[1]张浩,张鑫鹏,赵芊,等.无视网膜病变2型糖尿病患者黄斑区血管密度及其影响因素[J].眼科新进展,2020,40(11):1074-1078.[doi:10.13389/j.cnki.rao.2020.0240]
　ZHANG Hao,ZHANG Xinpeng,ZHAO Qian,et al.Analysis of vascular density and its risk factors in fundus imaging of patients with type 2 diabetes but without retinopathy[J].Recent Advances in Ophthalmology,2020,40(11):1074-1078.[doi:10.13389/j.cnki.rao.2020.0240]
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《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:
40卷
期数:
2020年11期
页码:
1074-1078
栏目:
应用研究
出版日期:
2020-11-05

文章信息/Info

Title:
Analysis of vascular density and its risk factors in fundus imaging of patients with type 2 diabetes but without retinopathy
作者:
张浩; 张鑫鹏; 赵芊; 张涵; 张云良; 刘爱华; 张欣鹏; 杨菊红
300134　天津市，国家卫生健康委员会激素与发育重点实验室（天津医科大学），天津市代谢性疾病重点实验室，天津医科大学朱宪彝纪念医院，天津市内分泌研究所（张浩，张鑫鹏，赵芊，杨菊红）；071000　河北省保定市，保定市第一中心医院内分泌一科，河北省光学感知技术创新中心（张浩，张涵，张云良）；300384　天津市，天津医科大学眼科医院，眼视光学院，眼科研究所，天津市视网膜功能与疾病重点实验室（刘爱华）；510006　广东省广州市，广东工业大学计算机学院（张欣鹏）
Author(s):
ZHANG Hao1; 2; ZHANG Xinpeng1; ZHAO Qian1; ZHANG Han2; ZHANG Yunliang2; LIU Aihua3; ZHANG Xinpeng4; YANG Juhong1
1.NHC Key Laboratory of Hormones and Development,Tianjin Medical University Chu Hsien-I Memorial Hospital & Tianjin Institute of Endocrinology
2.Department of Endocrinology,Baoding First Central Hospital,Hebei Provincial Center for Optical Sensing Innovations Baoding
3.Tianjin Key Laboratory of Retinal Functions and Diseases,Tianjin Medical University Eye Hospital
4.School of Computer Science and Technology,Guangdong University of Technology
关键词:
黄斑区血管密度; 糖尿病视网膜病变; 收缩压; 红细胞计数
Keywords:
fundus vascular density;  diabetic retinopathy;  systolic blood pressure;  red blood cell count
分类号:
R774
DOI:
10.13389/j.cnki.rao.2020.0240
文献标志码:
A
摘要:
目的　分析无视网膜病变2型糖尿病患者的黄斑区血管密度及其影响因素。方法　入选140例无视网膜病变的2型糖尿病患者，应用计算机辅助软件，采用基于方向跟踪和像素卷积描述的黄斑血管分割法自动计数患者黄斑区的血管密度。根据眼底血管密度中位数分为低血管密度组和高血管密度组，比较两组患者间一般资料及生化指标的差异。另外入选了40例健康体检者为健康对照组，同时在140例患者中选择年龄、性别、身高、体质量、血压等指标均匹配的40例作为糖尿病组，比较两组患者的黄斑区血管密度水平。结果　低血管密度组患者的年龄为（58.47±10.39）岁，收缩压为(135.23±12.67)mmHg（1 kPa=7.5 mmHg），均较高血管密度组［（50.86±13.86）岁、（129.73±10.41）mmHg］高，差异均有统计学意义（均为P<0.05）；低血管密度组患者的体质量为(74.00±11.05）kg，红细胞计数为(4.48±0.49)×1012个·L-1，红细胞压积为40.12%±4.24%，血红蛋白含量为(135.31±16.34) g·L-1，均较高血管密度组［（78.48±15.16）kg、（4.66±0.49）×1012个·L-1、42.10%±4.00%、（142.71±15.59）g·L-1］减少，差异均有统计学意义（均为P<0.05）。Logistics回归分析结果显示，收缩压和红细胞计数是黄斑区血管密度的独立影响因素，且与血管密度均呈负相关(r=-0.077、-4.062，均为P<0.05)。与糖尿病组（0.075 54±0.020 00）相比，健康对照组眼底血管密度（0.100 49±0.030 00）明显较高，差异具有统计学意义（P<0.001）。结论　利用计算机辅助软件可以自动快速识别黄斑区微循环障碍的患者。黄斑区血管密度与收缩压及红细胞计数有关。改善高血压及缺氧导致的红细胞计数减少可能有利于改善黄斑区血管密度，从而预防糖尿病视网膜病变。
Abstract:
Objective　To analyze the fundus vascular density and its influencing factors in patients with type 2 diabetes but without retinopathy. Methods　A total of 140 type 2 diabetes patients with non-diabetic retinopathy were enrolled. Computer-assisted software was used to automatically count the vascular density of the macular area with macular vascular segmentation based on direction tracking and pixel convolution in patients. Based on the median vascular density of the fundus, all patients were divided into low vascular density (LVD) group and high vascular density (HVD) group, and the differences of all general and biochemical indicators were compared between the two groups. In addition, 40 healthy subjects were selected for control group. At the same time, 40 diabetic patients with matching indexes such as age, gender, height, body mass and blood pressure were selected as diabetic group, and the density level of fundus vessels was compared between the two groups.Results　Compared with HVD group, the age ［(50.86±13.86) years vs. (58.47±10.39) years］ and systolic blood pressure (SBP) ［(129.73±10.41)mmHg (1 kPa=7.5 mmHg) vs. (135.23±12.67) mmHg］ in LVD group were higher (both P<0.05). The body mass of the patients in the LVD group was (74.0±11.05) kg, the red blood cell count was (4.48±0.49)×1012 cells·L-1, and the hematocrit was 40.12%±4.24%, the hemoglobin content was (135.31±16.34) g·L-1, all of which were higher than those in the HVD group ［(78.48±15.16) kg, (4.66±0.49)× 1012 cells·L-1, 42.10%±4.00%, (142.71±15.59)g·L-1］, and the difference was statistically significant (all P<0.05). Among the factors related to vascular density mentioned above, SBP and red blood cell count were independent risk factors for vascular density, and both were negatively correlated with fundus vascular density (r=-0.077, -4.062, both P<0.05). The fundus vascular density of the control group (0.100 49±0.030 00) was higher than that of the diabetic group (0.075 54±0.02000) under the premise of balanced basic information between the two groups, and the difference was statistically significant (P<0.001).Conclusion　Computer-assisted software is an easy, rapid and automate way to identify patients with microcirculatory disorder in the macula. The vascular density in the macula is associated with increased hypertension and red blood cell count. Improving red blood cell and hypertension may be beneficial in improving blood vessel density in the macular area and thus helpful in preventing diabetic retinopathy.

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备注/Memo

备注/Memo:
河北省医学适用技术跟踪项目（编号：G2019012）
更新日期/Last Update: 2020-11-05