中老年2型糖尿病患者视网膜病变的影响因素分析

Analysis of influencing factors of retinopathy in middle-aged and elderly patients with type 2 diabetes mellitus

目的探讨中老年2型糖尿病患者糖尿病性视网膜病变(DR)的影响因素。方法选取2018年1月~2019年12月于葫芦岛市中心医院收治的460例中老年2型糖尿病患者作为研究对象。对其进行病史采集、体格检查,抽取空腹静脉血检测生化指标,由专业眼科医师进行眼底检查,根据眼底情况分为正常眼底(NDR)组(295例)及糖尿病性视网膜病变(DR)组(165例)。总结葫芦岛市中心医院收治的中老年2型糖尿病患者视网膜病变的患病率。采用Logistic回归模型分析DR与各影响因素的相关性。结果DR患者患病率35.9%,其中病程<5年、5~10年、>10年DR患病率分别为18.1%、31.6%、53.8%,差异有统计学意义(P<0.05);DR组的病程、血清尿酸(SUA)、尿素氮(BUN)均高于NDR组,差异有统计学意义(P<0.05);两组的年龄、性别、体重指数(BMI)、收缩压(SBP)、舒张压(DBP)、糖化血红蛋白(HbA1c)、空腹血糖(FPG)、三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)及血肌酐(Scr)比较,差异无统计学意义(P>0.05);Logistic回归模型分析,病程(β=0.116,OR=1.123,95%CI:1.087~1.160)、SUA(β=0.003,OR=1.003,95%CI=1.000~1.005)为DR的独立危险因素(P<0.05)。结论中老年2型糖尿病患者DR患病率随着病程显著增加,病程、SUN是DR的独立危险因素。

Objective To investigate the influencing factors of diabetic retinopathy(DR)in middle-aged and elderly patients with type 2 diabetes mellitus.Methods A total of 460 middle-aged and elderly patients with type 2 diabetes mellitus who were admitted to Huludao Central Hospital from January 2018 to December 2019 were selected as the research subjects.They were subjected to history collection and physical examination,and fasting venous blood was collected to detect biochemical indicators.The fundus examination was performed by a professional ophthalmologist.According to the fundus conditions,they were divided into a normal fundus(NDR)group(295 cases)and a diabetic retinopathy(DR)group(165 cases).The prevalence of retinopathy in middle-aged and elderly patients with type 2 diabetes mellitus admitted to Huludao Central Hospital were summarized.Logistic regression model was used to analyze the correlation between DR and various influencing factors.Results The prevalence of DR was 35.9%,and the prevalence of DR was 18.1%,31.6%and 53.8%in patients with disease course<5 years,5-10 years and>10 years,respectively,the differences were statistically significant(P<0.05).The course of disease,serum uric acid(SUA)and blood urea nitrogen(BUN)of the DR groups were higher than those of the NDR group,the differences were statistically significant(P<0.05).There were no significant differences in age,gender,body mass index(BMI),systolic blood pressure(SBP),diastolic blood pressure(DBP),glycated hemoglobin(HbA1c),fasting plasma glucose(FPG),triglycerides(TG),total cholesterol(TC),low-density lipoprotein(LDL),high-density lipoprotein(HDL)and serum creatinine(Scr)between the two groups.Logistic regression analysis showed that the course of disease(β=0.116,OR=1.123,95%CI=1.087-1.160)and SUA(β=0.003,OR=1.003,95%CI=1.000-1.005)were independent risk factors of DR(P<0.05).Conclusion The prevalence of DR in middle-aged and elderly patients with type 2 diabetes mellitus significantly with the prolonged course of disease.Course of disease and SUA are independent risk factors for diabetic retinopathy.