糖尿病性视网膜病变相关因素(附76例随访观察)

Observation on Relative Factors of Retina Lesion of Diabetes

目的探讨糖尿病视网膜病变的相关因素。方法随访糖尿病视网膜病变(DR)单纯型Ⅰ、Ⅱ、Ⅲ期76例136眼。单纯型进展为增殖型糖尿病视网膜病变(PDR)Ⅳ期,随访2年为23眼(16%),5年为52眼(38%)。结果Ⅰ、Ⅱ、Ⅲ期进展至Ⅳ期的发生率,Ⅲ期>Ⅱ期,Ⅱ期>Ⅰ期,差别有显著性(P<0.05)。糖尿病黄斑水肿随访年限增长而增加,初诊黄斑水肿32眼,2年内增至44眼,5年内增至54眼。视网膜静脉串珠状改变,视网膜内大量微血管异常和4个象限内存在出血或微血管瘤是单纯型进展至PDR的危险性病变。血糖控制不良,糖尿病病程长、尿蛋白排泄率和高血压可能是单纯型进展至PDR的危险性因素。结论为预防或减少DR致盲,应早期发现并给予长期随访。

Objective To observe the relative factors of diabetes retina lesion. Methods 136 eyes of 76 eases of DR were followed up in simple stage of Ⅰ , Ⅱ and Ⅲ. The Proliferation DR in Ⅳ was 2 years in 23 eyes and 5 years in 52 eyes. The proliferation rate of Ⅰ , Ⅱ and Ⅲ to Ⅳ was higher gradually （ P 〈 0.05）. The macula retina increased with the follow - up. Also the vascular changes of the retina vein with the development of degree. Conclusion The bad control of blood glucose, duration of diabetes, high excretory rate of protein urine and hypertension might be the risk factors for DR to PDR. The prevention in early stage and follow- up should be taken.