青年增殖性糖尿病视网膜病变患者玻璃体切除术后致盲的影响因素分析

Influencing factors analysis of blindness for young adults with proliferative diabetic retinopathy after pars plana vitrectomy

目的 分析青年增殖性糖尿病视网膜病变(PDR)患者玻璃体切除术(PPV)后致盲的影响因素。方法 回顾性选取2014年10月—2022年1月于河北省眼科医院行PPV治疗的青年PDR患者313例,根据患者术后视力分为盲目组与非盲目组。比较2组患者的临床资料,采用多因素Logistic回归分析探讨青年PDR患者PPV后致盲的影响因素。结果 青年PDR患者PPV后盲目76例、非盲目237例,致盲发生率为24.3%。2组患者年龄、糖尿病病程、糖尿病类型、既往视网膜光凝治疗情况、术前盲目发生率、血尿素氮(BUN)、高密度脂蛋白胆固醇(HDL-C)与总胆红素(TBil)、白蛋白(Alb)、总蛋白(TP)水平比较,差异有统计学意义(P<0.05或P<0.01)。多因素Logistic回归分析结果显示,诊断年龄[OR=0.910,95%CI(0.856,0.968)]、TP水平[OR=0.952,95%CI(0.911,0.995)]是青年PDR患者PPV后致盲的独立影响因素(P<0.05)。结论 诊断年龄、TP水平是青年PDR患者PPV后致盲的独立影响因素,诊断年龄越小、血清TP水平越低,青年PDR患者PPV后盲目的风险越高。

Objective To analyse the influencing factors analysis of blindness for young adults with PDR after PPV.Methods A total of 313 cases young adults with PDR underwent PPV were selected from October 2014 to January 2022 in Hebei Eye Hospital were retrospectively analyzed,and they were divided into the blind group and the non-blind group.Clinical data were compared between the two groups.Multivariate Logistic regression analysis was used to explore the influencing factors of blindness in young PDR patients after PPV.Results There were 76 cases in the blind and 237 cases in the non-blind group after PPV in young adults with PDR,incidence of blindness was 24.3%.There were statistically significant differences of age,course of diabetes,diabetes type,previous retinal photocoagulation treatment,incidence of preoperative blindness,BUN,HDL-C,TBil,Alb and TP between the two groups(P<0.05 or P<0.01).Multivariate Logistic regression analysis showed that,diagnostic age[OR=0.910,95%CI(0.856,0.968)],TP level[OR=0.952,95%CI(0.911,0.995)]were independent influencing factors of blindness for young adults with PDR after PPV(P<0.05).Conclusion Diagnostic age and TP level are influencing factors of blindness in young PDR patients after PPV,the younger the diagnosis age and the lower the serum TP level,the higher the risk of blindness for young adults with PDR after PPV.