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[糖尿病患者和正常对照者视网膜小动脉的自身调节]

[Autoregulation of retinal arterioles in patients with diabetes mellitus and normal probands].

作者信息

Blum M, Kubetschka U, Hunger-Dathe W, Bachmann K, Müller U A, Strobel J

机构信息

Augenklinik der Friedrich-Schiller Universität Jena.

出版信息

Klin Monbl Augenheilkd. 2000 Jan;216(1):40-4. doi: 10.1055/s-2000-10514.

Abstract

BACKGROUND

Measurement of myogenic autoregulation of retinal arterioles was demonstrated by the use of the Retinal-Vessel-Analyzer (Carl Zeiss, Jena). The purpose of the presented study was to find a significant difference of this myogenic response in a group of healthy individuals vs. a group of patients with pathologic conditions.

PATIENTS AND METHODS

As a group of patients with known pathology in microcirculation patients with type 1 diabetes were chosen. By isometric exercise an identical rise in mean arterial blood-pressure was provoked in 20 patients with type-1 diabetes and 20 matched healthy volunteers. The myogenic response of retinal arterioles was measured in both groups by the use of the Retinal-Vessel-Analyzer. The Wilcoxon test was used for statistical analysis within the two groups whereas both groups were compared with each other by the use of the Mann-Whitney test.

RESULTS

Having the same age and same blood-pressure rise (p = 0.624) a significant better myogenic response was found in the healthy subjects vs. the diabetic group (p = 0.008). In the diabetic group no correlation was found between myogenic response and duration of diabetes (p = 0.982) or HbA1c values (p = 0.83).

CONCLUSIONS

In this study significant loss of autoregulation in patients with type 1 diabetes is demonstrated. By the use of the Retinal-Vessel-Analyzer noninvasive testing of the function of autoregulation of retinal arterioles is possible. This method might prove to be of great value in early detection of diabetic vessel pathology.

摘要

背景

使用视网膜血管分析仪(卡尔·蔡司,耶拿)证明了视网膜小动脉肌源性自动调节的测量。本研究的目的是找出一组健康个体与一组病理状况患者之间这种肌源性反应的显著差异。

患者与方法

选择1型糖尿病患者作为一组已知微循环病理的患者。通过等长运动,在20名1型糖尿病患者和20名匹配的健康志愿者中引发平均动脉血压相同程度的升高。两组均使用视网膜血管分析仪测量视网膜小动脉的肌源性反应。两组内的统计分析使用威尔科克森检验,而两组之间的比较使用曼 - 惠特尼检验。

结果

在年龄相同且血压升高程度相同(p = 0.624)的情况下,健康受试者的肌源性反应明显优于糖尿病组(p = 0.008)。在糖尿病组中,未发现肌源性反应与糖尿病病程(p = 0.982)或糖化血红蛋白值(p = 0.83)之间存在相关性。

结论

本研究证明1型糖尿病患者存在明显的自动调节功能丧失。使用视网膜血管分析仪可以对视网膜小动脉的自动调节功能进行无创检测。这种方法可能在糖尿病血管病变的早期检测中具有重要价值。

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