2011年四川省泸州市40岁及以上人群糖尿病视网膜病变患病率及影响因素调查  

Prevalence and influence of diabetic retinopathy in populations at the age of ≥ 40 years in Luzhou City, Sichuan Province in 2011

作　　者：张俊[1] 谢明捷[1] 吕红彬[1] 周琦[1] 万沁[2] 何跃[1] 

机构地区：[1]泸州医学院附属医院眼科,646000 [2]泸州医学院附属医院内分泌科,646000

出　　处：《中华眼科杂志》2013年第9期789-794,共6页Chinese Journal of Ophthalmology

基　　金：四川省教育厅基金（08ZA092）

摘　　要：目的了解四川省泸州市40岁及以上自然人群中糖尿病视网膜病变（DR）的患病情况和影响因素。方法分层整群随机抽样研究。2011年5—12月在四川省泸州市抽取3区4县的8002名40岁及以上的长住居民进行糖尿病普查。参照1999年世界卫生组织推荐的糖尿病诊断标准，对筛查出的1374例糖尿病患者进行问卷调查、体格检查、空腹血糖、餐后2h血糖、糖化血红蛋白（HbAlc）及视力、眼病、眼底等检查。部分患者采用荧光素眼底血管造影进行DR诊断，诊断标准参照1984年中华医学会眼科学分会眼底病学组制定的DR分期标准。各组问率的比较采用）（。检验、趋势）（。检验或Fisher确切概率法，采用多因素分析筛选DR的相关危险因素。结果实际接受检查7478人，受检率为93．48％，检出糖尿病患者1374例，患病率为18．37％；DR患者214例，在糖尿病患者中的患病率为15．57％，在所有受检者中的患病率为2．86％。其中非增生性DR194例，占接受检查DR患者的90．65％；增生性DR20例，占接受检查DR患者的9．35％。多因素分析结果显示，糖尿病病程（趋势X^2=189．21，P〈0．01）、HbAle水平（X^2=30．021，P〈0．01）、冠心病（X^2=4．075，P=0．044）与DR的患病率有密切关系。结论四川省泸州市糖尿病患者中DR患病率高；糖尿病病程、血糖水平及同时患有高血压病均是影响DR病情发展的重要因素；糖尿病患者的HbAle水平的变化可能与DR发生、发展密切相关。Objective To estimate the prevalence rate and risk factors of diabetic retinopathy（DR） in residents at the age of ≥40 years in Luzhou,Sichuan Province. Methods A multistage, stratified cluster random sampling method was used to select 7 communities of 8002 permanent residents （≥40 years old） for diabetes screened from May to December 2011 in Luzhou, Sichuan Province. Reference to the diagnostic criteria for diabetes recommended by World Health Organization in 1999, to the 1374 diabetes screening out patients with questionnaire, physical examination, fasting plasma glucose, 2-hours postprandial plasma glucose, glycosylated hemoglobin （ HbAlc ） and visual acuity, ocular diseases, fundus examination, etc. Some patients with fundus fluorescein angiography to the DR diagnosis, diagnostic criteria with reference to the diagnosis standard made by Chinese Ocular Fundus Diseases Society, Chinese Ophthalmological Society, Chinese Medical Association in 1984. Rates between the groups were compared using ~2 test,trend X2 test or Fisher exact test,using multivariate analysis of risk factors associated with DR screening. Results A total of 8002 people were chosen and invited to take part in the project,7478 persons completed the study, the overall response rate was 93.48%. One thousand three hundreds and seventy-four persons were diagnosed as diabetic patients,which took the proportion of 18.37% of the selected population, while 214 DR patients were found with the DR prevalence of 15.57% , occupying 2. 86% of the total. Of 214 patients, 194 cases were non-proliferative diabetic retinopathy,making up 90. 65% of DR patients, while 7 cases were found to be proliferative diabetic retinopathy, constitute 9.35% of DR patients. Multi-factor analysis manifest that there were close relationship between diabetic duration（ trend X^2 = 189.21, P 〈 0. 01 ）, the level of HbAlc （ X^2 = 30. 021, P 〈 0. 01 ）, coronary heart disease （ X^2 = 4. 075, P = 0. 044 ） and DR prevalence. Conclusions The prevalence of DR

关 键 词：糖尿病视网膜病变 患病率 抽样研究 

分 类 号：R587.2[医药卫生—内分泌]