论文部分内容阅读
目的通过角膜激光共焦显微镜研究角膜神经的改变与糖尿病周围神经病变(DPN)的相关性。方法入选45例2型糖尿病(T2DM)患者,其中合并DPN组25例,不伴DPN组20例,另选年龄相匹配的正常对照(NC)组10名,采用角膜激光共焦显微镜观察并记录受检者角膜上皮下神经的形态结构情况。结果 NC组的角膜上皮下神经较直,分支较少。糖尿病不伴DPN组角膜上皮下神经纤维长度与NC组相比无明显差异,但神经曲折度显著增加(P<0.05),神经分支密度亦明显增加(P<0.05)。而糖尿病合并DPN组的神经纤维长度相比于NC组、糖尿病不伴DPN组均显著减少,同时神经曲折度进一步增加,神经分支密度显著降低。结论糖尿病患者在周围神经病变的不同时期均有角膜上皮下神经的变化,提示使用角膜激光共焦显微镜进行角膜上皮下神经的形态结构观察对DPN的早期诊断有一定的价值。
Objective To investigate the correlation between corneal nerve changes and diabetic peripheral neuropathy (DPN) by corneal laser confocal microscopy. Methods Forty-five patients with type 2 diabetes mellitus (T2DM) were enrolled. Among them, 25 cases were complicated with DPN, 20 cases were not accompanied by DPN, 10 cases were matched by age-matched normal control group (NC), and were observed by corneal laser confocal microscope Morphology and structure of the subcutaneous nerve of the cornea of the subjects. Results The corneal subcutaneous nerve in NC group was straighter and had fewer branches. There was no significant difference in the length of corneal epithelial nerve fibers between diabetic DPN group and NC group, but the degree of neurological tortuosity was significantly increased (P <0.05) and the nerve branch density was also increased significantly (P <0.05). However, the length of nerve fibers in diabetic DPN group was significantly lower than that in NC group and diabetic without DPN group, meanwhile, the degree of neurological tortuosity increased further and the nerve branch density decreased significantly. Conclusion The changes of corneal subepithelial nerve in diabetic patients at different stages of peripheral neuropathy, suggesting that the use of corneal laser confocal microscopy of the morphology of the corneal epithelial nerve structure of the early diagnosis of DPN has a certain value.