引用本文: | 陈丽妃,黄慧,沈朝兰,陈琦.活体共聚焦显微镜在评估2型糖尿病患者角膜神经形态学变化中的临床应用[J].中国临床新医学,0,():-. |
| CHEN Li-fei,HUANG Hui,SHEN Chao-lan,CHEN Qi.活体共聚焦显微镜在评估2型糖尿病患者角膜神经形态学变化中的临床应用[J].中国临床新医学,0,():-. |
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摘要: |
[]目的 探索活体共聚焦显微镜在评估2型糖尿病患者角膜神经形态学变化中的临床应用。方法 选取2型糖尿病患者180例作为实验组,其中非糖尿病视网膜病变(Non-diabeticretinopathy,NDR)患者90例90眼(NDR组),合并有糖尿病视网膜病变(Diabeticretinopathy,DR)90例90眼(DR组),纳入正常对照组90例90眼,利用活体角膜共聚焦显微镜(in vivo confocal microscopy,IVCM)HRT-Ⅲ(Heidelberg Retina Tomograph -Ⅲ)对所有研究对象的角膜中央神经纤维密度(Corneal nerve fiber density,CNFD)、角膜神经分支密度(corneal nerve branch density,CNBD)、角膜神经纤维长度(corneal nerve fiber length,CNFL)进行检测,对比及分析三组间CNFD、CNBD、CNBD的差异,评价糖尿病患者角膜神经形态的改变。结果 NDR组的角膜神经纤维密度为(20.1±5.1)n/mm2 、DR组的为(15.7±4.6)n/mm2 ,两组的角膜神经纤维密度均低于正常对照组的角膜神经纤维密度(27.36±9.8)n/mm2 (均为P<0.05);NDR组的神经分支密度为(21.2±9.8)n/mm2、DR组的神经分支密度为(16.6±9.8)n/mm2,,两组角膜神经分支密度均低于正常对照组的角膜神经分支密度(27.9±12.1)n/mm2 (均为P<0.05);NDR组的神经纤维长度为(12.3±4.7)mm/mm2,DR组的神经纤维长度为(9.9±4.5)mm/mm2,两组均低于正常对照组神经纤维长度(15.1±4.3)mm/mm2(均为P<0.05);糖尿病患者中,DR患者的角膜神经纤维密度、神经分支密度、神经纤维长度均低于NDR患者(均为P<0.05)。结论 角膜共聚焦显微镜检查能够快速地、无创地、精准地检测出糖尿病患者角膜神经纤维的早期改变,可为预防、干预糖尿病肾病或糖尿病视网膜病变提供客观的科学依据。 |
关键词: []角膜共聚焦显微镜 糖尿病 角膜神经纤维 |
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基金项目:广西眼科疾病医学研究中心(编号:AD19245193) 广西卫健委科研课题(编号:Z20170375) |
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Clinical application of in vivo confocal microscopy in evaluating the morphological changes of corneal nerves in type 2 diabetic patients |
CHEN Li-fei,HUANG Hui,SHEN Chao-lan,CHEN Qi
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Department of Ophthalmology,the People′s Hospital of Guangxi Zhuang Autonomous Region
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Abstract: |
[] Objective To explore the clinical application of vivo confocal microscopy in evaluating the morphological changes of corneal nerves in type 2 diabetic patients. Methods 180 patients with type 2 diabetes were selected as the experimental group. Among them, 90 patients with non-diabetic retinopathy (NDR) had 90 eyes (NDR group), and 90 patients with diabetic retinopathy (DR) had 90 eyes (DR). Group), compared with 90 eyes of 90 cases of normal control group.Using in vivo confocal microscopy (IVCM) HRT-Ⅲ (Heidelberg Retina Tomograph -Ⅲ) to measure the corneal central nerve fiber of all subjects. Corneal nerve fiber density( CNFD), corneal nerve branch density (CNBD), and corneal nerve fiber length (CNFL) were tested to compare and analyze the differences among the three groups . Results The density of corneal nerve fibers in the NDR group was (20.1±5.1) n/mm2 and that in the DR group was (15.7±4.6) n/mm2. The density of corneal nerve fibers in both groups was lower than that in the normal control group ( 27.36±9.8)n/mm2 ( P<0.05); the nerve branch density of the NDR group is (21.2±9.8)n/mm2, the nerve branch density of the DR group is (16.6±9.8)n/mm2, both groups The density of corneal nerve branches was lower than that of the normal control group (27.9±12.1) n/mm2 (P<0.05); the nerve fiber length in the NDR group was (12.3±4.7) mm/mm2, and that of the DR group The length of nerve fiber was (9.9±4.5) mm/mm2, which was lower than that of the normal control group by (15.1±4.3) mm/mm2 (P<0.05); among diabetic patients, corneal nerve fiber density in DR patients , nerve branch density, and nerve fiber length were all lower than those of NDR patients (all P<0.05). Conclusion Confocal corneal microscopy can quickly, non-invasively and accurately detect the early changes of corneal nerve fibers in diabetic patients, and can provide objective scientific evidence for the prevention and intervention of diabetic nephropathy or diabetic retinopathy. |
Key words: Confocal microscopy Diabetes Cornea nerve fiber |