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韩国2型糖尿病患者减重手术后糖尿病视网膜病变的临床病程:一项试点研究。

CLINICAL COURSE OF DIABETIC RETINOPATHY IN KOREAN TYPE 2 DIABETES AFTER BARIATRIC SURGERY: A Pilot Study.

作者信息

Kim Yong Joon, Seo Du Ri, Kim Myung Jin, Lee Sung Jin, Hur Kyung Yul, Choi Kyung Seek

机构信息

Departments of *Ophthalmology, and †Surgery, Soonchunhyang University College of Medicine, Soonchunhyang University Seoul Hospital, Seoul, Korea.

出版信息

Retina. 2015 May;35(5):935-43. doi: 10.1097/IAE.0000000000000412.

Abstract

PURPOSE

To assess the changes in diabetic retinopathy (DR) in Type 2 diabetes (T2DM) patients after bariatric surgery.

METHODS

Consecutive 20 patients with T2DM who underwent bariatric surgery and were followed for at least 12 months were enrolled. The case history was reviewed retrospectively, and laboratory data were assessed at baseline and every 3 months postoperatively. Two retinal specialists evaluated the severity of DR with dilated fundus examination preoperatively and postoperatively. Factors associated with DR progression were assessed.

RESULTS

During the follow-up period, 2 of 12 patients without DR and 2 of 3 patients with mild nonproliferative DR before surgery developed moderate nonproliferative DR. All five patients with moderate nonproliferative DR or worse preoperatively had progression requiring intervention. Preexisting DR (P = 0.005) and albuminuria (P = 0.01) were identified as associated with DR progression. Six patients (30%) entered remission of T2DM, but remission of T2DM could not halt the DR progression.

CONCLUSION

Diabetic retinopathy progression can occur in patients with or without before DR after bariatric surgery, regardless of remission of T2DM. All patients with T2DM should be examined regularly by an ophthalmologist postoperatively, and more carefully patients with previous DR or albuminuria.

摘要

目的

评估2型糖尿病(T2DM)患者在接受减肥手术后糖尿病视网膜病变(DR)的变化。

方法

纳入连续20例接受减肥手术并随访至少12个月的T2DM患者。回顾性分析病历,并在基线及术后每3个月评估实验室数据。两名视网膜专科医生在术前和术后通过散瞳眼底检查评估DR的严重程度。评估与DR进展相关的因素。

结果

在随访期间,12例术前无DR的患者中有2例以及3例术前有轻度非增殖性DR的患者中有2例发展为中度非增殖性DR。术前有中度非增殖性DR或更严重病变的所有5例患者病情进展均需要干预。已有的DR(P = 0.005)和蛋白尿(P = 0.01)被确定与DR进展相关。6例患者(30%)进入T2DM缓解期,但T2DM缓解并不能阻止DR进展。

结论

无论T2DM是否缓解,减肥手术后有或无DR病史的患者均可能发生DR进展。所有T2DM患者术后均应定期接受眼科医生检查,既往有DR或蛋白尿的患者检查应更仔细。

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