北京农村地区高血糖人群糖尿病视网膜病变患病率及危险因素分析  

Prevalence and risk factors of diabetic retinopathy in rural population of Beijing

作　　者：信中[1] 马亚红[1] 赵蕾[1] 卢毅[1] 石敬[1] 杨金奎[1] 

机构地区：[1]首都医科大学附属北京同仁医院内分泌科,北京100730

出　　处：《临床荟萃》2010年第8期672-675,共4页Clinical Focus

摘　　要：目的探讨北京市顺义区南法信镇高血糖人群中糖尿病视网膜病变（DR）患病率和相关危险因素。方法对当地35岁以上的常住居民测定空腹血糖（FBG），对血糖5．6mmol／L及以上和有糖尿病史的人员进行进一步体检，包括身高、体质量、腰围、臀围、血压、FBG、肌酐（Cr）、丙氨酸转氨酶（ALT）及血脂等。共筛查受试者1293例，其中465例确诊为糖尿病，采取随机抽样的方法选取总人数的25％进行7个视野眼底照相检查。结果实际共有114例（98．3％）2型糖尿病及162例（78．2％）空腹血糖受损（IFG）患者参加了眼底照相。在2型糖尿病患者中DR的患病率为23．7％（27／114），其中增殖期DR（PDR）的患病率为1．8％（2／114）。IFG人群的DR的患病率为5．0％（8／162），均为非增殖期病变。在糖尿病患者中DR者同非DR者相比糖尿病病程、FBG及收缩压显著升高（P〈0．01或〈0．05）；Logistic回归分析显示病程及FBG与DR发生密切相关（OR=1．122，95％CI=1．017～1．239；OR=1．340，95％CI=1．079～1．665）。结论对具有高危因素（长病程、血糖控制差、高血压）的2型糖尿病患者，应注意控制危险因素，定期眼科检查以早期发现眼底病变。对在糖尿病前期人群中进行DR的早期眼底筛查的必要性及检查时机的选择尚需进一步研究。Objective To investigate the incidence and the correlative risk factors of diabetic retinopathy（DR） in patients with type 2 diabetes mellitus（T2DM） and pre-diabetic subjects who live in Nanfaxin district,Beijing. Methods Fasting blood glucose（FBG） was tested in persons aged over 35 years old. Subjects with FBG≥5.6 mmol/L and with history of T2DM were enrolled for further physical examination. The content of physical examination included body height,body mass, waist line, hip circumference, blood pressure and lipoprotein, etc. A total of 1 293 subjects were enrolled and 465 of them were T2DM. Seven field, stereoscopic fundus photography was used to confirm the diagnosis of DR in 25% subjects sampled randomly. Results 114（98.3%） cases of T2DM patients and 162（78.2%） impaired fasting glucose（IFG） subjects attended photography of ocular fundus. The incidence of DR was 23.7% （27/114） in T2DM patients and the incidence of proliferative diabetic retinopathy（PDR） was 1.8% （2/114） in them. The incidence of DR was 5.0% （8/162） in the IFG patients and all of them were not PDR. Duration of T2DM,FBG and systolic blood pressure were higher in the participants who had retinopathy compared with those in the participants without retinopathy（ P 〈0.01 or 〈0.05）. From the multiple logistic regression,diabetic duration and FBG were significant factors of DR in T2DM patients （ OR = 1. 122,95% CI = 1. 017=1. 239; OR = 1. 340,95% CI ： 1. 079=1. 665）. Conclusion DR examination should be strengthened in T2DM patients with longer duration or higher blood glucose. Control of blood pressure should be paid attention except for good control of blood glueose in preventing or reducing the disease occurrence. Routinely screen retinopathy in early phase for retinopathy in the pre-diabetie state requires further study.

关 键 词：糖尿病视网膜病变 危险因素 数据收集 

分 类 号：R587.1[医药卫生—内分泌]