上海市北新泾街道60岁及其以上居民糖尿病视网膜病变患病情况调查  

Epidemiology study on the occurrence of diabetic retinopathy in residents at the age of ≥ 60 years in Beixinjing blocks, Shanghai

作　　者：黄晓波[1] 邹海东[1] 王宁[1] 王伟伟 傅炯 沈彬杰 谢田华[1] 陈轶卉[1] 许迅[1] 张皙[1] 

机构地区：[1]上海交通大学附属第一人民医院眼科,200080 [2]上海市北新泾社区卫生服务中心

出　　处：《中华眼底病杂志》2010年第2期105-108,共4页Chinese Journal of Ocular Fundus Diseases

基　　金：卫生部＂视觉第一中国行动＂项目（200801） 上海市视觉复明临床医学中心课题（FM-040102-305）

摘　　要：目的 调查60岁及其以上糖尿病患病居民糖尿病视网膜病变（DR）患病情况和影响因素,并与2003年在同区域开展的DR调查结果进行比较分析.方法 2007年11月至2008年4月在上海市北新泾街道开展人群普查.对≥60岁糖尿病居民进行全身、视力、裂隙灯显微镜、直接和（或）间接检眼镜检查,免散瞳数字眼底照相机拍摄后极部45°范围内2个不同区域内的照片.采用多人分别独立读片的方式,根据2002年国际DR分型标准确立DR的诊断.在曾进入2003年流行病学调查的≥60岁糖尿病居民中随访到254例,将本次调查情况与前次调查结果进行对比.采用卡方检验统计分析与患病率相关的影响因素,通过逐步回归分析筛选出独立影响因素.结果 实际受检人数483例,受检率为91.30%.其中,DR患者121例,患病率为25.05%.非增生型DR和增生型DR的患病率分别为22.36%和2.69%.糖尿病病程是影响糖尿病患者DR患病率的独立因素.未发现影响非增生型DR和增生型DR构成比差异的因素.参加前后2次调查的254例糖尿病居民DR程度稳定或改善的比例达到92.52%.结论 ≥60岁糖尿病居民中DR患病率高 已在该社区开展的DR防盲措施已初显成效.Objective To estimate the prevalence of diabetic retinopathy （DR） in residents at the age of ≥ 60 years in Beixinjing blocks, Shanghai, and to analyze the changes and risk factors of the occurrence of DR while comparing with the previous epidemiology study in the same blocks in 2003. Methods With the help of an established resident health data, a epidemiology study was performed on all of the old residents （≥ 60 years old） with diabetes mellitus from November 2007 to April 2008. The epidemiology data included resident common information, health check, examination of visual acuity, slit-lamp biomieroscopy, direct ophthalmoscopy, and photography of 2 pictures covering 450 posterior ocular fundus area acquired by digital non-mydriasis fundus camera. The diagnosis of DR was drawn according to the international DR classification （2002）. The DR grade was compared in 254 residents who were involved in both of the two epidemiology studies in 2003 and 2007. Chi-square method was used to analyze the risk factors of DR and stepwise logistic analysis was used for identifying the independent factors. Results A total of 483 diabetic residents was included in this study with the inclusion rate of 91.30%, in whom 121 DR patients was found with the DR prevalence of 25.05%. The prevalence of non-proliferative DR and proliferative DR was 22. 36% and 2. 69%, respectively. The duration of diabetes was confirmed as the independent risk factor of DR prevalence, and no risk factor was found to affect the different ratio of non-proliferative and proliferative DR. Comparing to the results of the study in 2003, the DR grade remained steadily or decreased in 92.52% of the 254 diabetes residents. Conclusion The prevalence of DR is high in the diabetic residents at the age of ≥60 years. The intervention work of DR prevention in Beixinjing blocks is effective.

关 键 词：糖尿病视网膜病变/流行病学 糖尿病视网膜病变/诊断 流行病学方法 

分 类 号：R774.1[医药卫生—眼科] R587.26[医药卫生—临床医学]