【作者】 董秀清；

【导师】 周华祥；

【作者基本信息】 成都中医药大学 ， 中医眼科学， 2009， 硕士

【摘要】 目的：通过分析2型糖尿病性视网膜病变(Diabetic retinopathy, DR)患者和健康成年人的血常规中红细胞和血小板各参数及其他相关因素,探讨红细胞和血小板各参数对于DR治疗的临床意义。方法：选取2004年1月—2008年12月在成都中医药大学附属医院眼科已确诊为DR的住院病人106例,记录一般情况,由我院眼科医生进行眼底镜检查,FFA检查,检测患者入院后第一次血常规等。以82例健康成年人做对照组,应用spssl3.0统计软件,通过T检验、方差分析等统计方法,对比分析DR患者和健康成年人及DR不同分期(增殖期和非增殖期)的血常规中血小板各参数及红细胞各参数的变化,为DR及DR分期的治疗提供参考依据。结果：1、红细胞各参数：DR组、NPDR组、PDR组分别与对照组比较,RBC(红细胞数目)、HGB(血红蛋白),HCT(红细胞比容),MCV(红细胞平均体积),MCHC(红细胞平均血红蛋白浓度),差异具有显著的统计学意义,P<0.01；DR组、PDR组分别与对照组相比,RDW-CV(红细胞分布宽度变异系数)有显著统计学意义,P<0.01。在NPDR组和PDR组比较中,MCHC、RDW-CV差异具有统计学意义,P<0.05。MCH(红细胞平均血红蛋白量),各组间比较,差异均不具有统计学意义,P>0.05。2、血小板各参数：PLT(血小板计数),各组间比较均不具有统计学意义,P>0.05；MPV(血小板平均体积)、PCT(血小板压积)参数在DR组、PDR组分别与对照组比较中,差异具有统计学意义,P<0.05；PDW(血小板分布宽度)在DR组、NPDR组、PDR组分别与对照组比较中,差异具有显著统计学意义,P<0.01；在NPDR组和PDR组间比较中,血小板四参数均不具有统计学意义,P>0.05。3、年龄：NPDR组和PDR组发病的年龄相比,差异具有统计学意义,P<0.05。4、性别：发生DR、NPDR和PDR的性别比较,差异无统计学意义,P>0.05。5、糖尿病病程与糖尿病视网膜病变严重程度的关系：具有统计学意义P<0.05。结论：在本文条件下红细胞,各参数中RBC、HGB、HCT、MCV、MCHC、RDW-CV参数对于DR临床治疗有参考意义,其中MCHC、RDW-CV对于NPDR和PDR分期治疗有一定指导的意义；血小板各参数中MPV、PDW、PCT与DR有相关性,对于DR的治疗有指导意义。血小板四参数(PLT, MPV, PCT, PDW)对于DR不同分期的治疗均不具有临床指导性。DR、NPDR和PDR发病与性别无关。DR发生的年龄越小,发生PDR的几率越大。DR的严重程度与DM病程呈正相关。更多还原

【Abstract】 Objective:To explore the clinical treatment significance of various parameters of red blood cell, platelet and other relevant factors in DR, through analysising them in patients with Diabetic retinopathy and healthy adults.Methods:We selected 106 patients who have been diagnosed as DR from January 2004 to December 2008 in Chengdu University of Traditional Chinese Medicine Affiliated Hospital. The oculist have made record of their general conditions and all the patients had ophthalmoscope examination, FFA examination and blood routine test during their first visit.82 healthy adults was in the control group.We used statistical software spss13.0 and T-test,ANOVA statistical methods to analysis the changes in the various parameters of red blood cell and platelet between DR and healthy adults, NPDR and PDR.We were expected to provide referenced treatment evidence on DR and in different phases of DR.Results:1、Parameters of Red blood cell:Compare control group with DR group,NPDR group and PDR group, there was significant statistically difference in RBC(red blood cell count), HGB(hemoglobin),HCT (hematocrit), MCV (mean corpuscular volume), MCHC (mean corpuscular hemoglobin concentration). P＜0.01; Compare control group with DR group and NPDR group there was significant statistically difference in RDW-CV(red blood cell volume distribution width).P<0.01;compare NPDR group with PDR group there was statistically difference in RDW-CV and MCHC, P＜0.05. However, there was no statistically difference among all groups in MCH. (mean corpuscular hemoglobin volume)P> 0.05.2、Parameters of Platelet:There was no statistically difference among all groups in PLT (platelet count).P> 0.05; Compare control group with DR group and NPDR group there was statistically difference in MPV (mean platelet volume) and PCT (Pressure platelet plot). P<0.05; Compare control group with DR group,NPDR group and PDR group, there was significant statistically difference in PDW (platelet distribution width).P<0.01; Compaire NPDR group with PDR group there was no statistically difference in the 4 parameters of platelet.3、Age:Compaire NPDR group with PDR group there was statistical significance in age.P<0.05.4、Gender:the comparison in terms of gender of DR patients, including NPDR and PDR patients has no statistical significance, P> 0.05.5.The relationship between diabetes duration and severity of diabetic retinopathy:the difference has statistical significance, P＜0.05.Conclusion:Among Red blood cell parameters, theRBC, HGB, HCT, MCV, MCHC and RDW-CV parameters have clinically reference significance for the treatment of DR, and the MCHC, RDW-CV has certain clinical significance for the treatment of NDPR and DPR. Among platelet parameters, the chang of the RDW, MPV, and PCT have correlative with DR, they have clinically reference significance for the treatment of DR. The four platelet parameters have not statistically significant in comparison of NPDR group and PDR group. The occurrence of DR including the occurrence of NPDR and PDR is unrelated to gender. The younger age DR occurs in, the more probable PDR would occur. The occurrence of NPDR and PDR was positively related to the length of the courses of DM.更多还原