2型糖尿病视网膜病变的危险因素分析

Analysis of risk factors in diabetic retinopathy of type-two diabetes mellitus

目的探讨导致2型糖尿病患者发生糖尿病视网膜病变的危险因素,并对其进行分析。方法选取202例2型糖尿病患者,眼底镜观察视网膜变化,并检测HbA1c,24小时尿白蛋白定量,甘油三脂、总胆固醇,测量收缩压,舒张压。结果202例患者中有84例合并糖尿病视网膜病变(DR),患病率为41.6%。在DR组中,尿白蛋白总量>30 mg/24 h的2型糖尿病病例有42例,占DR组总数的67.86%;非DR组中,尿白蛋白总量>30 mg/24 h的2型糖尿病病例有20例,占非DR组总数的16.95%。通过对两组数据的数值进行独立样本t检验,DR组和非DR组中,收缩压,病程,糖化血红蛋白等危险因素有统计学意义(P<0.05),并对两组的24小时尿白蛋白定量进行非参数检验,结果显示两组的24小时尿白蛋白有显著统计学意义(P<0.01)。将上述可疑危险因素纳入Spearman相关分析,其中收缩压,病程,糖化血红蛋白及24小时尿白蛋白量与糖尿病视网膜病变有明显的相关性(P<0.05)。结论糖尿病视网膜病变发生及其严重程度与病程、糖化血红蛋白和血压有关,其中病程长短对糖尿病视网膜病变的发生影响最大,是决定糖尿病视网膜病变发生发展的关键因素,24小时尿白蛋白总量与糖尿病视网膜病变的严重程度具有平行关系。

Objective To probe and analysis the risk factors in diabetic retinopathy of Type-two Diabetes Mellitus. Method To select 202 patients who get Type-two Diabetes Mellitus, and observe the change in retina by opthalmoscope. To detect HbAlc, the quantitative examination of 24h urine protein and the blood pressure. Result In the 202 patients, 84 patients affiliate with diabetic retinopathy, the prevalence of which is 41.6%. There are 42 patients whose total urinary albumin 〉 30 mg/24 h in group DR accounting for 67.86% and 20 patients whose total urinary albumin 〉 30 mg/24 h in group NDR accounting for 16.95%. Through Independent-Samples 1T Test, there are great risk factors such as course of disease,blood pressure and HbA1 c. After using. Spearman Regression , we can see that course of disease, blood pressure,24h total urinary albumin and HbAlc are all associated with diabetic retinopathy. Conclusion The development of diabetic retinopathy is associated with hyperglycemia, severity level of diabetic retinopathy is associated with course of disease, blood pressure,24h total urinary albumin. Course of disease is the key point to determine the progress in DR. 24h total urinary albumin and the level of DR are at equal pace.