摘要
目的探讨肾脏疾病对2型糖尿病视网膜病变手术治疗时机及其疗效的评估价值。方法回顾性分析19例行眼底检查的2型糖尿病肾病的临床资料，并根据蛋白尿和肾功能情况，将有视网膜病变患者分为3组。分析糖尿病视网膜病变在各组2型糖尿病肾病中的发生情况和手术治疗效果。结果19例2型糖尿病肾病中15例（78．9％）伴有糖尿病视网膜病变，4例（21．1％）不伴有糖尿病视网膜病变。随着肾功能损伤程度的加重，糖尿病视网膜病变从非增生性进入增生性，重症患者激光或玻璃体切除手术后视功能无改善，病情仍会继续恶化。结论糖尿病视网膜病变的类型与分期与2型糖尿病肾病的严重程度相一致，后者可指导糖尿病视网膜病变手术时机的选择并有助于预后的判断，特别是在眼底无法查清的情况下，糖尿病肾病的临床表现对视网膜玻璃体手术的意义更为重要。
Objective To investigate the evaluation value of diabetic kidney disease on timing and effect of surgiacal treatment of diabetic retinopathy. Methods A retrospective analysis of clinical data and ocular fundus examination were performed on 19 patients of type 2 diabetes with diabetic kidney disease. All patients with diabetic kidney disease and retinopathy were divided into three groups according to proteinuria and renal function. The prevalence of diabetic retinopathy and effect of surgical treatment were analyzed in different groups of patients. Results Among 19 patients, 15 cases （ 78.9% ） with diabetic retinopathy, 4 cases（21.1% ） without diabetic retinopathy. With increasing of kidney lesion, the diabetic retinopathy was changed from non-proliferative retinopathy to proliferative retinopathy. Visual acuity was not changed after retinal laser photocoagulation or even vitrectomy in patients with severe kidney lesion. Conclusion The type and stage of diabetic retinopathy were closeiy associated with the severity of kidney disease in type 2 di- abetes, kidney disease might guide the timing of surgical treatment and judge the prognosis. The clinical manifestation of diabetic kidney disease might play a very important role in guiding the vitrectomy in diabetic retiuopathy, especially when ocular fundus could not be seen clearly.
出处
《中华眼外伤职业眼病杂志》
2011年第9期664-666,共3页
Chinese Journal of Ocular Trauma and Occupational Eye Disease
关键词
糖尿病
2型
糖尿病肾病
糖尿病视网膜病变
手术治疗
视力
Diabetes, type 2
Kidney disease, diabetic
Diabetic retinopathy
Treatment, surgical
Visual acuity
