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目的探讨视觉多焦视网膜电图(multi-focal ERG,mfERG)在糖尿病视网膜病变中的诊断价值。方法选择2015年1月~2016年1月首都医科大学附属北京同仁医院眼科门诊就诊的2型糖尿病视网膜病变患者42例作为观察组,选择同时期就诊的无视网膜病变的糖尿病患者40例作为对照组。两组患者均接受多焦视觉电生理仪检查,记录两组患者的mfERG N1波,P1波的振幅及潜伏期变化,检测糖化血红蛋白、血脂等指标。应用SPSS 19.0统计软件,P<0.05为差异有统计学意义。结果观察组患者的P1波振幅由环1~环5均降低(P<0.01),P1潜伏期则表现为环3~环5延迟,差异有统计学意义(P<0.05);与对照组相比,观察组患者的N1波的振幅环3(t=5.121,P<0.01)和环4(t=4.601,P<0.01)降低,差异有统计学意义,N1波潜伏期环5延迟,差异有统计学意义(t=3.214,P=0.031)。糖化血红蛋白(r=-0.708,P<0.05)和总胆固醇(r=-0.771,P<0.05)与糖尿病视网膜病变患者mfERG的P1振幅降低呈负相关。结论 mfERG是评估糖尿病视网膜病变视网膜功能的敏感检测方法,有效控制糖尿病患者的糖化血红蛋白和血脂水平,可以预防及延缓糖尿病视网膜病变的发生发展。
Objective To investigate the diagnostic value of multifocal ERG (mfERG) in diabetic retinopathy. Methods From January 2015 to January 2016, 42 patients with type 2 diabetic retinopathy undergoing ophthalmology clinic at Beijing Tongren Hospital affiliated to Capital Medical University were selected as the observation group and 40 patients without diabetes mellitus who were treated at the same period were selected as the control group . Two groups of patients underwent multifocal visual electrophysiological examination, recorded in two groups of patients mfERGN1 wave, P1 wave amplitude and latency changes, detection of glycated hemoglobin, blood lipids and other indicators. Application SPSS 19.0 statistical software, P <0.05 for the difference was statistically significant. Results The amplitudes of P1 wave in the observation group were decreased from ring 1 to ring 5 (P <0.01), and the latency of P1 was ring 3 to ring 5 (P <0.05). Compared with the control group , The amplitude of N1 wave in ring 3 (t = 5.121, P <0.01) and ring 4 (t = 4.601, P <0.01) in the observation group decreased significantly with the difference being statistically significant Significance (t = 3.214, P = 0.031). Glycated hemoglobin (r = -0.708, P <0.05) and total cholesterol (r = -0.771, P <0.05) were negatively correlated with decreased P1 amplitude of mfERG in patients with diabetic retinopathy. Conclusion mfERG is a sensitive method to evaluate retinal function in diabetic retinopathy. It can effectively control the level of HbA1c and blood lipid in diabetic patients and prevent and delay the development of diabetic retinopathy.