体检人群糖尿病视网膜病变筛查及危险因素分析  

Screening of Diabetic Retinopathy in Physical Examination Population and Its Risk Factors

作　　者：张彦敏 董俊婵 高冕 赵肖 牛晓芬 王力 白咏菊 ZHANG Yan-min;DONG Jun-chan;GAO Mian;ZHAO Xiao;NIU Xiao-fen;WANG Li;BAI Yong-ju(Healthy Management Center,980 Hospital of PLA Joint Logistics Support Forces,Shijiazhuang 050082,China;Emergency Department,980 Hospital of PLA Joint Logistics Support Forces,Shijiazhuang 050082,China;Department of Intensive Care Medicine,980 Hospital of PLA Joint Logistics Support Forces,Shijiazhuang 050082,China)

机构地区：[1]中国人民解放军联勤保障部队第九八〇医院健康管理中心,石家庄市050082 [2]中国人民解放军联勤保障部队第九八〇医院急诊科,石家庄市050082 [3]中国人民解放军联勤保障部队第九八〇医院重症医学科,石家庄市050082

出　　处：《解放军医药杂志》2020年第2期60-63,共4页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：军队保健专项课题(16BJZ47)

摘　　要：目的了解糖尿病患者并发糖尿病视网膜病变的发病状况,分析其发病的危险因素。方法选取我院体检中心2014年3月-2018年3月检出糖尿病患者9365例为研究对象,根据是否合并糖尿病视网膜病变分为糖尿病视网膜病变组5471例和单纯糖尿病组3624例,并将糖尿病视网膜病变组患者分为观察组2459例和对照组3012例,2组均给予药物治疗,观察组加用处方自我管理,对照组不采用处方自我管理。观察并比较2组的视力改善情况和眼底病变情况。分析糖尿病视网膜病变的危险因素。结果2组治疗后视力均优于治疗前,且观察组优于对照组(P<0.05)。观察组血管瘤数、出血灶面积、渗出灶面积均较治疗前减少,且观察组少于对照组(P<0.05)。糖尿病病程、舒张压、收缩压、平均血糖水平、高甘油三酯血症是糖尿病视网膜病变的独立危险因素(P<0.05,P<0.01)。结论血压、血糖、甘油三酯水平及糖尿病病程长短均为糖尿病视网膜病变发生的独立危险因素,通过对危险因素的控制,可有效降低视网膜病变程度,提高患者视力。Objective To study incidence condition of diabetic retinopathy in patients with diabetes mellitus and to analyze related risk factors affecting pathogenesy.Methods A total of 9365 diabetes mellitus patients were selected from physical examination center during March 2014 and March 2018,and the patients were divided into diabetic retinopathy group(n=5471)and simple diabetes group(n=3624)according to whether or not combination of diabetic retinopathy.The diabetic retinopathy group was divided into observation subgroup(n=2459)and control subgroup(n=3012).The two subgroups were given drug treatment,and observation subgroup was added self prescription management,while control subgroup did not been given self prescription management.Conditions of visual acuity improvement and eyeground lesions were observed and compared,and risk factors of diabetes mellitus combined with diabetic retinopathy were analyzed in two subgroups.Results Conditions of visual acuity after treatment were better than those before treatment in two groups,and the condition in observation group was better than that in control group(P<0.05).Values of hemangiomas number,areas of bleeding focus and exudation focus in observation group were lower than those in control group,and the values in observation group were lower than those in control group(P<0.05).Course of disease,blood pressure,glycosylated hemoglobin,blood sugar level,hypertriglyceridemic and triacylglycerol were independent risk factors of diabetic retinopathy in patients with diabetes mellitus(P<0.05).Conclusion Blood pressure,blood sugar and triglyceride levels in blood and duration of diabetic retinopathy are independent risk factors for diabetic retinopathy in patients with diabetes mellitus.Degree of retinopathy can be effectively reduced,and visual acuity can be improved by controlling the risk factors.

关 键 词：糖尿病 糖尿病视网膜病变 血管瘤 视力测定法 血糖自我监测 危险因素 

分 类 号：R587.26[医药卫生—内分泌]