| Objective: through the detection of OCTA in patients with different stages of DR and the collection,isolation and culture of peripheral blood,obtaining the quantitative index of macular OCTA and endothelial progenitor cells,analyze the related data and detect the function of peripheral endothelial progenitor cells.In order to understand the changes of vascular density and arch ring morphology of DR progression in macular area,and its effect on the function of endothelial progenitor cells,provided reliable basis for clinical DR staging diagnosis and follow-up of disease progression.And lay the foundation for the study of cytological level of DR progress.Method: Select the diabetic patients in our hospital from August2020 to October 2020,and recruit healthy people with a matching number.To perform related laboratory examinations and fundus examinations.According to the serious condition,the group will be established: A :Normal control group,B: Diabetes-free DR group,C: DR non-proliferative period,D: DR proliferation period,20 cases in each group,(each patient takes one eye as the research object,and the more severely diseased eye is included in the group.The left and right eyes are determined by random numbers for those with the same condition).Collect general information of subjects,extract peripheral venous blood to complete some blood biochemical index tests and compare endothelial progenitor cell functions(proliferation,adhesion,migration),perform OCTA inspection,import software to obtain quantitative data,and perform relevant statistical analysis.Results: A total of 80 subjects were included in this study,with the same number of cases in each group,and related inspections were completed as required.1.In the four groups of cases,the general conditions of the patients(gender,age,BMI)were not statistically significant(P>0.05),and the course of diabetes patients was statistically significant in each group(P<0.05);2.Perform blood Analysis of biochemical indicators indicated that HBA1C(%),blood glucose(mmol/l),and blood creatinine(umol/l)gradually increased with the progression of the disease,and there were differences in each index(P<0.05)3.Quantitative OCTA between each group,The comparative analysis of the index(3*3mm)shows that as the disease progresses,the linear density of blood vessels(center,inner layer,intact),vascular perfusion density(center,inner layer,intact),and FAZ fullness gradually decrease,and FAZ perimeter Gradually increase,the linear density of inner blood vessels,the linear density of intact blood vessels,the perfusion density of inner blood vessels,the perfusion density of intact blood vessels,and the FAZ fullness are statistically significant among the index groups(P<0.05);4.Correlation analysis revealed that the linear density of inner blood vessels,the linear density of intact blood vessels,the perfusion density of inner blood vessels,the perfusion density of intact blood vessels,and the degree of FAZ fullness were negatively correlated with the severity of the disease,and the linear density of inner blood vessels(r=-0.624,P<0.05)the strongest correlation;FAZ perimeter is positively correlated with disease severity.5.Perform diagnostic performance analysis.Inner vessel linear density,intact vessel linear density,inner vessel perfusion density,intact vessel perfusion density,FAZ fullness have certain diagnostic efficiency(AUC is 0.857,0.842,0.772,0.756,0.852,respectively)All are P<0.05),and the linear density of inner blood vessels has the highest diagnostic efficiency for the disease(the best diagnosis cut-off value is18.8,the sensitivity is 0.75,and the specificity is 0.85).6.By analyzing the functions(proliferation,adhesion,migration)of peripheral blood endothelial progenitor cells in patients of different stages,as the disease progresses,peripheral endothelial progenitor cell-related functions have decreased to varying degrees,and there is statistical comparison between groups Significance(P<0.05).Conclusion: During the development of DR,the severity of DR is closely related to the course of diabetes.There were some differences in fasting blood glucose,serum creatinine and Hb A1 c among patients with different stages.DR patients with macular OCTA(3 * 3 mm)inspection found that with the progress of the disease,in addition to the macular FAZ perimeter(perimeter)increased gradually,the regional density of linear density,vascular perfusion and FAZ enrichment degree index(form)decreases,layer within blood vessels of linear density,linear density,complete inner vascular perfusion density,the density of complete blood perfusion,FAZ enrichment degree.In the lining of the DR patients,blood vessels linear density,linear density,complete inner vascular perfusion density,the density of complete blood perfusion,FAZ enrichment degree index(form)and negatively correlated with the severity of disease,the inner most relevant linear density of the blood vessel(r = 0.624,P < 0.05),FAZ perimeter(perimeter)was positively related with the severity of disease(r = 0.214,P < 0.05).Among all the indicators of OCTA for the diagnosis of DR patients,the linear density of inner vessels has the highest diagnostic efficiency.With the progression of DR disease,the function of peripheral EPCs(proliferation,adhesion,migration)decreased,and the difference was statistically significant. |
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