上海市花木社区居民糖尿病视网膜病变防治知识及行为现况调查研究

Survey on the Awareness and Prevention of Diabetic Retinopathy among Patients with Diabetes Mellitus and Impaired Glucose Tolerance in the Huamu Community of Shanghai City

目的了解社区人群对糖尿病视网膜病变(DR)防治知识与防治行为的现状,为社区DR重点人群的防治提供参考。方法选取2016年1月—2017年1月在花木社区卫生服务中心由由服务站就诊或配药的501例糖尿病(DM)患者或糖耐量异常(IGT)者为研究对象,采用自行设计的问卷开展调查,包括居民对DR的认知情况(题目1~7)、居民采取DR防治措施的现状及意愿调查(题目8~10)。结果 DM患者与IGT者题目2(DR病因)、3(DR可预防控制)、5(DM定期检查眼底)、6(了解DR的途径)的认知情况分布比较,差异均有统计学意义(χ2=4.217、13.198、15.721、25.168,P<0.05)。DM患者与IGT者题目9(最近眼科检查时间)、10(是否定期眼底检查)的防治行为分布比较,差异均有统计学意义(u=2.156,χ~2=4.474,P<0.05)。不同性别IGT者题目10的分布比较,差异有统计学意义(χ~2=7.250,P=0.007)。不同年龄DM患者题目9、10的分布比较,差异有统计学意义(H=9.614,P=0.022;χ~2=23.449,P<0.001)。其中,<60岁与70~79岁的DM患者题目9的分布比较,差异有统计学意义(P<0.05);<60岁DM患者选择"会定期检查"的比例均高于60~69、70~79、≥80岁DM患者,60~69、70~79岁DM患者选择"会定期检查"的比例均高于≥80岁DM患者(P<0.05)。不同病程DM患者题目8(DR知识讲座)、10的分布比较,差异有统计学意义(χ~2=10.539,P=0.005;χ~2=6.353,P=0.042)。其中,病程>10年DM患者选择"参加过"的比例均高于病程<5、5~10年DM患者,病程<5年DM患者选择"会定期检查"的比例均高于病程5~10、>10年DM患者,病程5~10年DM患者选择"会定期检查"的比例高于病程>10年DM患者(P<0.05)。结论本社区居民对DR知晓率较低,且IGT者在认知程度和防治行为上均不及DM患者,因此对社区居民开展DR相关知识的健康宣教很有必要。

Objective To understand the current status of knowledge of the prevention and treatment of diabetic retinopathy（DR） in a community population and to provide a reference for DR prevention and treatment.Methods The study subjects consisted of 501 patients with diabetes mellitus（DM） or impaired glucose tolerance（IGT） who were treated in the Youyou service station of the Huamu Community Health Service Center between January 2016 and January 2017.A self-designed questionnaire was used for the survey.Items included the subjects＇ knowledge of DR（items 1-7）,current status of prevention and treatment of DR and willingness to take related measures（items 8-10）.Results There was a significant difference in knowledge in item 2（the cause of DR）,item 3（that DR can be prevented and controlled）,item 5（that DM patients need regular fundus examination） and item 6（the way to understand DR） between DM patients and IGT patients（χ~2=4.217,χ~2=13.198,χ~2=15.721,χ~2=25.168,P〈0.05）.The difference in the distribution of control behavior of item 9（the time of recent ophthalmology examination） and item 10（regular fundus examination） between DM patients and IGT subjects were statistically significant（u=2.156,χ~2=4.474,P〈0.05）.The difference in item 10 between male and female IGT subjects was statistically significant（χ~2=7.250,P=0.007）.DM patients of different ages showed a significant difference in items 9 and 10（H=9.614,P=0.022;χ~2=23.449,P〈0.001）,the difference in item 9 between DM patients 〈60 years old versus 70-79 years old was statistically significant（P〈0.05）,and the proportion of DM patients 〈60 years old who chose ＂receive regular examination＂ was higher than that of DM patients 60-69,70-79,≥ 80 years old（P〈0.05）.In addition,DM patients 60-69 years old and 70-79 years old comprised a higher proportion who choose ＂receive regular examination＂ than did DM patients ≥ 80 years old（P〈0.05）.DM patients with different disease courses differed regarding item 8（DR knowledge lecture） and item 10（χ~2=10.539,P=0.005;χ~2=6.353,P=0.042）,among them,DM patients with a disease course 10 years had a higher proportion who choose ＂once took DR knowledge lecture＂ than did those with a disease course 5,5-10 years.Moreover,DM patients with a disease course 〈5 years comprised a higher proportion who choose ＂receive regular examination＂ than did those with a disease course 5-10,〉10 years.DM patients with a disease course 5-10 years also had a higher proportion who choose ＂receive regular examination＂ than did those with a disease course 〉10 years（P〈0.05）.Conclusion The awareness of DR in the residents of this community is relatively low,and people with IGT have less awareness and fewer prevention behaviors than those with DM.Therefore,it is necessary to provide health education to provide DR-related knowledge to the community.