糖尿病视网膜病变发病机制研究

Study on the Pathogenesis of Diabetic Retinopathy

摘要: 糖尿病视网膜病变是工业化国家人口视力受损的主要原因。虽然视网膜神经功能的损伤发生在血管病变之前已经被证实，但是最常见的早期临床表现还是微动脉瘤和视网膜内出血。微血管损伤导致视网膜毛细血管的无灌注、棉绒斑、出血点的数量增加、静脉异常、视网膜微血管异常。在这个阶段期间，视网膜血管的通透性增加可以导致视网膜厚度的增加和视网膜渗出物的渗出，最终导致中心视力的下降。增殖期，视网膜动静脉闭塞，视盘、视网膜、虹膜及房角形成新生血管。这些新生血管导致牵拉性视网膜脱离和新生血管性青光眼。这时毛细血管的无灌注或黄斑处的水肿，玻璃体积血和血管扭曲及牵拉性视网膜脱离都可导致视力的丧失。

Abstract: Objective: Diabetic retinopathy is the main cause of visual impairment in the population of indus-trialized countries. Although damage to retinal nerve function has been confirmed before vascular lesions, the most common early clinical manifestations are microaneurysms and intraretinal hemorrhage. Microvascular damage leads to retinal capillaries, no perfusion of blood vessels, cotton wool spots, an increase in the number of bleeding points, venous abnormalities, and retinal microvascular abnormalities. During this phase, increased permeability of retinal blood vessels can lead to increased retinal thickness and retinal exudate exudation, eventually Lead to decreased central vision. During the proliferative phase, retinal arteriovenous occlusion, new blood vessels are formed in the optic disc, retina, iris, and atrial angle. These new blood vessels cause tractional retinal detachment and neovascular glaucoma. No capillary perfusion or macular at this time Edema at the site, vitreous hemorrhage, blood vessel distortion, and traction retinal detachment can all lead to vision loss.