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目的 :探讨血管紧张素转换酶抑制剂 (ACEI)对糖尿病患者眼部血流的影响。方法 :对非增殖期DR组 2 3例增殖期DR组 19例 ,对照组 19例检测服用ACEI前后血浆的血管紧张素Ⅱ (AngⅡ )水平 ,并应用彩色多普勒血流显像 (colorDopplerflowimaging ,CDFI)检测服药前后眼部循环的血流动力学变化 ,包括 :视网膜中央动脉 (centralretinalartery ,CRA) ,鼻侧和颞侧睫状后动脉 (posteriorcilliaryarteries,PCAs)及眼动脉 (ophthalmicartery ,OA)血流的收缩期峰速 (peaksystolicvelocity ,PSV) ,舒张末期流速 (end diastolicvelocity ,EDV)和阻力指数 (resistanceindex ,RI)。结果 :服药前DR组与正常组AngⅡ含量比较有非常显著性差异 (P <0 0 1) ;对照组服药前后AngⅡ含量、OA、CRA及PCAs血流速度差异无显著性。DR组服药前后AngⅡ含量比较差异有显著性 (P <0 0 5 )。DR组患者服药后OA血流速度较服药前略有提高 ,达不到正常标准 ,统计学处理差异无显著性 (P >0 0 5 ) ;非增殖期DR组与增殖期DR组CRA及PCAs血流速度服药后较服药前提高 ,统计学处理差异有显著性 (P <0 0 5 )。结论 :血管紧张素转换酶抑制剂 (ACEI)能改善糖尿病视网膜病变患者眼部循环。
Objective: To investigate the effect of angiotensin converting enzyme inhibitor (ACEI) on ocular blood flow in diabetic patients. Methods: Twenty-nine cases of proliferative DR in non-proliferative DR group and 19 cases of control group were enrolled in this study. Plasma angiotensin Ⅱ (AngⅡ) level before and after taking ACEI were measured. Color Doppler flow imaging (CDFI) was used to measure the hemodynamic changes of the ocular circulation before and after taking the medication. The changes included centralretinalartery (CRA), posteriorcilliary arterial (PCAs) and ophthalmicartery (OA) blood flow The peak systolic velocity (PSV), end diastolic velocity (EDV) and resistance index (RI) were measured. Results: There was a significant difference in the content of AngⅡ between the DR group and the normal group before taking the drug (P <0.01). There was no significant difference in the blood levels of AngⅡ, OA, CRA and PCAs in the control group before and after taking the drug. The levels of AngⅡ in DR group before and after treatment were significantly different (P <0.05). The blood flow velocity of OA in DR group was slightly higher than that of before treatment, which did not reach the normal level, the difference was not statistically significant (P> 0.05); CRA and PCAs blood in non-proliferative DR group and proliferative DR group Flow rate after taking medicine than before the increase, the statistical difference was statistically significant (P <0 05). Conclusion: Angiotensin-converting enzyme inhibitor (ACEI) can improve ocular circulation in patients with diabetic retinopathy.