摘要
目的探索临床前期糖尿病视网膜病变患者黄斑特征与肾小球滤过率的相关性。方法回顾性选取2023年1—12月天津医科大学眼科医院收治的541例临床前期糖尿病视网膜病变(pre-clinical stage of diabetic retinopathy,PCDR)患者的临床资料。通过估计肾小球滤过率(estimated glomerular filtration rate,eGFR),将患者分为G1组44例、G2组159例、G3组253例和G4组85例。对患者进行光学相干断层扫描血管成像(optical coherence tomography angiography,OCTA)等检查,对比各组代谢差异、黄斑区视网膜微血管密度及各层厚度。结果4组患者的体重指数、空腹血糖、糖化血红蛋白、白蛋白、尿素氮、肌酐、尿酸、总胆固醇、甘油三酯比较,差异均有统计学意义(P均<0.05)。4组患者黄斑区视网膜血管密度比较,差异无统计学意义(P>0.05)。4组患者黄斑区视网膜神经纤维层、神经节细胞层及节细胞复合层的平均厚度比较,差异均有统计学意义(P均<0.05)。去除年龄、性别因素后,患者体重指数、空腹血糖、糖化血红蛋白、白蛋白、尿素氮、肌酐、尿酸、总胆固醇及视网膜神经纤维层、神经节细胞层、节细胞复合层的平均厚度均与eGFR显著相关(P<0.05)。结论PCDR患者表现出视网膜神经纤维层、神经节细胞层及节细胞复合层平均厚度减少,此变化与视网膜神经损害有关,与患者eGFR正相关。
Objective To explore the correlation between macular features and glomerular filtration rate(eGFR)in patients with preclinical diabetic retinopathy(PCDR).Methods A retrospective analysis was conducted on patients undergoing diabetic retinopathy screening at Tianjin Medical University Eye Hospital from January to December 2023.A total of 541 PCDR patients were enrolled and divided into four groups based on eGFR:Group G1(n=44),G2(n=159),G3(n=253),and G4(n=85).Optical coherence tomography angiography(OCTA)was performed to compare metabolic differences,macular retinal microvascular density,and layer thickness across groups.Results There were significant differences in body mass index,fasting blood glucose,glycosylated hemoglobin,albumin,urea nitrogen,creatinine,uric acid,total cholesterol and triglyceride among the four groups(all P<0.05).There was no significant difference in retinal vascular density in macular area among the four groups(P>0.05).There were significant differences in the average thickness of retinal nerve fiber layer,ganglion cell layer and ganglion cell composite layer in the macular area among the four groups(all P<0.05).After removing age and gender factors,body mass index,fasting blood glucose,glycosylated hemoglobin,albumin,urea nitrogen,creatinine,uric acid,total cholesterol and the average thickness of retinal nerve fiber layer,ganglion cell layer and ganglion cell composite layer were significantly correlated with eGFR(P<0.05).Conclusion Patients with PCDR exhibited reduced thickness of the RNFL,GCL,and GCC,which is associated with retinal neural damage and positively correlated with eGFR.
作者
马良
胡立影
石羽
孙广东
MA Liang;HU Liying;SHI Yu;SUN Guangdong(Department of Nephrology,Tianjin People's Hospital,Tianjin 300121,China;Clinical Research Center,Tianjin Medical University Eye Hospital,Tianjin 300384,China)
出处
《糖尿病新世界》
2025年第11期1-5,共5页
Diabetes New World
基金
天津市教委科研计划项目(2022KJ258)。
