柳州市2型糖尿病患者视网膜病变的相关危险因素研究

Study on the risk factors of type 2 diabetic retinopathy in Liuzhou City

目的探讨2型糖尿病患者发生糖尿病视网膜病变(diabetic retinopathy,DR)的危险因素。方法通过眼底检查,将1 510例社区2型糖尿病患者按眼底病变情况分为糖尿病视网膜病变组与对照组,比较病例组与对照组相关因素的差异性,并采用多因素分析发现其独立的危险因素。结果糖尿病病程、糖化血红蛋白、收缩压、尿白蛋白在两组间的差异均有统计学意义(均有P<0.05);糖化血红蛋白水平处于7%~、8%~、≥9%的3组糖尿病患者相对于参照组(糖化血红蛋白水平<6%)发生DR的危险性均高(OR=1.431,95%CI:1.032~1.984;OR=1.804,95%CI:1.170~2.782;OR=2.612,95%CI:1.699~4.016);尿蛋白≥200 mg/L较参照组(<30 mg/L)发生DR风险高(OR=1.912,95%CI:1.219~2.999);病程15~年、≥20年发生DR的危险也较参照组(<5年)高(OR=1.553,95%CI:1.035~2.330;OR=2.038,95%CI:1.182~3.514);收缩压≥150 mm Hg发生DR风险(OR=1.749,95%CI:1.202~2.544)高于参照组(<120 mm Hg);年龄、性别、血脂、舒张压等指标差异均无统计学意义(均有P>0.05)。结论糖尿病病程长、高糖化血红蛋白、高血压、尿白蛋白升高可能是糖尿病视网膜病变发生的危险因素。

Objective To discuss the risk factors for type 2 diabetes patients with retinopathy( DR).Methods1 510 patients with type 2 diabetes mellitus in community were divided into diabetic retinopathy group and the control group according to eye fundus lesions.The differences of related parameters between diabetic retinopathy group and the control group were compared,and the independent risk factors were analyzed by using the multi-factor analysis.Results Parameters that conferred a significantly increased risk for diabetic retinopathy in the multivariate Logistic regression analysis including glycosylated hemoglobin( 7%-,8%-,≥9%,VS < 6%,( OR = 1.431,95% CI:1.032-1.984; OR = 1.804,95%CI:1.170-2.782; OR = 2.612,95% CI:1.699-4.016)),urinary albumin( ≥200 mg / LVS < 30 mg / L,( OR = 1.912,95% CI:1.219-2.999)),and duration of diabetes( 15-,≥20,VS < 5,( OR = 1.553,95% CI:1.035-2.330; OR =2.038,95% CI:1.182-3.514)),and systolic blood pressure( ≥150 mm Hg VS < 120 mm Hg,( OR = 1.749,95% CI:1.202-2.544)).No associations were found of diabetic retinopathy with age,gender,blood lipid,and diastolic blood pressure( P > 0.05).Conclusions Long duration of diabetes,higher glycolated hemoglobin,hypertension,and higher urinary albumin were risk factors for development of DR.