糖尿病视网膜病变的防治

Prevention and treatment of diabetic retinopathy

糖尿病视网膜病变(diabetic retinpathy,DR)是由于糖尿病患者糖代谢障碍而导致全身微血管循环障碍在眼部视网膜的表现,糖尿病损害视网膜主要是由于血糖增高、小血管管壁增厚、渗透性增大,使小血管更易变形和渗漏。同时可并发心脑肾等微血管病变。DR是糖尿病最常见的微血管并发症之一,是一种严重的致盲眼病,它的发生和发展不仅取决于代谢障碍的程度,并与糖尿病的发病年龄、病程长短、遗传因素和糖尿病控制情况有关。DR发展到增生性糖尿病视网膜病变是引起患者失明的主要原因。发病5a后DR发生率为25%,10a后增至60%,15a后可高达75%～80%,其中危害最大的增殖性视网膜病变占25%。DR的高发病率、高致盲率的特点,严重威胁着人类的生存质量。本文就近年来DR的防治作一综述。

Diabetic retinopathy（DR） is a retina manifestation of systemic capillary circulatory disorder caused by glycometabolism disorder. Damage to the retina was mainly the result of hyperglycemia, thickening and increased permeability of vascular walls. It is also accompanied with microvessel disorders of brain and kidney. DR is one of the most common microvessel complications of diabetes, which may cause vision loss severely. Its occurrence and development is depended on the degree of metabolic disorders and also related with age, course of the disease, genetic factor and management of diabetes. As the disease progresses, DR enters a proliferative stage, which is the main reason for blindness. The incidence of DR is 25% after 5 years of diabetes, 60% after 10 years and 75%-80% 15 years later, of which 25% are proliferative diabetic retinopathy. DR seriously threaten life quality of human. This paper reviews the prevention and treatment of DR.