烟台市牟平区糖尿病视网膜病变筛查患者复诊依从性及相关影响因素分析

qompliance of follow-up and the associated factors of diabetic retinopathy screening among diabetes patients in Muping District,Yantai City

目的研究烟台市牟平区在糖尿病患者中开展糖尿病视网膜病变(DR)筛查时,患者复查的依从性以及相关影响因素。方法随机选取于2012年4月至2013年6月在烟台市牟平区中医院进行免费DR筛查的438例糖尿病患者,调查其5年后进行DR复诊的依从性,并分析影响复诊患者依从性的可能因素,包括年龄、性别、身高、体重、教育程度、职业、既往全身病史、生活习惯(吸烟/酗酒)、糖尿病病程、糖尿病用药史、DR严重程度、糖化血红蛋白(HbA1c)、肾功能、血脂等。结果在438例患者中,5年后有159例患者能够按医嘱复诊,复诊率为36.3%。对影响复诊依从性的可能相关因素进行分析,发现患者依从性与职业种类(P=0.003)、HbA1c水平(P=0.006)有关,与其它因素均无关(P>0.05)。结论患者DR筛查复诊的依从性与职业种类和血糖控制情况有关。提示我国在DR的筛查中应注意对糖尿病患者进行控制血糖的宣教工作,并将某些职业的糖尿病人群如家务工作者、农民等列为重点。

ObjectiveTo investigate the compliance of follow-up and the associated factors of diabetic retinopathy screening among diabetes patients in Muping District, Yantai City.Methods438 diabetes patients who received free diabetic retinopathy （DR） screening in Traditional Chinese Medicine Hospital of Muping District of Yantai City from April 2012 to June 2013 were enrolled in the cross-sectional study. The re-examination rate at five years later, as well as the possible associated factors, including age, gender, height, weight, education level, occupation, past medical history, smoking and drinking habits, diabetes process, diabetes medication history, severity of DR, glycosylated hemoglobin （HbA1c）, renal functionand blood lipid were analyzed and evaluated.ResultsAmong 438 patients, 159 returned for check up five years later, with a follow-up rate of 36.3%. Further analysis revealed that follow-up rate was related to occupation types （P=0.003） and HbA1c level （P=0.006）. Other factors did not show statistical significance （P〉0.05）.ConclusionsThe compliance of DR screening visits is related to occupational type and blood glucose control. It is suggested that in the screening of DR in China, we should pay attention to the propaganda and education of diabetic patients to control blood glucose, and focus on some occupational diabetes people, such as housework workers and farmers.