摘要
目的观察非糖尿病腹膜透析(PD)患者黄斑区血流密度及灌注密度变化,初步分析其与血压、总蛋白、白蛋白、前白蛋白、血肌酐、尿素、超敏C反应蛋白的相关性。方法单中心、横断面、临床观察性研究。2018年1~12月于北京大学第一医院PD中心行PD治疗的非糖尿病患者63例63只眼(非糖尿病PD组)和正常健康者75名75只眼(健康对照组)纳入研究。均为单眼入组。非糖尿病PD组63例中,男性24例,女性39例;PD持续时间7~185个月,平均持续时间(67.87±48.36)个月。健康对照组75名中,男性33名,女性42名;平均年龄(54.2±13.2)岁。两组受检者年龄(t=-0.558)、性别构成比(χ2=0.492)、眼轴长度(t=-1.197)、BCVA比较,差异均无统计学意义(P>0.05)。采用OCT血管成像仪对受检者右眼黄斑区3 mm×3 mm、6 mm×6 mm范围进行扫描。测量黄斑区视网膜浅层毛细血管血流密度、灌注密度以及黄斑中心凹无血管区(FAZ)面积、周长、形态指数。两组受检眼黄斑区不同位置血流密度、灌注密度比较行独立样本t检验;与血压、总蛋白、白蛋白、前白蛋白、血肌酐、尿素、超敏C反应蛋白的相关性行Pearson相关性分析。结果与健康对照组比较,非糖尿病PD组受检眼不同扫描范围黄斑区视网膜浅层毛细血管血流密度及灌注密度均下降,其中黄斑血管3×3中心(t=-2.409)、黄斑血管3×3黄斑周(t=-2.423)、黄斑血管3×3完整(t=-2.759)、黄斑血管6×6完整(t=-1.882)、黄斑血管6×6外层(t=-2.188)和黄斑灌注3×3中心(t=-1.990)、黄斑灌注3×3完整(t=-2.719)、黄斑灌注6×6完整(t=-2.113)、黄斑灌注6×6外层(t=-2.205)差异有统计学意义(P<0.05)。两组受检眼FAZ面积比较,差异有统计学意义(t=1.985,P<0.05)。相关性分析发现,黄斑血管3×3完整与平均动脉压呈正相关(r=0.256,P=0.043);黄斑血管3×3完整、黄斑灌注3×3完整、黄斑血6×6完整与前白蛋白呈正相关(r=0.468、0.362、0.333;P<0.001,P=0.004、0.008);黄斑血管3×3完整、黄斑灌注6×6完整与超敏C反应蛋白呈负相关(r=-0.370、-0.287,P=0.005、0.030)。结论非糖尿病PD患者黄斑区视网膜浅层血流密度、灌注密度均较正常健康人降低。
Objective To observe the changes of blood flow density and perfusion density in the macula of non-diabetic peritoneal dialysis (PD) patients, and their correlation with blood pressure, total protein, albumin, prealbumin, serum creatinine, urea, and high-sensitivity C-reactive protein were preliminarily analyzed.Methods A single-center, cross-sectional, clinical observational study. From January to December 2018, 63 eyes of 63 non-diabetic patients (non-diabetic PD group) and 75 eyes of normal healthy people (the normal control group) who underwent PD treatment at the PD Center of Peking University First Hospital were included in the study. All were monocular into the group. Among the 63 patients in the non-diabetic PD group, 24 were males and 39 were females. The duration of PD was 7 to 185 months, with the average duration of 67.87±48.36 months. There were 75 healthy persons in the normal control group. There was no significant difference in age (t=-0.558), sex ratio (χ2=0.492), axial length (t=-1.197), and BCVA between the two groups (P>0.05). OCT angiography was used to scan the macular area of 3 mm×3 mm and 6 mm×6 mm in the subject’s right eye. The blood flow density and perfusion density of superficial retinal capillaries in the macular area, as well as the area, circumference, and morphological index of the foveal avascular zone (FAZ) were measured. The blood flow density and perfusion density at different locations in the macular area of the two groups of eyes were compared by independent sample t test. The blood pressure, total protein, albumin, prealbumin, serum creatinine, urea, and high-sensitivity C-reactive protein was performed by Pearson correlation analysis.Results Compared with the healthy control group, the blood flow density and perfusion density of superficial retinal capillaries in the macular area of the non-diabetic PD group decreased in different scanning ranges with the macular vessel 3×3 center (t=-2.409), the macular vessel 3×3 macular (t=-2.423), macular vessel 3×3 intact (t=-2.759), macular vessel 6×6 intact (t=-1.882), macular vessel 6×6 outer layer (t=-2.188), macular perfusion 3×3 center (t=-1.990), macular perfusion 3×3 complete (t=-2.719), macular perfusion 6×6 complete (t=-2.113), and macular perfusion 6×6 outer layer (t=-2.205). The difference was statistically significant (P<0.05). The comparison of the macular FAZ area of the two groups of eyes was statistically significant (t=1.985, P <0.05). Correlation analysis showed that 3×3 macular blood vessels were intact and mean arterial pressure was positively correlated (r=0.256, P=0.043). The macular blood vessels were 3×3 intact, macular perfusion was 3×3 intact, and macular blood was 6×6 intact, which the pre-white protein was positively correlated with (r=0.468, 0.362, 0.333;P<0.001, P=0.004, 0.008). The macular vessel 3×3 was intact, the macular perfusion 6×6 was intact, which the hypersensitive C-reactive protein was negatively correlated with (r=-0.370, -0.287, P=0.005, 0.030).Conclusion The superficial retinal blood flow density and perfusion density in the macular area of non-diabetic PD patients are lower than those of normal healthy people.
作者
郝健晨
赵楠
顾枭鹏
董捷
杨柳
Hao Jianchen;Zhao Nan;Gu Xiaopeng;Dong Jie;Yang Liu
出处
《中华眼底病杂志》
CAS
CSCD
北大核心
2020年第11期861-866,共6页
Chinese Journal of Ocular Fundus Diseases
关键词
腹膜透析
局部血流
灌注密度
Peritoneal dialysis
Regional blood flow
Macular perfusion
