济南市农村白内障患者糖尿病及糖尿病视网膜眼底病变患病率调查分析

Prevalence investigation on rural cataract patients with diabetes and diabetes retinal fundus lesions in Jinan city of Shandong province

目的了解济南市农村50岁以上白内障患者中糖尿病及糖尿病视网膜病变(DR)的患病率,为农村糖尿病视网膜病变的防治提供基本的流行病学数据。方法参照1999年WHO糖尿病专家组委员会提出的病因学分型诊断标准,对筛查的1 336名白内障患者进行如下检查,1问诊:一般情况、既往糖尿病病史等;2临床体格检查,计算体质量指数(BMI);3实验室检查:空腹血糖(FPG)、糖化血红蛋白(Hb A1c)等;4眼部检查:散瞳检查眼底,诊断标准参照1984年中华医学会眼科学会眼底病学组制定的DR分期标准。采用统计软件SPSS 13.0对观察数据进行统计学分析。结果收入院白内障患者1 336例,受检率为100%,检出280例糖尿病患者,患病率为20.95%。糖尿病视网膜病变患者92例,在糖尿病患者中的患病率为32.86%,在所有受检者中的患病率为5.98%,其中男性30例,为男性受检者的3.52%,女性62例,为女性受检者的4.68%,男女性别之间的患病率差异无统计学意义(P>0.05)。DR患病率在各年龄段有显著差异(P<0.05),其中65岁到80岁患病率最高,为该年龄段人群的6.04%。糖尿病病程、血压程度与DR的患病率有密切关系(P<0.05)。结论济南市入院农村白内障患者糖尿病患病率高;糖尿病病程、血糖水平及高血压病都是影响DR病情发展的重要因素。

Objective To explore the prevalence of rural cataract patients with diabetic retinopathy （DR）over 50 years old and to provide basic epidemiological data for prevention of diabetic retinopathy.Methods According to the 1999 W HO diabetes experts committee of etiological typing diagnosis standard,1336 cataract patients were performed the fol-lowing examinations,an inquiry of the general situation and history of diabetes;② clinical physical examination and body mass index （BMI）;③fasting blood glucose （FPG）and glycosylated hemoglobin （HbA1 c）,etc;④fundus ex-amination,diagnostic standard of Chinese Medical Association in 1984 to ocular fundus disease department of Ophthal-mology study group DR staging criteria.Results Of the 1336 patients,280 were diabetes,the prevalence rate was 20.95%;Of the 280 patients,92 had diabetic retinopathy,the prevalence rate was 32.86%.The prevalence rate of di-abetic retinopathy in all subjects was 5.98%.The prevalence of DR had significant differences in age （P〈0.05）, which was the highest in 65 to 80 years old patients 6.04%.There was a close relationship between the prevalence rate of diabetes,blood pressure and DR （P〈0.05）.Conclusion In-patient rural cataract patients had high prevalence of diabetes mellitus in Jinan city;Duration of diabetes,blood glucose level and hypertension are important factors influen-cing the development of DR diseases.