腹膜透析糖尿病患者眼底血管参数和认知功能评估的临床应用研究

廖瑾岚; 魏奇杰; 何颖颖; 廖玉梅; 熊子波; 王青; 丁大勇; 黄晓彦; 熊祖应

doi:10.7619/jcmp.20213252

腹膜透析糖尿病患者眼底血管参数和认知功能评估的临床应用研究

Clinical application of fundus vascular parameters and cognitive function evaluation in patients with diabetes undergoing peritoneal dialysis

摘要

摘要:
目的探讨腹膜透析合并糖尿病患者眼底血管参数(血管直径、曲率、分形维数)和认知功能评估的临床应用研究。
方法将26行腹膜透析合并糖尿病患者按认知功能测定结果分为认知功能正常组和认知功能受损组。对比2组人口统计学资料、相关指标、视网膜血管参数的差异。
结果认知功能正常组患者12例，认知功能受损组患者14例。与认知功能正常组比较，认知功能受损组合并症较多，残余肾功能较低，差异有统计学意义(P < 0.05)。认知功能受损组动脉平均管径、静脉平均管径、动静脉比率和静脉平均曲率数值略低于认知功能正常组; 动脉平均曲率及血管分形维数数值略高于认知功能正常组，但差异无统计学意义(P>0.05)。认知功能受损组微血管瘤发生率高于认知功能正常组，差异有统计学意义(P < 0.05)。
结论微血管瘤可能是腹膜透析合并糖尿病患者认知功能异常的眼底标志。

Abstract:
Objective To explore the clinical application of fundus vascular parameters (vessel diameter, curvature and fractal dimension) and cognitive function evaluation in patients with diabetes undergoing peritoneal dialysis.
Methods Twenty-six patients underwent peritoneal dialysis with diabetes were divided into normal cognitive function group and impaired cognitive function group according to the results of cognitive function measurement. Demographic data, related indicators and retinal vascular parameters were compared between the two groups.
Results There were 12 patients in the normal cognitive function group and 14 patients in the impaired cognitive function group. Compared with the normal cognitive function group, there were significantly more complications and lower residual renal function in the cognitive function impaired group (P < 0.05). The average diameter of arteries, average diameter of veins, arteriovenous ratio and average curvature of veins in the impaired cognitive function group were slightly lower than those in the normal cognitive function group; the mean arterial curvature and vascular fractal dimension were slightly higher than those of the normal cognitive function group, but the differences were not statistically significant (P>0.05). The incidence of microaneurysm in the impaired cognitive function group was significantly higher than that in the normal cognitive function group (P < 0.05).
Conclusion Microaneurysm may be a fundus marker of cognitive dysfunction in patients with diabetes undergoing peritoneal dialysis.

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