摘要目的:分析不同类型糖尿病性黄斑水肿（DME）患者血管及病变区域变化的差异。方法:选取2018年1月至2021年1月于河北医科大学第一医院就诊的DME患者196例为研究对象，根据是否存在黄斑区浆液性视网膜脱离（SRD）分为单纯弥漫性DME组（76例）及SRD型DME组（120例）。收集两组患者的年龄、性别、糖尿病病程等一般资料及血肌酐等实验室指标。对两组患者进行眼部常规检查及光学相干断层扫描血管成像检查，检测黄斑中心凹视网膜厚度（CST）、黄斑中心凹下方脉络膜厚度（SFCT）、黄斑中心凹无血管区（FAZ）面积及视网膜深浅层血流比（DSFR）。两组间比较采用独立样本 t检验，采用多因素logistic回归分析法分析DME患者合并SRD的影响因素。 结果:与单纯弥漫性DME组相比，SRD型DME组患者的CST［分别为（485.63±18.63）和（405.61±25.36）μm， t=32.395， P<0.001］、SFCT水平［分别为（295.46±51.16）和（274.16±52.98）μm， t=3.581， P<0.001］升高，DSFR水平（分别为1.10±0.05和1.16±0.12， t=6.164， P<0.001）和FAZ面积［分别为（0.31±0.16）和（0.38±0.12）mm 2， t=4.196， P<0.001］降低，差异均具有统计学意义。多因素logistic回归分析结果显示，SFCT、DSFR、FAZ面积均为DME患者合并SRD的影响因素（OR=1.905， P=0.005；OR=0.452， P=0.001；OR=0.658， P=0.012）。 结论:不同类型DME患者SFCT、DSFR、FAZ面积存在差异，上述3个指标均为DME患者发生SRD的影响因素。

abstractsObjective:To analyze the changes in blood vessel and lesion area in different types of diabetic macular edema (DME).Methods:A total of 196 patients with DME who were treated in First Hospital of Hebei Medical University from January 2018 to January 2021 were selected as the observation objects. They were divided into simple diffuse DME group [without serous retinal detachment (SRD), 126 cases] and observation group according to SRD type DME group (combined SRD, 192 cases). General data such as age, sex, duration of diabetes and creatinine were compared between the two groups. Routine eye examinations and optical coherence tomography angiography were performed in both groups. The macular foveal retinal thickness (CST), and subfoveal choroidal thickness (SFCT) of the fovea were compared between the two groups. The area of fovea avascular zone (FAZ) and the level of deep-superficial flow ratio (DSFR) were compared between the two groups. Independent sample t-test was used to compare the two groups. Multivariate logistic regression was used to analyze the influencing factors of DME patients with SRD. Results:Compared with the simple diffuse DME group, the CST in the SRD-type DME group [(485.63±18.63) μm vs. (405.61±25.36) μm, t=32.395, P<0.001] and SFCT levels [(295.46±51.16) μm vs. (274.16±52.98) μm, t=3.581, P<0.001] were increased, DSFR level (1.10±0.05 vs. 1.16±0.12, t=6.164, P<0.001) and FAZ area [(0.31±0.16) mm 2vs. (0.38±0.12) mm 2, t=4.196, P<0.001] were decreased, and the differences were statistically significant. Multivariate logistic regression analysis showed that SFCT, DSFR and FAZ area were independent risk factors for DME patients with SRD (OR=1.905, P=0.005; OR=0.452, P=0.001; OR=0.658, P=0.012). Conclusion:There were differences in SFCT, DSFR and FAZ area in patients with different types of DME, which were the risk factors for SRD in DME patients.