糖尿病性白内障发病因素研究  

A study of factors related to the incidence of cataract in patiens with non-insul-dependent diabetes mellitus

作　　者：曹征[1] 夏小平[2] 

机构地区：[1]东莞市石龙人民医院眼科,广东东莞523321 [2]广州中山大学第三附属医院眼科

出　　处：《中国基层医药》2005年第5期592-593,共2页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的探讨非胰岛素依赖型糖尿病性白内障发病的有关因素。方法对729例非胰岛素依赖型糖尿病患者检查视力、外眼、眼前段、眼底,血液检查项目包括血糖、糖化血红蛋白A1c(AHbA1c)、尿素氮(BUN)、肌酐(Cr)、尿酸(UA)、N乙酰βD氨基葡萄糖苷酶(NAG)、β2微球蛋白(β2MG)和白蛋白,尿液检查项目包括尿糖、pH、蛋白质、细胞、管型和酮体,白内障的诊断按Chylack等的晶状体混浊分类系统Ⅱ进行。结果白内障在本组糖尿病患者中的发生率为62.37%(494/729),白内障的发生与性别无关,但与糖尿病的病程有关。糖尿病病程少于5年(A组)、5～10年(B组)和10年以上(C组)者的发生率分别为49.67%(228/459)、71.84%(125/174)和88.68%(141/159)。A组和B组及C组间的白内障发生率差异有非常显著意义,B组及C组间的白内障发生率差异则无显著意义。在血液BUN和(或)Cr含量升高的糖尿病患者白内障的发生率明显高于BUN和(或)Cr含量正常的糖尿病患者。结论非胰岛素依赖型糖尿病患者病程的延长、肾功能不良及血糖控制不良可加速白内障的发展。Objective To investigate the factors related to the devlopment of cataract in patients with non-insulin-dependent diabetes mellitus(NIDDM).Methods 792 NIDDM patients received ophthalmologic examination including visual acuity,external status of the eyes,slit lamp microscopy and ophhthalmoscopy,on glucose,urea niurogen(BUN) creatinine creatinine(Cr),urine acid(UA),N-acetyl-β-D-glucosamindase(NAG),β_2-microglobulin(β_2-MG) and serum albumin in blood were quantitatively tested,glucose,pH balue protein,cells,cast and ketobodies in urine were assayed.Diagnosis of cataract was based on lens opacitie classification systen Ⅱ.Any case meeting 'N_Ⅱ','C_Ⅱ',or 'P_Ⅱ' level was diagnosed as cataract.Results The incidence of cataract in this group of NIDDM was 62.3%(494/792),which was significantly related to length of cataract in patiente suffering from NIDDM in the duration less than five years,from five to ten years and more than ten years were 49.67%(228/459),71.84%(125/174),and 88.68%(141/159) respectively.Occurrence rates of cataract in patients with the course of the disease from five to ten years and more than ten years were much higher than that of those with the course of disease less than five years(P<0.05 and P<0.01,respectively).Raising concentrations of blood urea nitrogen,creatinine,glycosylated hemoglobin HbA_1c(G-HbA_1c),N-acetyl-β-D-glucosamindase(NAG) and β_2-microglobulin(β_2-MG) indicated malfunction of the kidneys,and occurrence rate of cataract in these patients was higher.Conclusion The study in-dicates that prolongation of the course of NIDDM,renal dysfuncation as well as poor blood glucose control may accelerate the development of cataract in patients with NIDDM.

关 键 词：糖尿病性白内障 N-乙酰-Β-D氨基葡萄糖苷酶 因素研究 发病 非胰岛素依赖型 糖尿病患者 β2-微球蛋白 糖化血红蛋白 血糖控制不良 检查项目 晶状体混浊 糖尿病病程 肾功能不良 发生率 有关因素 分类系统 BUN 眼前段 白蛋白 

分 类 号：R587.1[医药卫生—内分泌] R776.1[医药卫生—内科学]