糖尿病性视网膜病变的相关危险因素研究

Study on the Related Risk Factors of Diabetic Retinopathy

目的观察糖尿病性视网膜病变的发生发展相关危险因素的研究分析。方法选取2019年3月至2020年4月在我科会诊等入组我院MMC(国家标准化代谢疾病管理中心)的糖尿病住院患者,用日本TOPCON公司裂隙灯显微镜行眼前节检查排除浅前房后散瞳联合前置镜行玻璃体和眼底检查。采用日本TOPCON公司免扩瞳数字眼底照相机拍摄双眼眼底后极部45°范围彩色眼底像。排除屈光间质混浊影响眼底检查者,最后选取150例作为研究对象,然后根据检查结果分成无DR组和患有DR两组(非增殖组和增殖组),共三组,进行随访复查眼底照(以黄斑为中心和以视盘为中心各一张),收集这些患者在MMC入组填写的调查问卷及相关检验结果进行比对分析,找出相关因素。结果年龄中非增值组>增值组>无DR组,糖尿病病程非增值组>增值组>无DR组,24h尿测尿微量自蛋白定量增值组>非增值组>无DR组,差异(P〈0.05)有意义。糖化血红蛋白、甘油三脂、胆固醇、空腹血糖、餐后2h血糖水平与是否发生周围神经病变相比,差异(P>0.05)无意义。结论糖尿病性视网膜病变的发生发展相关危险因素中,年龄较高、糖尿病病程较长,24h尿测尿微量自蛋白定量增高均为诱发的危险因素,因此应在临床患者中注意监测。

Objective To observe the risk factors of diabetic retinopathy.Methods From March 2019 to April 2020,diabetic inpatients admitted to MMC (National Center for standardized metabolic disease management) in our hospital were selected.The anterior segment was examined with slit lamp microscope of TOPCON company of Japan,excluding shallow anterior chamber posterior mydriasis,and vitreous and fundus examination were performed by anterior chamber anterior lens.The color fundus images of the posterior pole of both eyes were taken by TOPCON non dilating digital fundus camera of Japan.150 cases were selected as the research object after excluding the influence of refractive stromal opacity on fundus examination.According to the examination results,they were divided into two groups:the non proliferative group and the proliferative group.All three groups were followed up to review the fundus photography (one with macular as the center and one with the optic disc as the center).The questionnaire and related test results of these patients in the MMC group were collected Compare and analyze,find out the related factors.Results In the age,non increment grouP>increment grouP>no Dr group,diabetes duration non increment grouP>increment grouP>no Dr group,24h urine microautoprotein quantitative increment grouP>non increment grouP>no Dr group,the difference was significant (P<0.05).There was no significant difference in glycosylated hemoglobin,triglyceride,cholesterol,fasting blood glucose,2 h postprandial blood glucose with or without peripheral neuropathy (P>0.05).Conclusion Among the risk factors related to the occurrence and development of diabetic retinopathy,older age,longer duration of diabetes mellitus and increased microautoprotein in 24-hour urine test are the risk factors,so we should pay attention to monitoring in clinical patients.