上海某社区糖尿病人群视力损伤及视网膜病变的现况研究

Study of the status of visual impairment and retinopathy in the diabetic population in a community in Shanghai

目的:了解上海社区糖尿病(DM)患者的视力损伤及糖尿病视网膜病变(DR)患病情况和相关因素。方法:于2017年5-6月选择上海五里桥社区的937名DM患者作为调查对象,其中男性435人,女性502人,平均年龄(68±7)岁。通过检查获得视力、眼底照相、化验及体征资料,采用糖网远程筛查系统进行DR诊断。结果:根据日常生活视力,盲和中重度视力损伤的检出率分别为1.1%和8.0%;根据小孔视力,盲和中重度视力损伤的检出率分别为1.1%和4.1%。对773例眼底照相DR分级发现,DR的患病率为28.6%,其中轻、中、重度非增生性及增生性DR依次占25.8%、66.1%、6.3%及1.8%。Logistic回归分析显示空腹血糖、尿白蛋白与尿肌酐比值与DR相关。结论:社区DM居民中DR患病率较高,定期筛查、早期发现至关重要。提示需要重视可控危险因素的管理,预防糖尿病慢性并发症的发生。

Objective:To understand the visual impairment and related factors of diabetic retinopathy(DR)in patients with diabetes mellitus(DM)in a community in Shanghai.Methods:From May to June 2017,937 DM patients from Wuliqiao Community,Shanghai were selected as the survey subjects,including 435 males and 502 females,with an average age of(68±7)years.Visual acuity,fundus photography,laboratory tests and signs data were obtained by the examination and the sugar network remote screening system was used for DR diagnosis.Results:According to daily vision,the detection rates of blind and moderate to severe visual impairment were 1.1%and 8.0%,respectively;according to small hole vision,the detection rates of blind and moderate to severe visual impairment were 1.1%and 4.1%,respectively.According to the DR classification of 773 cases of fundus photography,the prevalence of DR was 28.6%,and among them,mild,moderate and severe non-proliferative and proliferative DR accounted for 25.8%,66.1%,6.3%and 1.8%,respectively.Logistic regression analysis showed that fasting blood sugar,urinary albumin and creatinine ratio were correlated with DR.Conclusion:The prevalence of DR is high among community DM residents,so regular screening and early detection are very important.It is suggested that attention should be paid to the management of controllable risk factors to prevent the occurrence of chronic complications of diabetes mellitus.