2型糖尿病视网膜病变患者的血清学相关指标研究

Researoh on serological related indicators in patients with type 2 diabetic retinopathy

目的探讨2型糖尿病患者视网膜病变与相关血清学检查指标的相关性。方法选取本市街道社区卫生服务中心60岁以上的1 000例糖尿病患者作为研究对象,按照直接眼底镜检查结果将其分为观察组540例和对照组460例。观察组患者均为2型糖尿病患者合并有视网膜病变,对照组患者均为2型糖尿病患者未合并有视网膜病变。分析年龄、病程、血糖指标、血压、糖化血红蛋白、血脂指标、尿肌酐等与2型糖尿病患者视网膜病变的关系。结果 2组患者病程、舒张压(DBP)、收缩压(SBP)比较有显著差异(P<0.05)。2组患者空腹血糖(FPG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(Hb A1c)比较有显著差异(P<0.05)。2组患者高密度脂蛋白(HDL)比较有显著差异(P<0.05),2组患者尿微量白蛋白(UMA)、尿肌酐(UCr)比较有显著差异(P<0.05)。2组患者高血压比例比较,差异有统计学意义(P<0.05),而性别、吸烟、饮酒、糖尿病家族史比例比较,差异均无统计学意义(P>0.05)。结论 2型糖尿病视网膜病变是由多因素共同作用所导致,与患者血压水平、血糖控制程度以及尿蛋白的排泄量等因素有关联。

Objective To investigate the correlation between serological related indicators and retinopathy of type 2 diabetes. Methods A total of 1000 patients with diabetes aged over 60 years in community health service center in Shanghai were selected and divided into two groups according to the funduscopic examination results. The observation group（ n =540） was all type 2 diabetic patients complicated with retinopathy, while the control group（ n =460） were type 2 diabetics without retinopathy. Correlation between retinopathy and indicators including age, course of disease, blood glucose, blood pressure, HbA1c, blood lipids, creatinine were analyzed. Results The disease course, diastolic blood pressure （DBP）, systolic blood pressure （SBP） between the two groups showed no significant difference （ P 〈0.05）. There were significant differences in fasting plasma glucose （FPG）, postprandial 2 h blood glucose （2 h PG）, and glycated hemoglobin （HbA1c） in the two groups （ P 〈0.05）. The high-density lipoprotein （HDL） between the two groups showed significant difference （ P 〈0.05）. The urine microalbumin（U-MA）, urine creatinine （UCr）, and proportion of hypertension between the two groups showed significant differences（ P 〈0.05）, while gender, smoking, alcohol consumption, and family diabetes history of the two groups had no significant difference （ P 〉0.05）. Conclusion Type 2 diabetic retinopathy is caused by multiple factors, and is positively correlated with the blood pressure level, the blood glucose control level in daily life and the excretion of urine protein.