糖尿病足与糖尿病视网膜病变相关性分析  

Correlation Analysis between Diabetic Foot and Diabetic Retinopathy

作　　者：赵宏伟[1] 南新帅 童宗中[3] 何凯[4] 李雨心 刘靓[1] 罗灵[1] 

机构地区：[1]解放军306医院眼科,北京100101 [2]安徽医科大学解放军306临床学院,北京100101 [3]四川省医学科学院四川省人民医院眼科,成都610072 [4]第三军医大学临床医学学员旅,重庆400038

出　　处：《解放军医药杂志》2016年第9期17-20,共4页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：国家自然科学基金面上项目(81271016;81371053)

摘　　要：目的分析糖尿病足(diabetic foot,DF)与糖尿病视网膜病变(diabetic retinopathy,DR)的相关性及DR进展的风险因素。方法回顾性分析2010年12月—2016年4月诊断DF并同期行眼底照相明确DR分期的病例249例次,分析二者在疾病分级和分期的相关性;并分析上述资料中同一患者多次以DF住院治疗时DR的进展情况,以及DF无进展患者的糖尿病病程、糖化血红蛋白、甘油三酯及胆固醇对DR进展的影响。结果糖尿病患者的DF分级与DR分期呈现明显正相关(P<0.01,rs=0.6026)。在多次住院的DF患者中,DF无进展患者中有21例(70.0%)DR分期发生了进展,而DF有进展患者中有13例(76.5%)DR病变分期发生了进展,差异无统计学意义(P>0.05)。在DF无进展的患者中,DR无进展组糖化血红蛋白、胆固醇及甘油三酯均低于DR有进展组(P=0.0146、<0.001和<0.001)。结论 DF与DR的严重程度呈正相关,DF比DR的进展存在滞后性,糖化血红蛋白、胆固醇及甘油三酯可能是预测DR病变进展更为迅速而敏感的指标。Objective To analyze correlation between diabetic foot （ DF） and diabetic retinopathy （ DR） and risk factors for DR progression. Methods Clinical data of 249 DF patients was retrospectively analyzed with identified DR grading by fundus photography admitted during December 2010 and April 2016, and then its correlation between dis-ease grading and staging were analyzed. Conditions of DR progression in the re-hospitalized DF patients were analyzed, and effects of course of diabetes, glycosylated hemoglobin, triglycerides and cholesterol on DR progression in patients without DF progression were evaluated. Results There is a significant positive correlation between DF grading and DR staging （P〈0. 01, rs =0. 6026）. In re-hospitalized patients, 21 patients （70. 0%） had progression of DR staging in pa-tients without DF progression, and 13 patients （76. 5%） had progression of DR staging in patients with DF progression, and the differences were not statistically significant （P〉 0. 05）. In patients without DF progression, levels of glycated hemoglobin, cholesterol and triglycerides in patients without DR progression were lower than those with DR progression （P=0. 0146, 〈0. 001 and 〈0. 001）. Conclusion Severe degrees of DF and DR are significantly positive correlated. DF progression is delayed than that of DR progression. Glycosylated hemoglobin, cholesterol and triglyceride may be used as indicators in prediction of DR progression in DF patients rapidly and sensitively.

关 键 词：糖尿病 2型 糖尿病足 糖尿病视网膜病变 

分 类 号：R587.2[医药卫生—内分泌]