北京市朝阳区南部医联体2型糖尿病患者DR患病率及相关因素分析

Prevalence and related factors of DR in patients with type 2 diabetes mellitus in the southern medical treatment combination of Chaoyang District,Beijing

目的:了解北京市朝阳区南部医联体2型糖尿病患者糖尿病视网膜病变(DR)的患病情况,并分析其危险因素。方法:于2016-11/2017-11采用分层整群随机抽样法从北京市朝阳区南部医联体社区卫生服务中心的居民健康档案中随机抽取40岁及以上的2型糖尿病患者840例作为研究对象。收集患者的临床资料、体格检查、血液检查结果,并对所有患者进行散瞳眼底检查。结果:北京市朝阳区南部医联体40岁及以上2型糖尿病患者DR患病率为35. 7%,其中轻、中、重度非增殖期和增殖期DR患病率分别为68. 3%、12. 3%、5. 0%、14. 3%。年龄、糖尿病病程、胰岛素治疗、Hb A1c、合并糖尿病足是DR发生的独立危险因素。结论:该地区DM患者DR患病率较高,社区医生在定期对糖尿病患者进行随访时,不仅应该敦促患者严格控制血糖、定期检测HbA1c,还应给予低龄、糖尿病病程长、胰岛素使用及合并糖尿病足的患者特别关注。

AIM:To understand the prevalence of diabetic retinopathy(DR)in patients with type 2 diabetes mellitus in the southern medical treatment combination of Chaoyang District,Beijing,and to analyze the risk factors.METHODS:A stratified cluster random sampling method was used to randomly select 840 residents aged 40 years and older who were diagnosed with type 2 diabetes mellitus as the target population for the survey from the residents health records of five Community Health Service Centers in the southern medical treatment combination of Chaoyang District,Beijing from November 2016 to November 2017.General patient data,physical examination,blood test results were collected,and all patients underwent dilated fundus examination.The prevalence of DR was calculated and Logistic regression was used to analyze DR risk factors.RESULTS:The prevalence of diabetic retinopathy in patients with type 2 diabetes mellitus in the southern medical treatment combination of Chaoyang District,Beijing was 35.7%,among which the prevalence of mild,moderate and severe nonproliferative and proliferative diseases was 68.3%,12.3%,5.0%and 14.3%,respectively.Age,duration,insulin use,HbA1c and diabetic foot were independent risk factors for DR.CONCLUSION:The prevalence of DR in patients with type 2 diabetes is higher in the area.When community doctors regularly follow up on diabetic patients,they should not only urge patients to strictly control blood sugar,regularly detect HbA1c,but also pay special attention to younger patients,patients with long course,patients with insulin use and patients with diabetic foot.