【作者】 余静；

【导师】 张倩；

【作者基本信息】 南昌大学 ， 眼科（专业学位）， 2017， 硕士

【摘要】 目的:1.观察并记录2型糖尿病视网膜病变(DR)患者与健康对照组的手指冷却试验(FCT)的结果,比较其差异性。2.分析2型糖尿病(T2DM)患者指温复温时间与其糖尿病视网膜病变严重程度的相关性,评估其作为DR患者微循环功能观察指标的价值。方法:78名2型糖尿病视网膜病变增生期患者、82名非增生期患者以及85名健康者对照组,所有受试者进入室温为22 -24℃和相对湿度为50-60 %的房间,正常衣着,静坐20～30min以后,用红外线电子测温计(DT 8806S,CEM,China)测3次右手食指指腹温度,取平均值,记为基础指温(baseline-T),然后将右手食指浸泡在4℃冷水中1min做手指冷却试验(finger cooling test,FCT)。记录冷却刺激后的即时手指温度(T0)、以后每隔一分钟测手指温度直至恢复至基础指温。基础指温与T0之差记为下降幅度,复温时间为恢复至基础指温所需要的时间。观察指标:观察并记录患者食指基础指温,T0、下降幅度及复温时间,通过分析复温时间来判断患者末梢循环与糖尿病视网膜病变程度的相关性。结果:正常组、非增生组及增生组组间比较采用单因素方差分析,各组间性别、年龄差异无统计学意义(P>0.05);复温时间及基础指温:正常组与非增生组、增生组比较差异均有统计学意义(P<0.05),非增生组与增生组比较差异也均有统计学意义(P<0.05);下降幅度:正常组与非增生组、增生组比较差异均有统计学意义(P<0.05),非增生组与增生组比较差异无统计学意义(P>0.05)。复温时间与其他各因素Pearson相关分析发现,复温时间与年龄、性别无相关性,与糖尿病病程、基础指温、下降幅度有一定的相关性(P<0.05)。结论:1.与健康对照组相比,DR患者组的复温时间明显延长,且增生期患者组较非增生期患者组的复温时间明显更长。2.DR患者较正常组的温度下降幅度较大,T0较低,且增生期患者组较非增生期患者组温度下降幅度更大。3.复温时间与病程、下降幅度呈正相关,与基础指温呈负相关。FCT的较长复温时间表明DR患者有微循环功能障碍。复温时间越长表明DR患者微循环功能越差。2型糖尿病患者指温复温时间能在一定程度上或可作为糖尿病视网膜病变程度的观测指标。更多还原

【Abstract】 Objective:1. The results of finger cooling test (FCT) in patients with type 2 diabetic retinopathy (DR) and healthy controls were observed and recorded, and their differences were compared 2. To analyze the correlation between the temperature and temperature of patients with type 2 diabetes mellitus (T2DM) and the severity of diabetic retinopathy, and to evaluate the value of microvascular function in DR patients.Methods:78 proliferative patients with type 2 diabetic retinopathy.82 non-proliferative patients and 85 healthy controls; All subjects entered room with room temperature of 22 -24 ℃ and relative humidity of 50-60%, After rest 20 to 30 minutes, the temperature of the right index finger was measured three times with an infrared electronic thermometer (DT 8806S, CEM, China), and the average finger was taken as the base-T, and then the right index finger was placed at 4 ℃ water 1min to do finger cooling test (finger cooling test).Instant finger temperature (TO) after stimulation cooled, after every one minute until the temperature of a finger base to the finger temperature recovery. The difference between the mean temperature and the TO is recorded as the descending rate and the rewarming time is the time required to return to the base finger temperature. Observation index: observe and record the index finger index finger finger temperature, decline and rewarming time, by analyzing the rewarming time to determine the peripheral circulation of patients with diabetic retinopathy degree.Results:Normal group, non-proliferative group and proliferative group were compared using single factor analysis of variance.There was no significant difference in sex and age in three groups (P> 0.05). Rewarming time and baseline-Time:there was statistically significant between the normal group compare with the non-proliferative group and the proliferative group (P <0.05), and non-proliferative group compare with proliferative group also have statistically significant (P <0.05). Decline: there was statistically significant between the normal group compare with the non-proliferative group and the proliferative group (P <0.05), but there was no significant difference between non-proliferative group with proliferative group have statistically significant (P > 0.05).Rewarming time with each other Pearson correlation analysis of factors found rewarming time and age, sex had no correlation with duration of diabetes, the foundation refers to the temperature, the decline has some correlation (P <0.05)Conclusion:1. Compared with the healthy control group, rewarming time of DR patients was significantly longer, and the proliferative group was longer than non-proliferative group.2. The temperature decline of DR patients was larger than that of normal group,TO was lower, and the proliferative group was longer than non-proliferative group.3.There was a positive correlation between the rewarming time and the course of disease, and the decline was significant.and there was a negatively correlation between the rewarming time and baseline-Time。Longer rewarming time indicates that DR patients have microcirculatory dysfunction. The longer the rewarming time indicates the worse the microcirculation function of DR patients. Type 2 diabetes patients with temperature rewarming time to a certain extent or can be used as diabetic retinopathy degree of observation indicators.更多还原