2型糖尿病黄斑病变的相关因素分析

Analysis of risk factors of maculopathy in patients with type 2 diabetes mellitus.

目的研究2型糖尿病患者中糖尿病性黄斑病变的相关因素。方法对83例2型糖尿病患者的黄斑病变与血压、病程、糖化血红蛋白、总胆固醇、甘油三酯、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、载脂蛋白Al、载脂蛋白B100、血尿素氮和血肌酐进行Logistic回归分析。结果在83例糖尿病病人中,有黄斑病变患者35例。在16例增殖型糖尿病视网膜病变病人中,有黄斑病变病人数12例,较非增殖型糖尿病视网膜病变的病人多(P<001)。Logistic回归分析发现糖尿病性黄斑病变与血浆总胆固醇(β=-313,P<005)、低密度脂蛋白胆固醇(β=4077,P<005)和神经病变(β=-2655,P<005)呈显著相关,与糖尿病的严重程度(国内分期)呈显著相关(β=2423,P<001)。结论糖尿病性黄斑病变与脂代谢紊乱、神经病变和与糖尿病视网膜病变的严重程度密切相关。提示严格控制血糖、血脂等相关危险因素,对预防和控制黄斑病变有重要意义。

Objective: To investigate the risk factors of diabetic maculopathy in patients with type 2 diabetes mellitus. Methods: Multiple logistic regression analysis was used to analyze the risk factors of diabetic maculopathy in 83 patients with type 2 diabetes mellitus. Blood pressure, duration of disease, glycosylated hemoglobin A 1c ,total cholesterol,high-density lipoprotein-cholesterol,low-density lipoprotein-cholesterol,apoprotein A 1,apoprotein B 100 ,blood urea nitrogen and creatinine regression model. Results:Diabetic maculopathy was found in 35 of 83 patients with type 2 diabetes. The prevalence of maculopathy was significantly higher in proliferative diabetic retinopathy than that in non-proliferative diabetic retinopathy (P<0.01). Multiple logistic regression analysis revealed that diabetic maculopathy was significantly correlated with TC(β=-3.13, P<0.05), LDL-C levels(β=4.077,P<0.05), neuropathy (β=-2.655, P<0.05)and showed a highly significant correlation with classification of diabetes(β=2.423,P<0.01). Conclusions:Diabetic maculopathy is associated with diabetic neuropathy, disturbance of lipid metabolism and the severity of diabetic retinopathy, suggesting the important role of tight control of hyperglycaemia, hyperlipidemia and other risk factors in prevention and treatment of maculopathy. [