目的：探讨彩色多普勒成像在糖尿病视网膜病变(DR)患者中的应用价值。

方法：选取2015-05/2017-05在我院就诊的2型糖尿病患者103例103眼，其中无糖尿病视网膜病变(NDR)患者32例32眼，非增殖性糖尿病视网膜病变(NPDR)患者40例40眼，增殖性糖尿病视网膜病变(PDR)患者31例31眼，同时选取健康志愿者40例40眼作为正常对照组，采用彩色多普勒超声检查各组视网膜中央动脉(CRA)、睫状后动脉(PCA)、眼动脉(OA)的最大收缩期血流速度(PSV)、舒张末期血流速度(EDV)和阻力指数(RI)。

结果：各组CRA、PCA和OA的PSV、EDV和RI比较差异有统计学意义(P<0.05)； NDR组CRA、PCA、OA的PSV分别为12.38±2.10、13.36±2.55和32.04±6.07cm/s，明显高于NPDR组(9.70±1.67、12.20±2.01、27.40±4.32cm/s)和PDR组(7.13±1.40、10.31±1.82和22.10±3.51cm/s)，差异有统计学意义(P<0.05)，EDV分别为4.67±1.20、5.61±1.25和8.40±1.51cm/s，明显高于NPDR组(3.52±1.19、5.01±1.30和6.61±1.67cm/s)和PDR组(2.48±1.02、4.11±1.04和4.01±1.52cm/s)，差异有统计学意义(P<0.05)，而RI分别为0.63±0.07、0.60±0.04和0.77±0.05)，明显低于NPDR组(0.72±0.06、0.67±0.05和0.81±0.03)和PDR组(0.80±0.09、0.74±0.06和0.86±0.04)，差异有统计学意义(P<0.05)。

结论：彩色多普勒成像监测糖尿病眼部血管血流动力学变化，可为早期发现糖尿病视网膜病变提供依据。

METHODS: Totally 103 cases(103 eyes)of type 2 diabetes mellitus were selected from May 2015 to May 2017 in our hospital, there were 32 patients 32 eyes with non diabetic retinopathy(NDR), 40 patients 40 eyes with non proliferative diabetic retinopathy(NPDR), and 31 patients 31 eyes with proliferative diabetic retinopathy(PDR), 40 healthy volunteers(40 eyes)were selected as control group, the maximum systolic blood flow velocity(PSV), end diastolic velocity(EDV)and resistance index(RI)of the central retinal artery(CRA), posterior ciliary artery(PCA)and ophthalmic artery(OA)were detected by color Doppler ultrasound.

RESULTS: The difference of PSV, EDV and RI of CRA, PCA and OA in each group was statistically significant(P<0.05). The PSV of CRA, PCA and OA in NDR group were 12.38±2.10cm/s, 13.36±2.55cm/s and 32.04±6.07cm/s, significantly higher than that of NPDR group(9.70±1.67cm/s, 12.20±2.01cm/s and 27.40±4.32cm/s)and PDR group(7.13±1.40cm/s, 10.31±1.82cm/s and 22.10±3.51cm/s)(P<0.05). EDV were 4.67±1.20cm/s, 5.61±1.25cm/s and 8.40±1.51cm/s, significantly higher than that of NPDR group(3.52±1.19cm/s, 5.01±1.30cm/s and 6.61±1.67cm/s)and PDR group(2.48±1.02cm/s, 4.11±1.04cm/s and 4.01±1.52cm/s)(P<0.05). And RI were 0.63±0.07, 0.60±0.04 and 0.77±0.05, was significantly lower than that of NPDR group(0.72±0.06, 0.67±0.05 and 0.81±0.03)and PDR group(0.80±0.09, 0.74±0.06 and 0.86±0.04)(P<0.05).

CONCLUSION: Color Doppler ultrasound monitoring the hemodynamic changes of ocular blood vessels in diabetes can provide evidence for early detection of diabetic retinopathy.