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目的:研究糖尿病患者中央角膜厚度与血糖浓度(糖化血红蛋白,HbA1c)的关系。方法:对52例HbA1c>7%的2型糖尿病患者行单中心、前瞻性临床试验。结果显示,平均随访6mo后,血糖浓度控制效果不佳。记录性别、病程,采用超声波测厚仪测量中央角膜厚度,取三次测量的平均值。患者在内分泌科门诊进行治疗。当HbA1c≤7%时,再次记录中央角膜厚度,并比较治疗前后的HbA1c水平和中央角膜厚度。结果:治疗前后平均中央角膜厚度分别为552.30±29.26μm和542.36±27.20μm,平均HbA1c水平分别为(9.36±1.79)%和(6.45±0.70)%,差异显著(P=0.0001,配对t检验)。结论:中央角膜厚度随HbA1c水平的降低(血糖控制良好)而显著下降,但高血糖和正常血糖患者中央角膜厚度平均值均在正常范围内。因此,在对糖尿病患者进行眼部检查时应注意HbA1c。
Objective: To investigate the relationship between central corneal thickness and blood glucose (HbA1c) in diabetic patients. Methods: A total of 52 HbA1c> 7% type 2 diabetic patients underwent a single center, prospective clinical trial. The results showed that after a mean follow-up of 6 months, the effect of blood glucose control was poor. Record sex, duration of disease, the use of ultrasonic thickness gauge central corneal thickness, take the average of three measurements. Patients in the endocrine clinic for treatment. When HbA1c≤7%, the central corneal thickness was recorded again, and the levels of HbA1c and central corneal thickness before and after treatment were compared. Results: The average central corneal thickness before and after treatment were 552.30 ± 29.26μm and 542.36 ± 27.20μm, respectively. The mean HbA1c levels were (9.36 ± 1.79)% and (6.45 ± 0.70)%, respectively, with significant difference (P = 0.0001, paired t test) . CONCLUSIONS: Central corneal thickness decreases significantly with lower HbA1c levels (good glycemic control), but the average central corneal thickness in patients with hyperglycemia and normal glucose is within the normal range. Therefore, HbA1c should be noted when eye examination is performed on diabetic patients.