[1]陆炯,李函,邢茜,等.基于角膜共焦激光显微镜检测的角膜基底神经变化与2型糖尿病视网膜微血管病变的相关性研究[J].眼科新进展,2017,37(9):863-866.[doi:10.13389/j.cnki.rao.2017.0219]
　LU Jiong,LI Han,XING Qian,et al.Correlation of corneal basal nerve changes with type 2 diabetic renal microangiopathy based on confocal laser microscopy[J].Recent Advances in Ophthalmology,2017,37(9):863-866.[doi:10.13389/j.cnki.rao.2017.0219]
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基于角膜共焦激光显微镜检测的角膜基底神经变化与2型糖尿病视网膜微血管病变的相关性研究/HTML
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《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:
37卷
期数:
2017年9期
页码:
863-866
栏目:
应用研究
出版日期:
2017-09-05

文章信息/Info

Title:
Correlation of corneal basal nerve changes with type 2 diabetic renal microangiopathy based on confocal laser microscopy
作者:
陆炯; 李函; 邢茜; 孟逸芳
215500　江苏省常熟市第二人民医院眼科
Author(s):
LU Jiong; LI Han; XING Qian; MENG Yi-Fang
Department of Ophthalmology，the Second People’s Hospital of Changshu，Changshu 215500，Jiangsu Province，China
关键词:
角膜共焦激光显微镜; 角膜神经; 视网膜微血管病变; 2型糖尿病
Keywords:
confocal laser microscopy; corneal nerve; retinal microvascular disease; type 2 diabetes mellitus
分类号:
R772
DOI:
10.13389/j.cnki.rao.2017.0219
文献标志码:
A
摘要:
目的　探讨角膜共焦激光显微镜检测的角膜基底神经变化与2型糖尿病（type 2 diabetes mellitus，T2DM）视网膜微血管病变的相关性。方法　选取2016年2月至2017年2月在我院治疗的T2DM患者118例，其中合并糖尿病视网膜病变（diabetic retinopathy，DR）患者57例（DR组），无DR患者61例（NDR组），同时选取健康志愿者60人作为对照组，所有研究对象采用角膜共焦激光显微镜检查，分析角膜神经形态参数与临床指标的关系。结果　DR组角膜神经纤维密度、角膜神经分支密度和角膜神经长度分别为（20.03±4.22）条·mm-2、（22.01±7.05）条·mm-2和（9.50±1.76）mm·mm-2，明显小于对照组和NDR组（均为P＜0.05），而角膜神经纤维弯曲度为0.30±0.03，明显高于对照组和NDR组（均为P＜0.05）；DR患者中，Ⅲ期患者角膜神经纤维密度、角膜神经分支密度和角膜神经长度明显小于Ⅰ期和Ⅱ期DR患者（均为P＜0.05），而角膜神经纤维弯曲度明显高于Ⅰ期和Ⅱ期DR患者（均为P＜0.05）。DR组病程为（12.04±2.48）a，明显高于NDR组（P＜0.05），而空腹C肽和空腹胰岛素分别为（1.41±0.58）μg·L-1和（20.05±7.91）mU·L-1，明显低于NDR组（均为P＜0.05）。T2DM患者病程与角膜神经分支密度及角膜神经纤维长度呈负相关（r=-0.322、-0.317，均为P＜0.05）；空腹C肽与角膜神经分支密度呈正相关（r=0.298，P＜0.05），与角膜神经弯曲度呈负相关（r=-0.311，P＜0.05）。结论　T2DM视网膜微血管病变患者角膜神经形态参数异常，对病程较长或空腹C肽水平低的T2DM患者应用角膜共激光显微镜检测有助于早期发现微血管病变。
Abstract:
Objective　To investigate the relationship between corneal basal nerve change and type 2 diabetic retinopathy based on confocal laser microscopy.Methods　Together 118 patients with type 2 diabetes （T2D） were collected in our hospital from February 2016 to February 2017，including 57 patients with diabetic retinopathy （DR group） and 61 patients without DR （NDR group）.For comparison，60 healthy volunteers were selected as the control group.And all the subjects were examined by corneal confocal laser microscopy to analyze the relationship between the morphological parameters of the corneal nerve and clinical variables.Results　Corneal nerve fiber density，corneal nerve branch density and corneal nerve branch length in DR group were （20.03±4.22）·mm-2，（22.01±7.05）·mm-2 and （9.50±1.76）mm·mm-2，significantly less than those of the control group and NDR group （all P<0.05）；and corneal nerve fiber curvature was （0.30±0.03），significantly higher than that of the control group and NDR group （all P<0.05）；In DR patients，phase Ⅲ patients had smaller the corneal nerve fiber density，corneal nerve branch density and corneal nerve branch length，but the larger corneal nerve fiber curvature than the phase Ⅰ and Ⅱ patients （all P<0.05）；course of disease of DR group was （12.04±2.48） years，which was significantly higher than that of NDR group （P<0.05），while fasting C peptide and fasting insulin were （1.41±0.58） μg·L-1 and （20.05±7.91）mU·L-1，respectively，significantly lower than those of NDR group （all P<0.05）；The duration of T2D was negatively correlated with the corneal nerve branch density and corneal nerve branch length （r=-0.322,-0.317，all P<0.05）；Fasting C peptide was positively correlated with the corneal nerve branch density （r=0.298，P<0.05），and negatively correlated with the corneal nerve curvature （r=-0.311，P<0.05）.Conclusion　Patients with T2D retinopathy have abnormal morphology of corneal nerve.And confocal laser scanning microscopy is conducive to the early detection of microvascular disease in T2D patients with a longer course of disease or a low level of fasting C peptide.

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更新日期/Last Update: 2017-10-12