方法：收集2013-02/2014-02在安阳市眼科医院眼底病科收治的需行全视网膜光凝术治疗的DR(Ⅲ～Ⅳ期)住院病例60例120眼，同时设立正常对照组(HC)55例110眼。使用PHILIPS HD6彩色多普勒超声诊断仪检测正常人55例110眼和糖尿病视网膜病变患者60例120眼的视网膜中央动脉(CRA)和睫状后短动脉(PCAs)，记录收缩期血流峰速(PSV)。视网膜光凝术前和术后第1、7d，1、3、6mo行彩色多普勒超声检查、闪光视网膜电流图及视力检查。

结果：观察组治疗前后视网膜中央动脉血流峰速分别与正常对照组比较，差异有统计学意义(均P<0.05)； 全视网膜光凝术后各时间点分别与术前比较，差异有统计学意义(均P<0.05)。观察组治疗前后睫状后短动脉血流峰速分别与正常对照组比较，差异有统计学意义(均P<0.05)； 全视网膜光凝术后各时间点分别与术前比较，术后1d差异有统计学意义(P<0.05)，术后7d，1、3、6mo差异均无统计学意义(>0.05、>0.05、>0.05、>0.05)。观察组治疗前后视网膜电流图a波振幅(aA)和b波振幅(bA)分别与正常对照组比较，差异有统计学意义(均P<0.05)； 观察组治疗后aA和bA分别与治疗前比较，差异有统计学意义(均P<0.05)。观察组治疗前后视网膜电流图a波峰值时间(aT)和b波峰值时间(bT)分别与正常对照组比较，差异有统计学意义(均P<0.05)； 观察组治疗后aT和bT分别与治疗前比较，差异无统计学意义(均P>0.05)。随访6mo，患者视力有不同程度地提高或保持不变，49例98眼患者视力提高1～3行不等，有效率82%； 11例22眼视力保持不变。

结论：激光光凝术是治疗DR的有效手段，从长期临床效果上可显著降低视网膜中央动脉的PSV，改善和稳定病情，保护视功能。彩色多普勒超声血流显像能够无创、可重复性、动态实时观察DR患者眼部血管血流动力学的变化，在临床上为治疗提供参考依据。

METHODS: We collected 60 patients(120 eyes)with diabetic retinopathy(Ⅲ～Ⅳstage)from February 2013 to February 2014 in Anyang Eye Hospital admitted in fundus disease department. The health control(HC)group of 55 normal people was established simultaneously. Ocular blood flow velocity of the 55 normal people(110 eyes)and the 60 patients(120 eyes)was examined by CDFI of central retinal artery(CRA)and posterior ciliary artery(PCAs)using the PHILIPS HD6. Peak systolic velocity(PSV)was recorded. The examinations of CDFI, electroretinogram(ERG)and the vision were performed in pre-operation, 1,7d, 1, 3 and 6mo postoperatively.

RESULTS: Compared the PSV of CRA of the DR group before and after photocoagulation to the data of the HC group, there was a significant difference(P<0.05); compared the PSV of CRA of the DR group after photocoagulation with the data before, there was a significant difference(P<0.05). Compared the PSV of PCAs of the DR group before and after photocoagulation to the data of the HC group, there was a significant difference(P<0.05); compared the PSV of PCAs of the DR group after photocoagulation with the data before, there was a significant difference at 1d postoperatively(P<0.05), there was no significant difference at 7d, 1, 3 and 6mo(P>0.05). Compared the aA and bA of ERG of the DR group before and after photocoagulation to the data of the HC group, there was a significant difference(P<0.05). Compared the aA and bA of ERG of the DR group after photocoagulation with the data before, there was a significant difference(P<0.05). Compared the aT and bT of ERG of the DR group before and after photocoagulation to the data of the HC group, there was a significant difference(P<0.05); compared the aT and bT of ERG of the group DR after photocoagulation with the data before, there was no significant difference(P>0.05). The vision of 49 cases(98 eyes)was improved 1 to 3 rows, the effective rate was 82%.The vision of 11 cases(22 eyes)remained constant.

CONCLUSION: Retinal laser photocoagulation is an effective treatment to diabetic retinopathy patients, which can significantly reduce the peak systolic velocity of the central retinal artery, improve and stabilize the condition, protect visual function in long-term clinical effect. Color doppler flow imaging can observe the changes of ocular vessel flow velocity in diabetic' eyes noninvasively, repeatedly and in real time, providing a basis for clinical treatments.