2型糖尿病患者糖尿病视网膜病变危险因素分析

Risk factors for diabetic retinopathy in patients with type 2 diabetes mellitus

目的分析2型糖尿病住院患者糖尿病视网膜病变(diabetic retinopathy,DR)的患病率及其危险因素,阐明这些因素与糖尿病视网膜病变发生的关系。方法采用横断面研究方法,纳入2型糖尿病患者218例,依据DR诊断标准将其分为DR组和无DR(NDR)组,其中DR组62例,NDR组156例。DR组依据病变程度分为轻、中、重度非增生性DR(NPDR)组以及增生性DR(PDR)组。检测并记录患者的年龄、性别、糖尿病病程、血压、体质量指数(BMI)、糖化血红蛋白(HbA1c)、空腹血糖(FBG)、血脂、眼轴长度、前房深度及肾功能等相关指标。采用Logistic回归分析,筛选DR的危险因素。结果218例2型糖尿病患者中DR的患病率为28.44%(62/218)。DR组与NDR组患者的年龄、糖尿病病程、收缩压、舒张压、HbA1c、FBG、血肌酐、尿白蛋白/尿肌酐比值(UACR)、眼轴长度及前房深度比较,差异均有统计学意义(P<0.05)。Logistic回归分析结果显示,年龄、FBG、UACR和眼轴长度是DR的独立危险因素(OR=0.790、84.969、1.250、0.007,P=0.023、0.025、0.040、0.033)。结论年龄小、眼轴短、FBG和UACR水平高的2型糖尿病患者并发DR的风险高,早期诊断,可以减少DR的患病率,并控制其进展。

Objective To analyze the prevalence and risk factors of diabetic retinopathy(DR)in inpatients with type 2 diabetes and provide scientific basis for the prevention and treatment of diabetic retinopathy.Methods Cross sectional study was performed.A total of 218 patients with type 2 diabetes were included,who were divided into the DR group and the non-diabetic retinopathy(NDR)group according to the DR diagnostic criteria,including 62 patients in the DR group and 156 patients in the NDR group.The DR group was subdivided into mild,moderate and severe non-proliferative DR(NPDR)group and proliferative DR(PDR)group.The age and sex of patients,course of diabetes,systolic blood pressure(SBP),diastolic blood pressure(DBP),body mass index(BMI),glycosylated hemoglobin(HbA1c),fasting blood glucose(FBG),blood lipid,axial length(AL),anterior chamber depth(ACD)and renal function were detected.Logistic regression was used to analyze the risk factors of DR.Results The prevalence of DR inpatients with was type 2 diabetes was 28.44%(62/218).The course of diabetes,age,SBP,DBP,HbA1c,FBG,creatinine,urinary albumin/creatinine ratio(UACR),AL and ACD were statistically significant between DR group and NDR group(P<0.05).Stepwise logistic analysis identified that age,FBG,UACR and AL are the independent risk factors of DR(OR=0.790,84.969,1.250,0.007;P=0.023,0.025,0.040,0.033).Conclusion If patients with type 2 diabetes are young and have short axial eyes and high levels of FBG and UACR,they are at a high risk of developing DR.Early diagnosis can reduce the prevalence of DR and control its progression.