【摘要】 目的 了解糖化血红蛋白（HbA1c）与糖尿病患者白内障术后角膜内皮细胞形态变化之间的关系。方法 选择2017年11月至2020年1月在我院行白内障超声乳化摘除联合人工晶状体植入术的老年性白内障患者107例（118眼），分为三组：A组（HbA1C≤8%），和B组（HbA1C>8%）,C组为不合并糖尿病的老年白内障患者。检测三组患者手术前、术后1周、术后1个月、术后3个月的中央角膜厚度（CCT）、角膜内皮细胞密度（CD）、变异系数（CV）、六角形细胞比例（HEX）、平均内皮细胞面积(AVG）情况，对比分析。结果 三组患者的术前CCT(F=0.36,P=0.698>0.05)、CD(F=0.01,P=0.99> 0.05)、 CV(F=1.982,P=0.142> 0.05)、 HEX(F=0.254,P=0.776> 0.05)、AVG(F=0.029,P=0.97>0.05)差异无统计学意义；与术前相比，术后三组患者的CD、HEX均减少，CV、AVG均增大，差异有统计学意义（P <0.05）；术后1周，三组患者的CD(F=5.33, P=0.00<0.05)、CV(F=12.957, P=0.00<0.05)、HEX(F=6.257, P=0.003<0.05)、AVG(F=6.865, P=0.002<0.05)，差异均有统计学意义（P<0.05），其中B组各项指标变化最大；术后1周，三组患者的CCT均高于术前（F=14.528, P=0.00<0.05）；术后1个月、术后3个月，三组患者的CCT与术前相比无统计学差异（P>0.05）。结论 糖尿病患者白内障超声乳化术后角膜内皮的损伤比单纯老年性白内障患者更重，高糖化血红蛋白组角膜内皮损伤更重，术后恢复所需时间较长，HbA1c可以作为常规术前检查。更多还原

【Abstract】 Objetive To investigate the relationship between glycosylated hemoglobin(HbA1c) and the changes of corneal endothelium after cataract surgery in diabetic patients. Method A total of 105 patients with age-related cataracts(118 eyes) who underwent phacoemulsification and IOL implantation in our hospital from November 2017 to January 2020 were selected and divided into three groups: group A(HbA1C≤8%) and group B(HbA1C>8%), and group C were patients for age-related cataracts without diabetes. Central corneal thickness(CCT), corneal endothelial cell density(CD), coefficient of variation(CV), HEX cell ratio(HEX), and average endothelial cell area(AVG) of the three groups were measured before, 1 week, 1 month, and 3 months after surgery. Three groups of patients with postoperative 1 week CCT are higher than preoperative( P<0.05). There was no significant difference in CCT between the three groups at 1 month and 3 months after operation and before operation( P>0.05). Results The preoperative CCT(F=0.36, P=0.698>0.05), CD(F=0.01, P= 0.99>0.05), CV(F=1.982, P=0.142>0.05), HEX(F=0.254,P= 0.776>0.05), AVG( F=0.029, P=0.97>0.05) of the three groups of patients, the difference was not statistically significant;Compared with preoperatively, CD and HEX of the three groups of patients after operation were reduced, but CV and AVG were increased, the difference was statistically significant( P< 0.05); One week after the operation, CD(F=5.33, P=0.00<0.05), CV( F=12.957, P= 0.00<0.05), HEX( F =6.257, P= 0.003< 0.05), AVG( F=6.865, P=0.002< 0.05), the differences were statistically significant( P<0.05), at the same time, group B has the largest change in various indicators. The CCT of the three groups was higher than that of the preoperative one week after operation(F=14.528, P=0.00<0.05); there was no significant difference in the CCT of the three groups of patients at one month and three months after the operation( P> 0.05). Conclusion The corneal endothelium injury after cataract phacoemulsification in diabetic patients was more severe than that in senile cataract patients without diabetes mellitus. Patients with high Hemoglobin a1c had more severe corneal endothelium injury and a longer recovery time after surgery. Hemoglobin a1c can be used as a routine preoperative examination for patients with diabetes.更多还原