。對(duì)照組32例雙眼無(wú)視網(wǎng)膜靜脈阻塞的糖尿病患者中,有高血壓的12例,高血脂的13例,血糖控制不良的12例。 結(jié)論： 視網(wǎng)膜分支靜脈阻塞可能是促進(jìn)增生型糖尿病視網(wǎng)膜病變形成的眼內(nèi)危險(xiǎn)性因素之一,而高度近視可能是抑制糖尿病視網(wǎng)膜病變加重保護(hù)性因素之一,且隨著近視度數(shù)的加深,這種保護(hù)作用越明顯；伴有高血壓、高血脂、血糖控制不良的糖尿病患者更易發(fā)生視網(wǎng)膜分支靜脈阻塞。
[Abstract]:Aim: to analyze the relationship between retinal branch vein occlusion (RVO) and high myopia and asymmetric diabetic retinopathy (ADM), and to determine the factors related to the promotion and inhibition of diabetic retinopathy. Methods: the data of 86 patients with type 2 diabetes mellitus from January 2007 to December 2010 were retrospectively analyzed. 32 of them were non-proliferative diabetic retinopathy with retinal branch vein occlusion and contralateral non-proliferative diabetic retinopathy with retinal branch vein occlusion. And 22 eyes of diabetic retinopathy with high myopia above 6.00D but opposite side emmetropia, and 32 patients with diabetes without retinal vein occlusion were used as control group, their age and sex were used as control group. The course of diabetes was matched with 32 patients with monocular retinal branch vein occlusion. To analyze the relationship between retinal branch vein occlusion and high myopia and asymmetric diabetic retinopathy, the relationship between different diopters of high myopia and diabetic retinopathy, and the relationship between the occurrence of retinal branch vein occlusion and the whole body condition. Results: in 32 patients with type 2 diabetes mellitus, the degree of diabetic retinopathy was more serious than that of the contralateral eyes. 16 eyes developed proliferative diabetic retinopathy, 3 eyes complicated with traction retinal detachment. In the other 16 eyes, mild NPDR3 eyes, moderate NPDR5 eyes, severe NPDR8 eyes, contralateral retinal vein occlusion eyes, no obvious DR3 eyes, mild NPDR9 eyes, moderate NPDR12 eyes, severe NPDR8 eyes; In 22 patients with type 2 diabetes with monocular high myopia, the degree of diabetic retinopathy was significantly less than that of contralateral positive vision. No diabetic retinopathy (DR) or only non-proliferative diabetic omentopathy (NPDR), and no proliferative diabetic retinopathy (PDR). There was no obvious DR10 in eyes, mild NPDR7 in eyes, moderate NPDR3 in eyes and severe NPDR2 in eyes. In the contralateral emmetropia, there was no obvious retinopathy in 1 eye, mild NPDR3 in 1 eye, moderate NPDR5 in the eyes, severe NPDR5 in the eyes, PDR8 in the eyes, and 2 eyes in the PDR complicated with traction retinal detachment. The higher the diopter of high myopia, the more slight the diabetic retinopathy. Among 32 patients with monocular BRVO, 21 had hypertension, 19 had hyperlipidemia and 23 had poor blood glucose control. In the control group, there were 12 cases of hypertension, 13 cases of hyperlipidemia and 12 cases of poor blood glucose control. Conclusion: retinal branch vein occlusion may be one of the intraocular risk factors to promote the formation of proliferative diabetic retinopathy, and high myopia may be one of the protective factors to inhibit the exacerbation of diabetic retinopathy. And with the deepening of myopia, this protective effect is more obvious; Diabetic patients with hypertension, hyperlipidemia and poor blood glucose control are more likely to develop retinal branch vein occlusion.
【學(xué)位授予單位】：南昌大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2011
【分類(lèi)號(hào)】：R774.1

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