眼底检查在糖尿病患者诊治中的价值

Ophthalmologic consultation on diabetic patients

目的 了解眼科检查在糖尿病患者临床诊治中的价值。方法 收集我院 2 0 0 1年 9月至 2 0 0 3年 3月临床各科室住院的糖尿病患者会诊邀请共 2 18例 ,4 36只眼。询问病史 ,进行视力、裂隙灯、眼底镜检查 ,发现眼底存在可疑或阳性体征者再散瞳检查眼底 ,并行眼底荧光血管造影检查等。结果 2 18例患者中除去因白内障影响眼底检查的 33例床边会诊外 ,其余 185例患者完成检眼镜眼底检查 ,其中 16 7例完善基本眼科检查 ,发现存在糖尿病性视网膜病变 (diabeticretinopathy ,DR)者 10 0例 ,占5 4 .0 5 % ,197眼。随着糖尿病病程的延长DR的发生率增加 (χ2 =19.938,P =0 .0 0 1SpearmanCorrelationR =1.0 0 0 ,P <0 .0 0 0 1) ,且DR程度亦显著不同 (χ2 =2 7.999,P =0 .0 32 )。DR的程度越重 ,患者视力越差 (χ2 =81.18,P <0 .0 0 0 1;SeparmanCorrelationR =- 0 .35 9,P<0 .0 0 0 5 )。结论 DR发生率及病变的程度与糖尿病的病程密切相关 ,随病程的延长、并发症的发生 ,视网膜病变的发生率升高 ,病情加重。眼科检查有助于评价患者的病情控制情况 。

Objective To investigate the value of ophthalmologic consultation on diabetic patients.Methods Two hundred and eighteen(436 eyes) patients from different departments all over the hospital received ophthalmologic consultation.Visual acuities,slit light microscope,ophthalmolscope were performed to these patients.Pupils were dilated to carry out the ophthalmolscope and fluorescein angiography.Results One hundred and sixty seven cases of these 218 patients received the ophthalmologic examination consummately,100 cases were found to have diabetic retinopathy.With the development of diabetes mellitus the incidence of diabetic retinopathy increased (χ 2= 19.938 , P = 0.001 ;Spearman Correlation R = 1.000 , P < 0.0001 ),and the severity of diabetic retinopathy diffeved(χ 2= 27.999 , P = 0.032 ).The best corrected visual acuity decreased with increasing severity of diabetic retinopathy in diabetic patients(χ 2= 81.18 , P < 0.0001 ;Separman Correlation R = -0.359 , P < 0.0005 ).Conclusion The application of ophthalmologic consultation in diabetes mellitus helps to give better control to the disease,and with unique responsibilities to ensure appropriate medical evaluation.