上海市北新泾社区2型糖尿病患者轻度视力损伤的患病率及影响因素分析  

Prevalence and risk factors of mild vision loss in patients with type 2 diabetes in Beixinjing Community of Shanghai

作　　者：邹海东[1] 徐娴[1] 贺江南[2] 许迅[1] 杜宣[1] 白雪林 张波[2] 何鲜桂[2] 陆丽娜[2] 朱剑锋[2] 赵家良[4] 

机构地区：[1]上海交通大学附属第一人民医院眼科中心,200080 [2]上海市眼科医院上海市眼病防治中心 [3]上海市新泾镇社区卫生服务中心 [4]中国医学科学院 北京协和医学院北京协和医院眼科

出　　处：《中华医学杂志》2016年第3期210-215,共6页National Medical Journal of China

基　　金：基金项目：国家自然科学基金（81371069）;上海浦江人才计划[PJ（2012）0001652];上海市卫生与计划生育委员会新百人计划（XBR2013109）;上海申康医院发展中心科研项目（SHDC12012123）

摘　　要：目的调查上海市北新泾社区2型糖尿病患者轻度视力损伤的患病率及影响因素。方法本研究为以人群为基础的横断面研究。2014年10月至2015年1月对上海市北新泾社区2型糖尿病患者进行视力及眼部检查。采用整群随机抽样的方法抽取22个基本抽样单位，正式现场调查前先进行预调查。轻度视力损伤的定义采用国际眼科学会理事会的标准：最佳矫正视力〈0．8，且≥0．3，计算单眼和双眼轻度视力损伤的患病率，判断导致轻度视力损伤的原因。采用logistic回归分析双眼轻度视力损伤的影响因素。结果在调查的2582例2型糖尿病患者中，2216例接受并完成眼部检查，受检率为85．8％。单眼轻度视力损伤591例，患病率为26．7％；双眼轻度视力损伤650例，患病率为29．3％；轻度视力损伤眼共1891眼，占总体4432眼的42．7％。白内障（占31．3％，591／1891）和糖尿病视网膜病变（占27．3％，517／1891）是导致轻度视力损伤的前两位原因。不明原因的双眼轻度视力损伤共201例，占总体2216例2型糖尿病患者的9．1％。高龄，女性，教育程度低，高糖化血红蛋白水平，长糖尿病病程是双眼轻度视力损伤和双眼原因不明确的轻度视力损伤的影响因素（均P〈0．05）。结论轻度视力损伤在2型糖尿病患者中患病率较高，强化血糖控制可能有助于防控轻度视力损伤。Objective To investigate the prevalence and risk factors of mild vision loss in adult patients with type 2 diabetes in Beixinjing Community, Shanghai, China. Methods A population-based, cross-sectional survey among 2 216 Chinese Han adult patients with type 2 diabetes was conducted from October 2014 to January 2015. Random cluster sampling was used to enroll diabetic patients based on the local Chronic Diseases Prevention and Control System data. The survey was preceded by a pilot study in which operational methods were refined and quality assurance evaluation was carried out. Eligible participants underwent a comprehensive eye examination, including the best corrected visual acuity （BCVA） test using the logarithm of the minimum angle resolution charts. Mild vision loss was defined as BCVA 〈 20/32 to ≥ 20/63 following the International Council of Ophthalmology （ICO） 2002 definitions. The primary causes of visual impairment and blindness were determined. The prevalence and causes of monocular and binocular mild vision loss were investigated. Logistic regression analysis was used to determine the related risk factors of binocular mild vision loss. Results Among 2 582 patients, 2 216 were examined, and the response rate was 85.8%. Monocular mild vision loss was found in 591 patients with a prevalence rate of 26. 7%. Binocular mild vision loss was detected in 650 patients, with a prevalence rate of 29. 3%. Totally 1 891 eyes were confirmed as mild vision loss. Diabetic retinopathy （27. 3%, 517/1 891 ） were the second leading cause of mild vision loss, after cataract （ 31.3% , 591/1 891 ） . Binocular mild vision loss of unknown reasons happened in 201 persons. Old age, female gender, lower educational level, higher glycosylated hemoglobin Alc level and longer duration of diabetes were associated with the prevalence of total binocular mild vision loss and binocular mild vision loss of unknown reasons. Conclusion The prevalence of mild vision loss is higher among adult patients with type 2 diabetes i

关 键 词：视力 低 糖尿病 2型 患病率 视力试验 最佳矫正视力 

分 类 号：R587.2[医药卫生—内分泌] R77[医药卫生—内科学]