2型糖尿病并原发性青光眼临床资料分析及危险因素探讨  

Clinical data and risk factors in type 2 diabetic patients complicated with primary glaucoma

作　　者：周竞雄[1] 施亚雄[1] 林家煜[1] 梁波[1] 陈晓毓[1] 林夏鸿[1] 李希圣[1] 洪玉[2] 

机构地区：[1]福建医科大学附属第二医院内分泌科,泉州362000 [2]福建医科大学附属第二医院眼科

出　　处：《中华内分泌代谢杂志》2013年第8期674-678,共5页Chinese Journal of Endocrinology and Metabolism

摘　　要：目的通过分析临床资料，探讨2型糖尿病患者发生原发性青光眼的危险因素。方法选取住院患者167例，2型糖尿病并原发性青光眼组61例；2型糖尿病无青光眼组60例；原发性青光眼无糖尿病组46例。检测血压、血糖、血脂、HbA1c眼内压、尿白蛋白排泄率、颈动脉内膜中层厚度。采用x。检验、方差分析、t检验和相关分析进行数据统计。结果2型糖尿病并原发性青光眼患者（1）平均年龄（63．4±12．2）岁；原发性开角型青光眼（POAG）13例占21．3％，原发性闭角型青光眼（PACG）48例占78．7％。（2）收缩压和眼内压高于2型糖尿病无青光眼组[分别是（142±17对132±18）mmHg（1mmHg=0．133kPa）；（38．0±2．3对14．6±2．5）mmHg，均P〈0．01]。（3）女性收缩压和眼内压高于男性[分别是（1454-16对136±17）mmHg；（41．9±15．2对33．2±11．0）mmHg，均P〈0．05]。（4）代谢综合征患者收缩压和眼内压高于非代谢综合征者[分别是（147±16对137±17）mmHg；（40．8±17．4对36．0±11．6）mmHg，均P〈0．05]。（5）眼内压与收缩压、尿白蛋白排泄率正相关（分别是r=0．21，P〈0．01；r=0．25，P〈0．05）；校正收缩压后，眼内压与尿白蛋白排泄率不相关。结论住院2型糖尿病并原发性青光眼患者多为闭角型青光眼．致盲率高：老年、女性、高收缩压、代谢综合征可能是糖尿病并原发性青光眼的危险因素。Objective To explore the risk factors from clinical data in type 2 diabetic patients complicated with primary glaucoma. Methods A total of 167 hospitalized patients were included, including 61 type 2 diabetic patients with primary glaucoma （ DM-PG）, 60 diabetic patients without glaucoma（DM-WG） and 46 age and gender- matched isolated primary glaucoma （I-PG） patients. Blood pressure, intraocular pressure （IOP） , fasting plasma glucose（FPG）, blood lipid, urinary albumin excretion rate （UAER）, and carotid artery intima-median thickness （CIMT） were measured in all of the patients. Results In the DM-PG group, （ 1 ） The mean age was （ 63.4 ___ 12.2 ） years. 13 （21.3 % ） patients had primary open-angle glaucoma （POAG）, 48 patients （78.7 % ） had primary angle- closur glaucoma （PACG）. （ 2 ） Systolic blood pressure （SBP） and IOP were both significantly higher than those in DM- WG group [ （ 142 ＋ 17 vs 132 ＋ 18 ） mm Hg （ 1 mm Hg = 0.133 kPa ） ; （ 38.0 -＋ 2.3 vs 14.6 -＋ 2.5 ） mm Hg, respectively ; both P〈0.011. （ 3 ） SBP and IOP in female patients were higher than those in male [ （ 145 ＋ 16 vs 136 ＋ 17 ） mm Hg; （41.9 ＋ 15.2 vs 33.2 -＋ 11.0 ） mm Hg, respectively ; both P 〈0.05 1- （ 4 ） SBP and IOP in patients with metabolic syndrome were higher than those in patients without metabolic syndrome [ （ 147 -＋ 16 vs 137 e 17 ） mm Hg, （ 40.8 -＋ 17.4 vs 36.0 -＋ 11.6 ） mm Hg, respectively ; both P〈0.05 ]. （ 5 ） lOP had a positive correlation with SBP and UAER （ r = 0.21, P〈 0. 01; r = 0. 25, P〈0. 05, respectively）. After a correction in SBP, IOP was not associated with UAER. Conclusions PACG is the major type of glaucoma in type 2 diabetic patients complicated with primary glaucoma, with a fairly high rate of blindness. Old age, female, higher SBP, and metabolic syndrome may be considered as risk factors of type 2 diabetic patients complicated with primary glaucoma.

关 键 词：糖尿病 2型 原发性青光眼 危险因素 

分 类 号：R775.2[医药卫生—眼科]