2型糖尿病视网膜病变的相关因素分析

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

目的探讨糖尿病视网膜病变(DR)与全身因素的关系。方法对473例2型糖尿病患者根据眼底病变程度分为无DR组(NDR)、背景型DR组(BDR)、增殖型DR组(PDR)三组。比较三组在年龄、糖尿病病程、血压(BP)、体重指数(BMI)、空腹血糖(FBG)、糖化血红蛋白(HbA1c)、尿微量白蛋白排泄率(UAER)、甘油三酯(TG)、胆固醇(TC)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)、尿素氮(BUN)、肌酐(Cr)以及空腹和餐后2小时C肽(CP0和CP2)的不同。采用logistic回归分析DR与各因素的相关性。结果 BDR组与NDR组比较:年龄、病程、SBP、DBP、UAER、TC、LDL-C、BUN、CP0和CP2有显著差异(P<0.05、0.001、0.001、0.05、0.001、0.001、0.001、0.05、0.001、0.001);PDR组与NDR组比较:病程、SBP、DBP、BMI、UAER、BUN、CP0和CP2有显著差异(P<0.001、0.001、0.05、0.05、0.001、0.05、0.05、0.001);PDR与BDR组比较:年龄、SBP、DBP有显著差异(P均<0.05)。经logistic回归分析显示,病程、UAER、TC是DR发生的危险因素(OR=1.090、1.002、1.361,P均<0.05),CP2是DR发生的保护因素(OR=0.865,P=0.001)。结论 DR的发生及其严重程度与病程、UAER、TC及CP2密切相关,重视对DR相关因素的监测与评价有助于DR的预防和治疗。

Objective To study the relationship between diabetic retinopathy（DR） and relevant factors.Methods A total of 473 type-2 diabetic patients were divided into three groups,NDR,BDR,and PDR,by the degree of diabetic retinopathy.Analyses the differences of the 3 groups in terms of age,diabetic duration,BP,BMI,FBG,HbA1c,UAER,TG,TC,HDL-C,LDL-C,BUN,Cr,CP0,and CP2.Logistic regression analysis is used to analyses the possible factors that might affect the DR.Results There are statistically significant differences in age,diabetic duration,SBP,DBP,UAER,TC,LDL-C,BUN,CP0 and CP2 between BDR and NDR（P0.05,0.001,0.001,0.05,0.001,0.001,0.001,0.05,0.001,0.001）.There are statistically significant differences in diabetic duration,SBP,DBP,BMI,UAER,BUN,CP0 and CP 2 between PDR and NDR（P0.001,0.001,0.05,0.05,0.001,0.05,0.05,0.001）.There are statistically significant differences in age,SBP,and DBP,between PDR and BDR（P0.05）.Logistic regression analysis showed that diabetic duration,UAER and TC were independent risk factors（OR=1.090,1.002,1.361,P0.05） and CP 2 was a protective factor for DR（OR=0.865,P=0.001）.Conclusion A closed correlation has been found between diabetic duration,UAER,TC and CP 2 and the development of DR.Monitoring and evaluating systemic factors would be helpful for prevention and treatment of DR.