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目的:分析降糖治疗对糖尿病患者眼屈光度的影响。方法:新诊断的糖尿病患者20例,检测治疗前血糖、糖化血红蛋白(HbA1c)、空腹及餐后2h C肽。测定双眼屈光度、角膜曲率、前房深度及晶状体厚度,并在降糖治疗1,2,3,4wk分别复测以上眼部指标。分析屈光度改变与各生化指标的相关性及降糖治疗前后各眼部指标的变化。结果:降糖治疗后所有患者均出现远视性屈光改变,改变幅度与HbA1c和治疗1wk的降糖速度呈正相关,与治疗前血糖、空腹及餐后2h C肽无相关性,持续约2 ~4wk逐渐恢复至治疗前屈光水平。治疗前后,角膜曲率、前房深度和晶状体厚度等未见显著性变化。结论:降糖治疗导致糖尿病患者出现暂时性远视改变,改变幅度主要取决于治疗前HbA1c水平及前7d的降糖速度。其发生机制可能与晶状体水合化导致的屈光力降低有关,而非晶状体形态的改变。
Objective: To analyze the effect of hypoglycemic therapy on the diopter of diabetic patients. Methods: Twenty newly diagnosed diabetic patients were tested for pretreatment blood glucose, HbA1c, fasting and postprandial 2h C peptide. The binocular refractive power, corneal curvature, anterior chamber depth and lens thickness were measured. The ocular indexes were re-measured in the hypoglycemic treatment 1,2,3,4wk respectively. Analysis of diopter changes and the biochemical indicators of correlation and hypoglycemic treatment of eye indicators before and after changes. Results: All patients undergoing hypoglycemic treatment showed hyperopic refractive changes. The changes were positively correlated with the hypoglycemic rate of HbA1c and 1wk, and no correlation with pretreatment blood glucose, fasting and postprandial 2h C peptide, lasting about 2 ~ 4wk gradually restored to before treatment, refractive level. Before and after treatment, corneal curvature, anterior chamber depth and lens thickness, no significant changes. Conclusion: Hypoglycemia treatment results in transient hyperopia in diabetic patients. The extent of HbA1c change and the rate of hypoglycemic glucose in the first 7 days are mainly the changes. Its mechanism may be related to lens hydration caused by decreased refractive power, rather than changes in lens morphology.