摘要
目的 探讨活体共聚焦显微镜(IVCM)在评估2型糖尿病患者角膜神经形态学变化中的临床应用价值。方法 选取2017年12月至2019年12月确诊的2型糖尿病患者180例,根据其是否合并糖尿病视网膜病变(DR)将其分为非糖尿病视网膜病变(NDR)组(90例,90眼)和DR组(90例,90眼)。另选择同期健康志愿者90名(90眼)作为对照组。均行IVCM检查,比较三组角膜中央神经纤维密度(CNFD)、角膜神经分支密度(CNBD)、角膜神经纤维长度(CNFL)。结果 IVCM检查见NDR组和DR组的角膜神经纤维的数量及分支较对照组减少,走行僵直。NDR组和DR组的CNFD、CNBD和CNFL水平均显著低于对照组(P<0.05)。DR组的CNFD、CNBD和CNFL水平显著低于NDR组(P<0.05)。结论 IVCM检查能够快速、无创、精准地检测出糖尿病患者角膜神经纤维的早期改变,可为DR的预防、早诊断、早干预提供客观的科学依据。
Objective To explore the clinical application value of in-vivo confocal microscopy(IVCM)in evaluating the morphological changes of corneal nerves in patients with type 2 diabetes.Methods One hundred and eighty patients with type 2 diabetes diagnosed from DecembeR2017 to DecembeR2019 were selected,and divided into non-diabetic retinopathy(NDR)group(90 cases,90 eyes)and diabetic retinopathy(DR)group(90 cases,90 eyes)according to whether they were complicated with diabetic retinopathy.Ninety healthy volunteers(90 eyes)during the same period were selected as the control group.All the research subjects underwent IVCM examination,and the central corneal nerve fiber density(CNFD),corneal nerve branch density(CNBD)and corneal nerve fiber length(CNFL)were compared among the three groups.Results The IVCM examination showed that the number and branches of corneal nerve fibers in the NDR group and the DR group were less than those in the control group,and the course of corneal nerve fibers was stiff.The levels of CNFD,CNBD and CNFL in the NDR group and the DR group were significantly lower than those in the control group(P<0.05).The levels of CNFD,CNBD and CNFL in the DR group were significantly lower than those in the NDR group(P<0.05).Conclusion IVCM examination can quickly,non-invasively and accurately detect the early changes of corneal nerve fibers in diabetic patients,and can provide objective scientific basis for the prevention,early diagnosis and early intervention of DR.
作者
陈丽妃
黄慧
沈朝兰
陈琦
李敏
CHEN Li-fei;HUANG Hui;SHEN Chao-lan(Department of Ophthalmology,the People′s Hospital of Guangxi Zhuang Autonomous Region,Nanning 530021,China)
出处
《中国临床新医学》
2022年第12期1163-1166,共4页
CHINESE JOURNAL OF NEW CLINICAL MEDICINE
基金
广西科技计划项目(编号:桂科AD19245193)
广西卫生健康委科研课题(编号:Z20170375
Z2016623)。
关键词
活体共聚焦显微镜
糖尿病
角膜神经纤维
In-vivo confocal microscopy(IVCM)
Diabetes
Cornea nerve fiber
