增殖性糖尿病视网膜病变患者视力预后不良的影响因素分析  

Risk factors influencing prognosis in surgical patients with proliferative diabetic retinopathy

作　　者：沈朝兰[1] 黄孔乾 崔凌[1] 吕明良[1] 唐芬 钟海彬[1] 赵昕[1] Chao-Lan Shen;Kong-Qian Huang;Ling Cui;Ming-Liang Lyu;Fen Tang;Hai-Bin Zhong;Xin Zhao(Department of Ophthalmology,the People's Hospital of Guangxi Zhuang Autonomous Region,Nanning 530021,Guangxi Zhuang Autonomous Region,China)

机构地区：[1]广西壮族自治区人民医院眼科,广西南宁530021

出　　处：《国际眼科杂志》2020年第4期703-706,共4页International Eye Science

基　　金：广西壮族自治区科技厅科技攻关计划(No.桂科攻1598012-17)。

摘　　要：目的:分析微创玻璃体切割术(PPV)治疗增殖性糖尿病视网膜病变(PDR)视力预后不良的影响因素。方法:回顾性分析2016-01/2018-12就诊于我院眼科的PDR患者90例90眼的临床资料,根据术后3mo最佳矫正视力情况分为预后良好组(72眼)和预后不良组(18眼),对可能影响预后的术前临床相关因素进行分析,探讨其与疾病预后转归的关系。结果:纳入性别、年龄、糖尿病视网膜病变病程及术前全视网膜光凝(PRP)治疗史、糖化血红蛋白(HbA1c)、眼部B超(牵引性视网膜脱离、视网膜水肿情况)、光学相干断层扫描(黄斑区视网膜脱离、视网膜椭圆体带完整性及视网膜外层高反射灶情况)检查结果进行分析,两组患者术前PRP治疗史、HbA1c、OCT检查黄斑区视网膜脱离和视网膜外层高反射灶情况均有差异(P<0.05),其中术前HbA1c(OR=1.439,P=0.009)和OCT检查黄斑区视网膜脱离情况(OR=4.007,P=0.040)为PDR术后视力预后不良的独立危险因素。结论:术前HbA1c水平和黄斑区视网膜脱离是PDR术后短期视力预后不良的独立危险因素。AIM:To investigate the clinical and imaging data of proliferative diabetic retinopathy(PDR)treated by pars plana vitrectomy(PPV),and to further explore the risk factors associated with poor prognosis.METHODS:Data of 90 eyes of 90 patients at Guangxi Zhuang Autonomous Region People’s Hospital from January 2016 to December 2018 were retrospectively reviewed.According to the postoperative visual acuity,the patients were divided into favorable prognosis group(group A)and unfavorable prognosis group(group B).To explore the clinical and image risk factors and prognosis of disease outcome.Univariate analysis uses Chi-square analysis,while multivariate analysis takes Logistic regression analysis.RESULTS:Univariate analysis showed that there was much more difference between good prognosis and those with poor prognosis:the preoperational PRP treatment experience(P=0.042),HbA1c(P=0.008),OCT-TRD(P=0.004),OCT-HRF(P=0.005).Multivariate logistic regression analysis showed that HbA1c(OR=1.439,P=0.009)and OCT-TRD(OR=4.007,P=0.040)were independent risk factors for poor prognosis after proliferative diabetic retinopathy.CONCLUSION:HbA1c and OCT-TRD are independent predictors of poor prognosis in PDR patient.

关 键 词：光学相干断层扫描 增殖性糖尿病视网膜病变 糖化血红蛋白 预后 危险因素 

分 类 号：R587.2[医药卫生—内分泌] R774.1[医药卫生—内科学]