非增殖性糖尿病视网膜病变与空腹血糖、餐后2h血糖及血液流变学的相关性研究

目的：探讨空腹血糖（FBG）、餐后2h血糖（2hPBG）、血粘度水平在糖尿病视网膜病变（Diabetic retinopathy,DR）发生和发展中的临床意义。方法：对44例2型糖尿病患者及20名正常人进行FBG、2hPBG、血液流变学检测,应用眼底荧光血管造影（fluorescein fundus angiography,FFA）进行DR的诊断、分期。研究对象分为：对照组、非糖尿病视网膜病变（non diabeticretinopathy,NDR）组和非增殖性糖尿病视网膜病变（nonproliferative diabeticretinopathy,NPDR）组,NPDR组进一步分为DR-Ⅰ,DR-Ⅱ,DR-Ⅲ组。结果：NPDR组2hPBG高于NDR组,差异具有统计学意义（P〈0.01）。FBG水平NPDR组与NDR组之间无差异（P〉0.05）;血流变全血高切还原粘度及全血低切还原粘度、血浆粘度、血沉K值、红细胞变性指数、红细胞刚性指数,NPDR组、NDR组与对照组（正常人）之间具有显著性差异,但NPDR组之间及NPDR组、NDR组两者之间无显著性差异。结论：DR的程度和进展与2hPBG水平、血流变学密切相关,FBG并不是一个控制糖尿病及其并发症的理想监测指标。

Correlation between non-proliferative diabetic retinopathy and fasting blood glucose,2h postprandial blood glucose, hemorr-heology

Objective: To study the clinical significance between fasting blood glucose (FBG), 2h postprandial blood glucose(2hPBG)and hemorrheology in the occurrence and development of diabetic retinopathy(DR). Methods: The subjects were divided into control, non diabetic retinopathy (NDR) and non proliferative diabetic retinopathy(NPDR) group which include DR-Ⅰ,DR-Ⅱ and DR-Ⅲ groups. FBG,2hPBG and hemorrheology of 44 patients with type 2 diabetes and 20 normal subjects were detected in which DR was diagnosed and staging by fluorescein fundus angiography (FFA). Results: There was no difference in FBG among groups(P>0.05)and the 2hPBG of NPDR group was higher than that of NDR and conrol group(P<0.01).The blood high sheer reduced viscosity,blood low shearreduced viscosity,plasma viscosity,equation K value of ESR in NPDR and NDR groups were higher than that of conrol gruop(P<0.01),but index of rigidity(IR)and deformability index(DI)of NPDR and NDR groups were lower than that of conrol(P<0.01). Conclusion: This study suggested that DR and its progression might be closely related to the 2hPBG and hemorrheology. FBG is not a desirable marker for controling diabetes mellitus and its complication.