2型糖尿病视网膜病变患病情况及其危险因素

Prevalence and risk factors of type 2 diabetic retinopathy

目的探讨2型糖尿病视网膜病变的患病情况及其危险因素。方法选取北京丰台医院2018年1月至2020年1月收治的535例2型糖尿病患者作为研究对象,采用眼底照相或荧光素钠眼底血管造影(FFA)检测患者是否合并视网膜病变,据此将患者分为视网膜病变组和非视网膜病变组,统计视网膜病变发生率,采用自制的临床资料收集表收集两组患者一般资料及实验室资料,采用单因素χ^(2)分析及多因素logistic回归分析2型糖尿病视网膜病变的危险因素。结果535例2型糖尿病患者中合并视网膜病变144例,占26.92%,未合并视网膜病变391例,占73.08%。视网膜病变组和非视网膜病变组年龄、收缩压(SBP)、舒张压(DBP)、糖尿病病程、总胆固醇、甘油三酯、低密度脂蛋白、糖化血红蛋白、空腹血糖、尿微量蛋白比较,差异有统计学意义(P<0.05)。多因素logistic回归分析显示,年龄(OR=2.061,95%CI 1.082~3.392)、SBP(OR=1.943,95%CI 1.003~3.433)、DBP(OR=1.846,95%CI 1.001~3.396)、糖尿病病程(OR=2.050,95%CI 1.042~3.941)、总胆固醇(OR=1.962,95%CI 1.060~3.368)、甘油三酯(OR=1.826,95%CI 1.011~3.218)、低密度脂蛋白(OR=1.887,95%CI 1.010~3.307)、糖化血红蛋白(OR=2.030,95%CI 1.015~3.828)、空腹血糖(OR=2.132,95%CI 1.022~3.177)、尿微量蛋白(OR=1.910,95%CI1.017~3.269)是2型糖尿病视网膜病变的独立危险因素(P<0.05)。结论2型糖尿病合并视网膜病变的风险较高,其影响因素主要与年龄、血压、糖尿病病程、尿微量白蛋白、总胆固醇、甘油三酯、低密度脂蛋白、糖化血红蛋白和空腹血糖有关。

Objective To investigate the prevalence and risk factors of type 2 diabetic retinopathy.Methods A total of 535 patients with type 2 diabetes admitted to Beijing FengTai Hospital from January 2018 to January 2020 were selected as the research objects.Fundus photography or fundus fluorescein angiography(FFA)were used to detect whether the patients were complicated with retinopathy.Then the patients were divided into retinopathy group and non retinopathy group.The incidence of retinopathy was counted.General data and laboratory data of two groups were collected by using self-made clinical data collection table.Univariateχ^(2) analysis and multivariate logistic regression were used to analyze the risk factors of type 2 diabetic retinopathy.Results Totally 144 cases were complicated with retinopathy among 535 patients with type 2 diabetes,accounting for 26.92%,and 391 cases were not complicated retinopathy,accounting for 73.08%.There were significant differences in age,SBP,DBP,duration of diabetes,total cholesterol,triglycerides,low-density lipoprotein,glycosylated hemoglobin,fasting blood glucose and urine microprotein between retinopathy group and non-retinopathy group(P<0.05).Multivariate logistic regression analysis showed that age(OR=2.061,95%CI 1.082-3.392),SBP(OR=1.943,95%CI 1.003-3.433),DBP(OR=1.846,95%CI1.001-3.396),diabetes(OR=2.050,95%CI 1.042-3.941),total cholesterol(OR=1.962,95%CI 1.060-3.368),triglyceride(OR=1.826,95%CI 1.011-3.281),low-density lipoprotein(OR=1.887,95%CI1.010-3.307),glycosylated hemoglobin(OR=2.030,95%CI 1.015-3.828),fasting blood glucose(OR=2.132,95%CI 1.022-3.177),and urinary microalbumin(OR=1.910,95%CI 1.017-3.269)were independent risk factors for type 2 diabetic retinopathy(all P<0.05).Conclusion Type 2 diabetes has a higher risk of retinopathy.The main influencing factors are age,blood pressure,duration of diabetes,microalbuminuria,total cholesterol,triglycerides,low-density lipoprotein,glycosylated hemoglobin,and fasting blood glucose.