眼科首诊糖尿病43例分析

Analysis of 43 cases diagnosed as diabetes that first visit at Ophthalmology

目的 分析首诊于眼科后确诊为2型糖尿病患者的早期眼部症状和体征,为糖尿病的早期诊断提供参考.方法 对2008年10月至2013年5月在昔阳县人民医院就诊的43例（76只眼）以视力下降、眼红、眼胀、畏光、流泪及复视等眼科症状就诊的疑为2型糖尿病患者,给予裂隙灯显微镜检查,眼前节、眼后节,空腹血糖、餐后2h血糖及尿糖检查,部分患者行荧光素眼底血管造影检查.结果 43例患者均为2型糖尿病.76只眼中有不同形态、不同程度的晶状体混浊36只眼（47.4％,36/76）,葡萄膜炎12只眼（15.8％.12/76）,眼外肌麻痹4只眼（5.3％,4/76）,视网膜病变10只眼（13.1％,10/76）,视神经病变4只眼（5.3％,4/76）,屈光异常10只眼（13.1％,10/76）.结论 因眼部并发症而首诊于眼科的糖尿病缺乏糖尿病的典型症状,临床工作中应加以重视,以免延误治疗.

Objective To analyze the ophthalmic condition of patients who initially visited ophthalmology department,but diagnosed as Type 2 diabetics and discuss early eye symptoms of diabetics.Then provide references for the early diagnosis of diabetes to effectively suppress diabetes to cause blinding eye disease.Methods Suspecting 43 patients（76 eyes）,who visited ophthalmology department with eye symptoms of decreased vision,redness,eye swelling,photophobia,tearing and double vision and other signs,as Type 2 diabetics and giving examination of slit-lamp microscope,anterior segment,posterior segment,fasting blood-glucose,2-hour post prandial blood-glucose and urine examination.Some patients were given fundus fluorescein angiography.Results Forty-three patients were Type 2 diabetics.There were 36 eyes （47.4%,36/76） with different forms,varying degrees of lens opacity,12 eyes （15.8%,12/76） with uveitis,4 eyes （5.3%,4/76） with extraocular muscle paralysis,10 eyes （13.1%,10/76） with retinopathy,4 eyes （5.3%,4/76） with optic neuropathy,10 eyes （13.1%,10/ 76）with ametropia.Conclusions Attention should be paid in clinical work to avoid delays in treatment of diabetics who initially visited ophthalmology department for ocular complications,though they lack typical symptoms of diabetes.