Tip 1 Diabetes Mellituslu Çocukların Retinal Doppler Ultrasonografi Bulguları ve Homosistein Düzeyleri

Yıl 2008, Cilt: 6 Sayı: 2, 19 - 25, 01.09.2008

Tolga Altuğ Şen , Ayşegül Bükülmez Reşit Köken Hamide Melek Tevfik Demir Ramazan Albayrak Bumin Değirmenci Murat Acar

Öz

Amaç: Tip 1 diyabetli çocuklarda diyabetik retinopatiyle ilişkili oldukları düşünülen plazma homosistein düzeylerinin ölçülmeleri, retinal arterlerdeki kanakım hızlarının Doppler ultrasonografiyle değerlendirilerek sağlıklı çocuklarınölçümleriyle kıyaslanmaları için bu çalışma planlanmıştır. Gereç ve Yöntem: Çalışmamız için tip 1 diyabet tanısıyla izlenen yaşları 8-18 Ortalama 13,2±4,3 arasında olan, 42 hasta 22 kız, 20 erkek seçilmiştir. Tip 1 diyabet tanılı çocukların ortalama hastalık süreleri 5,02±2,99 yıldır. Kontrol grubuiçin yaşları 9-18 Ortalama 14,01±3,5 arasında olan 30 çocuk 15 erkek, 15 kız seçilmiştir. Vakaların santral retinal arter ve oftalmik arterlerinden pik sistolikhız, diyastolik hız, rezistivite indeksi ve pulsatilite indeksi ölçümleri yapılmıştır. Bulgular: Tip 1 diyabetli çocuklarla kontrol grubundaki çocuklar arasında sadece santral retinal arter diyastolik hızları için, iyi ve kötü kontrollü tip 1 diyabetliçocukların arasında ise sadece oftalmik arter Vmax ölçümleri için anlamlı farklılıklar bulunurken p0,05 . Kötü metabolik kontrollü tip 1 diyabetli hastaların oftalmik arter rezistivite indeksleri 0,82±0,04 , iyi metabolik kontrollü tip 1 diyabetlihastaların rezistivite indekslerine göre 0,76±0,08 daha yüksek bulunmuştur.Tip 1 diyabet tanılı çocukların ortalama homosistein düzeylerinin 10,3±2,18μmol/L , kontrol grubundaki çocuklara 9,12±1,9 μmol/L göre daha yüksek, kötü kontrollü tip 1 diyabetli çocukların ortalama homosistein düzeylerinin 11,33±2 ,05 μmol/L iyi kontrollü çocuklara 9,42±2,12 μmol/L göre daha yüksekolduğu ve aradaki farkların anlamlı olduğu tespit edilmiştir p

Anahtar Kelimeler

Doppler ultrasonografi, tip 1 diyabet, çocuklar, retinal kanakımı, retina, homosistein

Retinal Doppler Ultrasound and Homocystein Levels in Children with Type I Diabetes Mellitus

Öz

Aim: We aimed to measure plasma homocysteine levels and retinal arterial blood flow of type 1 diabetic children by Doppler ultrasound, which were known to be related with diabetic retinopathy and to compare them with healthy children. Materials and Methods: We selected 42 diabetic children 22 females, 20 males , between the ages of 8 to18 years mean 13,2±4,3 . Mean duration of type 1 diabetes was 5,02±2,99 years. For the control group, 30 children 15 females, 15 males between the ages of 9 to 18 years mean 14,01±3,5 were selected. In central retinal arteries and ophthalmic arteries, peak systolic velocity, diastolic velocity, pulsatility and resistivity indexes were measured. Results: Except for the higher central retinal artery diastolic velocity in the control group, retinal blood flow velocities were similiar in diabetic children and the control group p0,05 . Mean ophthalmic artery peak systolic velocity 37,33±12,79 cm/sec for well controlled diabetic children was higher than the poorly controlled group 31,1±17,17 cm/sec ; mean ophthalmic artery resistivity index 0,76±0,08 for well controlled group was lower than the mean resistivity index 0,82±0,04 of poorly controlled group. Plasma homocysteine levels were higher in diabetic children 10,3±2,18 μmol/L than the control group 9,12±1,9 μmol/L p

Anahtar Kelimeler

Doppler ultrasound, type 1 diabetes, children, retinal blood flow, retina, homocysteine

Kaynakça

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