網膜症の有無にかかわらず，妊娠前糖尿病を有する妊婦における眼科動脈のドップラー指標．

Doppler Indices of the Ophthalmic Artery in Pregnant Women With Pregestational Diabetes Mellitus With and Without Retinopathy.

• Gizeli de Fátima Ribeiro Dos Anjos
• Márcia Aires Rodrigues de Freitas
• Maria Célia Alves Dos Santos
• Angélica Lemos Debs Diniz

抄録

目的:

網膜症のある妊娠前糖尿病の妊婦とない妊婦の眼科ドップラー流速計測パターンを、妊娠間近の妊婦と比較して評価すること。

OBJECTIVES: To evaluate ophthalmic Doppler velocimetry patterns in pregnant women with pregestational diabetes mellitus with and without retinopathy in comparison to pregnant women without gestational intercurrences.

方法:

この横断的観察研究では，網膜症のある糖尿病患者（n = 12），網膜症のない糖尿病患者（n = 85），糖尿病対照群（n = 122）の 3 群の妊婦における，抵抗指数（RI），脈動指数，ピーク収縮期速度，第 2 ピーク収縮期速度，ピーク比，および末期拡張期速度（EDV）を含む眼科動脈のドップラー指標を分析した．統計解析には、95％の確率でKruskal-Wallis検定を用いた。

METHODS: This cross-sectional observational study analyzed Doppler indices of the ophthalmic arteries, including the resistive index (RI), pulsatility index, peak systolic velocity, second peak systolic velocity, peak ratio, and end-diastolic velocity (EDV), in 3 groups of pregnant women: diabetic with retinopathy (n = 12); diabetic without retinopathy (n = 85); and nondiabetic controls (n = 122). The Kruskal-Wallis test was used for the statistical analysis with a probability of 95%.

結果:

網膜症のある妊婦とない妊婦、糖尿病のない対照群の平均妊娠年齢±SDはそれぞれ29.1±2.2、29.7±2.7、31±1.0weeksであり、群間に有意差はなかった（P>.099）。網膜症のある群の平均RIは対照群に比べて有意に高かったが（P = 0.030）、網膜症のない群と比較して有意差はなかった（P = 0.204）。対照群のRIは、網膜症のない群と比較して有意差はなかった（P = 0.079）。EDVは、対照群に比べて網膜症のある群で有意に低かったが（P = 0.015）、網膜症のない群と比較して差はなかった（P = 0.217）。

RESULTS: The mean gestational ages ± SDs of pregnant women with and without retinopathy and nondiabetic controls were 29.1 ± 2.2, 29.7 ± 2.7, and 31 ± 1.0 weeks, respectively, with no significant differences between the groups (P > .099). The mean RI in the group with retinopathy was significantly higher (P = .030) than in the control group, but it did not significantly differ compared to the group without retinopathy (P = .204). The RI in the control group did not differ from that in the group without retinopathy (P = .079). The EDV was significantly lower in the group with retinopathy (P = .015) in relation to the control group, but there were no differences compared to the group without retinopathy (P = .217).

結論:

妊娠前糖尿病と網膜症を有する妊婦では、眼科動脈の血管インピーダンスが増加し、EDVが低下していたが、これはおそらく網膜血管の虚血、血栓症、新生血管化に関連していると考えられる。

CONCLUSIONS: Pregnant women with pregestational diabetes mellitus and retinopathy had increased vascular impedance in the ophthalmic artery together with a reduction in the EDV, which was probably related to ischemia, thrombosis, and neovascularization of retinal vessels.

© 2020 American Institute of Ultrasound in Medicine.