轻度糖尿病患者视网膜病变进展与血糖控制的关系  

Progression of retinopathy is related to glycemic control even in patientswith mild diabetes mellitus

作　　者：孙洪臣[1,2] 刘波[1,2] 黄建纲[1,2] 李静敏[1,2] 贡雅洁[1,2] 

机构地区：[1]大连医科大学第一临床学院眼科 [2]大连医科大学第二临床学院眼科

出　　处：《大连医科大学学报》1998年第2期39-42,共4页Journal of Dalian Medical University

摘　　要：研究轻度糖尿病患者视网膜病变的进展。检查了１４７例只有饮食治疗的患者，１９９３年１月至１９９５年７月１４７例均做了眼部检查并采用饮食治疗，随访至１９９７年１０月，平均随访时间３４±１１年。在这期间以平均糖化血红蛋白（ＨｂＡＩＣ）作为血糖控制的水平。在基线有１３２例（９０％）无糖尿病视网膜病变和１５例（１０％）有轻度非增殖型视网膜病变。无视网膜病变进展者１１３例，２７例视网膜病变进展至Ⅰ期，６例进展至Ⅱ期，仅１例进展至Ⅳ期增殖型视网膜病变。Ⅰ期ＨｂＡＩＣ（％）为６５±１３，病变进展至Ⅱ期有较高ＨｂＡＩＣ（％）（７２±１２），差异很显著（Ｐ＜００１），提示ＨｂＡＩＣ水平即使稍为增高。To study the progression of retinopathy in patients with mild diabetes mellitus,we examined 147 patients treated with diet alone at baseline.The patients participated in an ophthalmological screening and control programme,and diettreatment from January 1993 to July 1995 were included in this study and followed until October 1997.Mean followup time was 34±11 years.The mean HbAIc values for the study period were used to estimate the level of glycemic control.At baseline,132 of the patients(90%)had no retinopathy,and 15(10%)had mild nonproliferative diabetic retinopathy.There was no retinopathy progression in 113 patients,was progression to 1 stage retinopathy in 27 patients,and to 2 stage retinopathy in 6 patients.Only one patient progressed to proliferative diabetic retinopathy 4 stage.The mean HbAIc(%) in 1 stage DR was 65±13.Higher HbAIc in 2 stage DR (72±12)correlated to increased progression(P<0.01).These data indicate that even slight increasing of HBAIc might be associated with a risk of retinopathy progression.

关 键 词：糖尿病 视网膜病变 饮食治疗 血糖控制 

分 类 号：R774.1[医药卫生—眼科] R587.2[医药卫生—临床医学]