老年2型糖尿病患者发生糖尿病性视网膜病变的影响因素二元logistic回归分析

Binary logstics regression analysis of influencing factors of diabetic retinopathy in elderly patients with type 2 diabetes mellitus

目的探讨老年2型糖尿病(T2DM)患者发生糖尿病性视网膜病变(DR)的影响因素,为DR防治提供依据。方法回顾性选取郑州大学第一附属医院2020年1月至2022年12月收治的老年T2DM患者236例。根据眼底照相检查及荧光素眼底血管造影结果判定是否发生DR,分为DR组和非DR组。单因素和二元logistic回归分析老年T2DM患者发生DR的影响因素。结果236例老年T2DM患者中,DR发生率为27.12%;单因素分析结果显示,DR组和非DR组患者年龄、糖尿病病程、吸烟史、胰岛素治疗情况、收缩压、舒张压、空腹血糖(FPG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(HbA1c)、尿素氮、血尿酸、血肌酐比较,差异有统计学意义(P<0.05);二元logstics回归分析结果显示,年龄、糖尿病病程、吸烟史、FPG、HbA1c、血肌酐是老年T2DM患者发生DR的独立影响因素(P<0.05)。结论在对老年T2DM患者管理过程中,针对上述老年T2DM患者发生DR的影响因素,应逐一排查,并早期采取防治措施,以降低DR发生概率,为早期DR防治提供依据。

Objective To explore the influencing factors of diabetic retinopathy(DR)in elderly patients with type 2 dia⁃betes mellitus(T2DM),and to provide evidence for the prevention and treatment of DR.Methods Totally 236 elderly patients with T2DM from January 2020 to December 2022 were selected retrospectively.According to the results of fun⁃dus photography and fluorescein fundus angiography,all patients were divided into DR group and non-DR group.Uni⁃variate and binary logistic regression analysis were used to detected influencing factors of DR in elderly patients with T2DM.Results Among 236 elderly patients with T2DM,the incidence of DR was 27.12%.The results of univariate a⁃nalysis showed that there were significant differences in the age,diabetes course,smoking history,insulin treatment,systolic blood pressure,diastolic blood pressure,fasting plasma glucose(FPG,)2 h postprandial blood glucose(2 h PG),hemoglobin A1c(HbA1c),urea nitrogen,serum uric acid and serum creatinine between DR group and non-DR group(P<0.05).Binary logstics regression analysis showed that age,duration of diabetes,smoking history,FPG,HbA1c and serum creatinine were independent influencing factors of DR in elderly patients with T2DM(P<0.05).Conclusion In the management of elderly patients with T2DM,we should investigate the influencing factors of DR in elderly patients with T2DM one by one,and take early prevention measures to reduce the probability of DR and provide basis for early prevention and treatment of DR.