中国血液净化 ›› 2023, Vol. 22 ›› Issue (02): 136-140.doi: 10.3969/j.issn.1671-4091.2023.02.013

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血液透析对糖尿病视网膜病变影响的研究进展

邓望月   胡大军   鲁碧玉   董 佩   

  1. 443000 宜昌,1三峡大学附属第二人民医院肾内科/三峡大学中西医结合肾病研究所
  • 收稿日期:2022-08-08 修回日期:2022-09-23 出版日期:2023-02-12 发布日期:2023-02-12
  • 通讯作者: 胡大军 E-mail:3487210688@163.com
  • 基金资助:
    湖北省教育厅中青年人才项目(Q20211206)

Research progress in the influence of hemodialysis on diabetic retinopathy

DENG Wang-yue, HU Da-jun1, LU Bi-yu, DONG Pei   

  1. Department of Nephrology, he Second People's Hospital Affiliated to Three Gorges University, Institute of Integrated Chinese and Western Medicine on Kidney Disease, Three Gorges University, Yichang 443000, China
  • Received:2022-08-08 Revised:2022-09-23 Online:2023-02-12 Published:2023-02-12
  • Contact: 443000 宜昌,1三峡大学附属第二人民医院肾内科/三峡大学中西医结合肾病研究所 E-mail:3487210688@163.com

摘要: 糖尿病视网膜病变(diabetic retinopathy,DR)和糖尿病肾病(diabetic nephropathy,DN)是糖尿病(diabetes mellitus,DM)患者常见的2种慢性微血管并发症。据报道DR和DN具有相关性,可相互预测,相互影响。DR和DN早期不易察觉,随着病情的逐渐进展,前者可出现黄斑水肿、渗出,玻璃体出血,视网膜脱落,甚至失明;后者可最终发展为终末期肾病(end stage renal disease,ESRD)。血液透析(hemodialysis,HD)是目前血液净化中最常用来改善ESRD的治疗方式。HD可通过清除ESRD患者体内毒素、多余的体液来改善DM和DN对视力的损害,然而,随着透析时间的延长,HD对活性氧(reactive oxygen species,ROS)清除能力的下降,可能会加重DR患者视力的损害。因此,探讨HD患者DR的进展将有助于人们更加准确的评估DR在HD患者中的病情严重程度,并及时采取合理的措施,减少HD患者视力的损害,降低失明率,在提高HD患者生活质量方面具有重要的意义。

关键词: 血液透析, 糖尿病视网膜病变, 糖尿病肾病, 氧化应激, 炎症

Abstract: Diabetic retinopathy and diabetic nephropathy are two common chronic microvascular complications in diabetic patients. It is reported that diabetic retinopathy and diabetic nephropathy are correlated and can be predicted and influenced each other. Diabetic retinopathy and diabetic nephropathy are hardly to be recognized at the early stage. With the gradual progress of the diseases, the former is present with macular edema, exudation, vitreous hemorrhage, retinal detachment and even blindness, and the latter eventually progresses to end-stage renal disease. Hemodialysis is currently the most useful treatment for blood purification to improve end-stage renal disease. Hemodialysis can improve diabetic visual impairment and nephropathy by eliminating toxins and excess body fluid in end-stage renal disease patients. However, the ability to eliminate reactive oxygen species (ROS) by hemodialysis reduces with the elongation of dialysis age, leading to the aggravation of visual impairment in diabetic retinopathy patients. Therefore, how to accurately assess the extent of the retinopathy and reverse the progression of the retinopathy are essential to prevent visual loss and blindness and to improve the quality of life in hemodialysis patients with diabetic retinopathy.

Key words: Hemodialysis, Diabetic retinopathy, Diabetic nephropathy, Oxidative stress, Inflammation

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