宁夏部分社区2型糖尿病视网膜病变患病率及影响因素

Prevalence of diabetic retinopathy of type 2 diabetes mellitus patients in multi-district communities in Ningxia and root causes

目的探讨宁夏多地社区2型糖尿病(T2DM)患者视网膜病变(DR)的患病率,分析DR的影响因素,为社区T2DM患者防控DR提供理论依据。方法2018-12-18-2019-04-04,选取宁夏银川市兴庆区、中卫市沙坡头区、石嘴山市平罗县和吴忠市所辖青铜峡市4地共16家社区的1794例T2DM患者为研究对象,对患者进行问卷调查、体格检查、实验室检查和DR眼底检查。根据DR眼底检查结果,将患者分为非糖尿病视网膜病变(NDR)组和DR组,DR组又分为非增殖型糖尿病视网膜病变(NPDR)组和增殖型糖尿病视网膜病变(PDR)组。采用SPSS 25.0对数据进行方差分析、χ2检验和多因素二元Logistic回归分析。结果1794例T2DM患者中,DR患者562例,患病率为31.33%。不同年龄(χ2=15.645,P<0.001)、糖化血红蛋白(HbA1c)水平(χ2=30.242,P<0.001)及尿微量白蛋白/尿肌酐(ACR)水平(χ2=17.681,P<0.001)的DR患病率不同,差异有统计学意义。多因素二元Logistic回归分析结果显示,年龄≥65岁、居住地为农村、体质量指数(BMI)升高、血脂异常、ACR≥4.17及HbA1c升高是DR发生发展的危险因素。结论宁夏多地社区T2DM患者DR患病率较高。高龄农村患者为DR发生的高危人群,在控制体质量的同时需防止血脂异常的发生,同时应加强T2DM患者HbA1c自我管理和ACR监测工作。

Objective To explore the prevalence of Diabetic retinopathy(DR)in patients with type two diabetes mellitus(T2DM)in many communities in Ningxia,and analyzd the root causes of DR,and provide a theoretical basis for the prevention and control of DR in T2DM patients in the communities.Methods From December 18,2018 to April 4,2019,a total of 1794 T2DM patients from 16 communities in Xingqing District of Yinchuan City,Shapotou District of Zhongwei City,Pingluo County of Shizuishan City,and Qingtongxia City of Wuzhong City were selected as the study subjects.Questionnaire survey,physical examination,laboratory examination and fundus examination of diabetic retinopathy were performed on the patients.According to the results of fundus examination of diabetic retinopathy,patients were divided into non-diabetic retinopathy(NDR)and diabetic retinopathy(DR),and DR was further divided into non-proliferative diabetic retinopathy(NPDR)and proliferative diabetic retinopathy(PDR).SPSS 25.0 was used for analysis of variance,χ2 test and multivariate binary Logistic regression analysis.Results Among the 1794 T2DM patients,562 were DR patients,with a prevalence rate of 31.33%.The prevalence of DR was different in different age groups,and the difference was statistically significant(χ2=15.645,P<0.001).The prevalence of DR in different hemoglobin A1C(HbA1c)groups is different,and the difference was statistically significant(χ2=30.242,P<0.001).The prevalence of DR in different ACR groups was different,and the difference was statistically significant(χ2=17.681,P<0.001).Multivariate binary Logistic regression analysis showed that age≥65 years old,rural residence,increased BMI,dyslipidemia,ACR≥4.17,and elevated HbA1c are root causes for the development of DR.Conclusions The prevalence of DR in T2DM patients in many communities in Ningxia is relatively high.Older rural patients are high-risk groups for DR,and they need to prevent dyslipidemia while controlling their weight.At the same time,self-management of HbA1c and ACR monitoring of T2DM patients should be strengthened.