早期诊断并合理治疗状态下老年人DR患病率和发病率调查分析

Prevalence and incidence of diabetic retinopathy in the elderly people with early diagnosis and rational treatment

目的:了解老年人群在早期诊断、合理治疗状态下糖尿病视网膜病变(diabetic retinopathy,DR)的患病率和发病率,探讨其流行特征和相关危险因素。方法:对2000-05/2006-05在我院进行健康查体的离休老年糖尿病人群进行眼底检查,如发现有微小血管瘤或更严重的改变则确诊为DR,并予眼底荧光血管造影检查,采用Logistic回归分析对5a中新发现的DR的危险因素进行分析。结果:共有2 194例糖尿病患者参与检查,平均随访5.8a,DR的患病率在15.38%～16.20%之间波动,年发病率为8.38‰。经Logistic多元逐步回归分析发现空腹血糖(FPG)、平均动脉压(MBP)、糖尿病病程、体质指数(BMI)、尿蛋白定量(MAU)与DR的发生明显相关。结论:该研究组老年人糖尿病的患病率及发病率较以往我国一般人群为高,但其DR的患病率和发病率较其它调查组明显降低,说明在血糖、血压、血脂等控制良好的情况下可有效控制DR的发生。

AIM： To determine the prevalence and incidence of diabetic retinopathy （ DR ） and to investigate the epidemiological characteristics as weal as associated risk factors in the elderly people with early diagnosis and rational treatment in Beijing area. METHODS： A survey was conducted among cases of diabetes diagnosed in general hospital from May 2000 to May 2006, the diagnosis of DR was confirmed by ophthalmoscopy and fundus fluorescein angiography （FFA）, multivariable analysis was used to show the risk factors for development of DR in 5 years. RESULTS： Totally 2194 individuals of diabetes were performed DR screening, the average follow-up duration was 5.8 years. The prevalence of DR increased slightly from 15.38% in 2000 to 16.20% in 2006; the incidence of DR was 8. 38‰/year. Logistic regression test showed fasting plasma glucose （ FPG ）, body mass index （ BMI）, mean arterial blood pressure （ MBP）, microalbunminuria （MAU） and duration were risk factors related to the incidence of DR. CONCLUSION： The prevalence and incidence of DM in the elderly people are significantly higher than that in general population, but their prevalence and incidence of DR are notably lower than that in general population, it confirms that DR could be controlled if FPG, BMI, MBP and MAU maintained good condition.