摘要
目的分析白内障术治疗糖尿病视网膜病变(DR)合并白内障后患者瞳孔改变及其影响因素。方法回顾性选取2020年2月至2021年2月中国人民解放军中部战区总医院DR合并白内障超声乳化摘除联合人工晶状体植入手术患者2000例(2000眼)。比较不同性别、年龄、DR病程(0~5、6~10、11~15、16~20年)、糖化血红蛋白(HbA1c)水平(≤8.4%、8.5%~13.4%、>13.4%)、眼底荧光造影检查结果(增殖期、非增殖期)患者的术后散瞳时间和瞳孔直径,并分析术后散瞳时间和瞳孔直径与一般资料的相关性,多元Logistic回归分析术后散瞳时间和瞳孔直径的影响因素。结果性别、年龄、HbA1c水平与术后散瞳时间和瞳孔直径无关(P>0.05);糖尿病病程0~5、6~10、11~15、16~20年患者的术后散瞳时间逐渐延长,眼底荧光造影检查增殖期患者的术后散瞳时间长于非增殖期,差异均有统计学意义(P<0.05)。糖尿病病程0~5、6~10、11~15、16~20年患者的术后瞳孔直径逐渐缩短,眼底荧光造影检查增殖期患者的术后瞳孔直径短于非增殖期,差异均有统计学意义(P<0.05)。2000例患者的术后散瞳时间与糖尿病病程、眼底荧光造影检查均呈显著的正相关关系(P<0.05);术后瞳孔直径与糖尿病病程、眼底荧光造影检查均呈显著的负相关关系(P<0.05)。多元Logistic回归分析显示,2000例患者的术后散瞳时间和瞳孔直径影响因素包括糖尿病病程和眼底荧光造影检查结果(P<0.05)。结论白内障术治疗DR合并白内障后患者的术后散瞳时间与糖尿病病程、眼底荧光造影检查均呈显著的正相关关系,术后瞳孔直径与糖尿病病程、眼底荧光造影检查均呈显著的负相关关系,糖尿病病程和眼底荧光造影检查结果是患者的术后散瞳时间和瞳孔直径的影响因素。
Objective To analyze the changes of pupil and its influencing factors after cataract surgery for diabetic retinopathy(DR)with cataract.Methods 2000 patients(2000 eyes)with DR combined with phacoemulsification and intraocular lens implantation in Central theater General Hospital of the Chinese people's Liberation Army from February 2020 to February 2021 were retrospectively selected to analyze postoperative dilation time and pupil diameter of 2000 patients,the postoperative mydriasis time and pupil diameter of patients with different gender,age,DR course(0~5,6~10,11~15,16~20 years),hemoglobin A1c(HbA1c)level(≤8.4%,8.5%~13.4%,>13.4%)and fundus fluorescein angiography(proliferative stage and non proliferative stage)were compared,and the correlation between postoperative dilation time and general data were compared.Multivariate Logistic regression analysis of postoperative pupil change factors.Results Gender,age and HbA1c level were not related to postoperative mydriasis time and pupil diameter(P>0.05).The postoperative dilation time of patients with 0~5,6~10,11~15 and 16~20 years of diabetes was gradually prolonged,the postoperative dilation time of patients in proliferative stage was longer than that in non-proliferative stage,the differences were statistically significant(P<0.05).The postoperative pupil diameter was gradually shortened in patients with 0~5,6~10,11~15,16~20 years of diabetes,,fundus fluorescein angiography showed that the postoperative pupil diameter of patients in proliferating stage was shorter than that in non-proliferating stage,the differences were statistically significant(P<0.05).There was a significant positive correlation between postoperative dilated pupil time and the course of diabetes and fundus fluorescein angiography(P<0.05);there was a significant negative correlation between postoperative pupil diameter and the course of diabetes and fundus fluorescein angiography(P<0.05).Multivariate Logistic regression analysis showed that the influencing factors of postoperative dilation time and pupil diameter in 2000 patients included the course of diabetes,fundus fluorescein examination results(P<0.05).Conclusion Cataract surgery treatment of DR with cataract patients after postoperative mydriatic time and duration of diabetes,fundus fluorescence angiography examination was significantly positive correlation,the pupil diameter and diabetes duration,fundus fluorescence angiography examination are significantly negative correlation relationship and the duration of diabetes and fundus fluorescein angiography were the influencing factors of postoperative mydriasis time and pupil diameter.
作者
廖芙蓉
杨磊
曾波
鲍雨萌
LIAO Fu-rong;YANG Lei;ZENG Bo(Department of Ophthalmology,PLA Central Theater General Hospital,Wuhan Hubei 430061,China.)
出处
《临床和实验医学杂志》
2022年第12期1314-1317,共4页
Journal of Clinical and Experimental Medicine
基金
湖北省技术创新专项重大项目(编号:2017ACA099)。
