2型糖尿病患者糖尿病视网膜病变的预测性因素研究

Predictive factors of type 2 diabetic retinopathy

目的探讨2型糖尿病患者糖尿病视网膜病变(diabetic retinopathy,DR)的预测性因素。方法 628例2型糖尿病患者纳入本研究,记录糖尿病危险因素、并发症及实验室检查结果。运用SPSS 16.0软件包建立数据库,并用χ2检验进行统计学分析,Logistic回归分析危险因素和DR的关系。结果 628例2型糖尿病患者(46%为男性)中DR患者166例(占26.4%)。DR和糖尿病家族史(P=0.040 0)、高血压(P=0.000 1)、糖尿病病程(P=0.000 1)、血糖控制不良(P=0.000 1)及糖尿病发病年龄(P=0.000 1)均有显著关联。然而DR和血脂及肥胖并未发现有相关性(均为P>0.05)。Logistic回归分析中,对年龄及性别进行调整以后,血糖控制不佳(P=0.014)、高血压(P=0.000 1)、糖尿病病程(P=0.000 1)和糖尿病家族史(P=0.012)均是DR的独立危险因素。结论基因及环境等后天性因素对DR的发生发展会产生影响。

Objective To assess the predictive factors of type 2 diabetic retinop- athy （DR）. Methods A cross-sectional study was designed by recruiting 528 type 2 diabetic patients. Diabetes risk factors, complications, laboratory results were recorded. SPSS 15.0 software was used to establish the database, and the relationship between predictive factors and DR was analyzed by Logistic regression analysis. Results Of the 528 diabetic patients （45% man） ,prevalence of DR was 25.4%. There were significant associations between DR and family history of diabetes （P = 0.040 0）, hyperten- sion （P = 0. 000 1 ）, diabetic duration （ P = 0. 000 1 ）, poor glycemic control （ P = 0. 000 1 ） and age of onset of diabetes （P = 0. 000 1 ）. However, no significant associa- tions were found between DR and dyslipidemia, obesity （ all P 〉 0.05 ）. In Logistic regression model,poor glycemic control （P = 0. 014 0） ,hypertension （P = 0. 000 1 ）, duration of diabetes （P =0.000 1 ） and family history of diabetes （P =0.012 0） independently predicted DR after adjustment for age and sex. Conclusion The genetic and epigenetic factors are the predictive factors for DR.