糖尿病视网膜病变与特发性黄斑裂孔患者玻璃体酸碱度的检测与比较

doi:10.3877/cma.j.issn.2095-2007.2019.01.007

目的

检测并比较糖尿病视网膜病变(DR)与特发性黄斑裂孔(IMH)患者玻璃体酸碱度(pH)值，探究离体玻璃体暴露于室温22℃的空气环境中pH值的变化规律。

方法

选择山东省潍坊医学院附属医院眼科中心2018年5月至2018年12月收治的DR患者15例(15只眼)，为DR组；同一时期收治的IMH患者16例(16只眼)，为IMH组。所有患者均由同一术者实施标准三切口23 G玻璃体切割术。术中，采集玻璃体腔中部未被稀释及污染的玻璃体标本0.2~0.5 ml，立即转移至灭菌量杯中。使用已较准的pH30A笔式酸度计行pH值检测，并于5 min、10 min、15 min、20 min、25 min、30 min及60 min后复测。全部检测数据中，年龄和玻璃体pH值以均数±标准差(±s )表示。组间数据差异的比较，采用独立样本t检验；性别的组间比较，采用Fisher确切概率法。以P<0.05为差异有统计学意义。

结果

所有患者离体的玻璃体均呈弱碱性，DR组患者玻璃体pH值为(7.83±0.24)，IMH组患者玻璃体pH值为(7.66±0.11)。DR组患者玻璃体pH值明显高于IMH组患者玻璃体pH值，差异具有统计学意义(t＝2.45，P<0.05)。DR组与IMH组患者玻璃体离体后暴露于室温22℃及空气中，其pH值短时间内即明显升高，且在一定时间内随时间延长而逐渐升高。

结论

DR患者与IMH患者玻璃体均呈弱碱性。其中，DR患者玻璃体pH值高于IMH患者玻璃体pH值；且全部患者的玻璃体离体后，其pH值在一定时间内随暴露于室温的空气中时间的延长而增加。

关键词: 糖尿病视网膜病变, 特发性黄斑裂孔, 玻璃体酸碱度, 酸碱度

Objective

The aim of this study was detect and compare the vitreous acidity and alkalinity (pH) in patients with diabetic retinopathy (DR) and idiopathic macular hole (IMH), and to explore the changes of pH in vitreous exposed to air and room temperature at 22℃.

Methods

Fifteen patients (15 eyes) with DR were admitted to the Ophthalmological Center of Affiliated Hospital of Weifang Medical College from May 2018 to December 2018 as DR group, and 16 patients (16 eyes) with IMH were admitted to the same period as IMH group. All patients underwent standard three-incision 23 G vitrectomy by the same surgeon. During the operation, 0.2-0.5 ml of undiluted and contaminated vitreous specimens in the middle of the vitreous cavity were collected and immediately transferred to the sterilization cup. The pH value was measured with a standard pH30A pen acidity meter, and was repeated after 5 min, 10 min, 15 min, 20 min, 25 min, 30 min and 60 min. In all the data, age and vitreous pH were expressed as mean (±s ). Independent sample t test was used to compare the differences between groups, and Fisher's exact probability method was used to compare the differences between groups. The difference was statistically significant with P<0.05.

Results

The vitreous pH values of DR group and IMH group were (7.83±0.24) and (7.66±0.11) respectively. The vitreous pH value of DR group was significantly higher than that of IMH group (t=2.45, P<0.05). The pH value of DR group and IMH group increased significantly in a short time after vitreous body was exposed to room temperature and air in vitro, and gradually increased over time.

Conclusions

Vitreous bodies of DR patients and IMH patients were weakly alkaline. Among them, the vitreous pH value of DR patients was higher than that of IMH patients. After vitreous body was isolated, the pH value of all patients increased with the prolongation of exposure to air and room temperature for a certain period of time.

Key words: Diabetic retinopathy, Idiopathic macular hole, Vitreous pH

表1 糖尿病视网膜病变组与特发性黄斑裂孔组患者一般资料的比较

组别	例数	年龄(±s，岁)	性别(男/女)
糖尿病视网膜病组	15	58.67±7.58	7/8
特发性黄斑裂孔组	16	59.25±11.11	10/6
t值		0.17
P值		>0.05	>0.05

表1 糖尿病视网膜病变组与特发性黄斑裂孔组患者一般资料的比较

组别	例数	年龄(±s，岁)	性别(男/女)
糖尿病视网膜病组	15	58.67±7.58	7/8
特发性黄斑裂孔组	16	59.25±11.11	10/6
t值		0.17
P值		>0.05	>0.05

图1 糖尿病视网膜病变组和特发性黄斑裂孔组患者玻璃体酸碱度的比较　糖尿病视网膜病变组患者玻璃体酸碱度明显高于特发性黄斑裂孔组患者玻璃体

图2 离体玻璃体酸碱度随时间变化规律　特发性黄斑裂孔组与糖尿病视网膜病变组均随时间延长均呈明显上升趋势，暴露初期上升速度较快

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Detection and comparison of vitreous pondus hydrogenii in patients with diabetic retinopathy and idiopathic macular hole

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Detection and comparison of vitreous pondus hydrogenii in patients with diabetic retinopathy and idiopathic macular hole