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要約 目的:HbA1c急速低下による網膜厚への影響を検討。
方法・対象:HbA1c10%以上の2型糖尿病患者39例に対して,血糖コントロール強化を行うとともに,網膜厚を測定した。
結果:HbA1cは3か月間に4.62±1.80%低下し,網膜前膜などを除外すると,無糖尿病網膜症(NDR)25例,単純糖尿病網膜症(SDR)10例であった。NDRおよび黄斑浮腫のないSDRの網膜厚は6か月後にそれぞれ1.1%,2.8%増加していたが,有意でなかった。HbA1cが3か月間で5.8%低下し,貧血と血圧低下を合併した1例で,6か月後に網膜厚が8.7%増加した。
結論:HbA1cが急速に低下しても網膜厚は有意には増加しなかったが,全身状態により網膜厚が増加する可能性がある。
Abstract Objective:To examine the effect of a rapid decrease in glycosylated hemoglobin(HbA1c)on retinal thickness.
Methods and subjects:This study included 39 patients with type Ⅱ diabetes mellitus and HbA1c≧10%. Retinal thickness was measured in association with enhanced glycemic control.
Results:The HbA1c values decreased by 4.62±1.80% in 3 months. When patients with preretinal membrane were excluded, non-diabetic retinopathy(NDR)and simple diabetic retinopathy(SDR)were found in 25 and 10 patients, respectively. After 6 months, the mean retinal thickness increased by 1.1% for NDR and 2.8% for SDR with no macular edema. The difference was not significant. In one patient with concomitant anemia and hypotension in whom HbA1c decreased by 5.8% over a period of 3 months, retinal thickness increased by 8.7%.
Conclusions:A rapid decrease in HbA1c values was not associated with increase in retinal thickness. However, an increase in retinal thickness might be dependent on general conditions.
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