黑龙江省住院2型糖尿病患者视网膜病变患病率及其相关因素分析  

Prevalence and related factors of retinopathy in hospitalized patients with type 2 diabetes mellitus in Heilongjiang Province

作　　者：马雪菲 李梦 刘昊凌[1] 于艳梅 李斌武[3] 孟艳玲 谭丽艳[5] 张秀珍[6] 靳丽萍[7] 马永文[8] 姜海虹 朱瑞增 张健[11] 赵文杰 李卓 张伟 邓志梅 匡洪宇[1] Ma Xuefei;Li Meng;Liu Haoling;Yu Yanmei;Li Binwu;Meng Yanling;Tan Liyan;Zhang Xiuzhen;Jin Liping;Ma Yongwen;Jiang Haihong;Zhu Ruizeng;Zhang Jian;Zhao Wenjie;Li Zhuo;Zhang Wei;Deng Zhimei;Kuang Hongyul(Department of Endocrinology,First Affiliated Hospital of Harbin Medical University,Harbin 150000,China;Department of Endocrinology,Mudanjiang Cardiovascular Hospital,Mudanjiang 157011,China;Department of Endocrinology,General Hospital of Jixi Mining Group,Jixi 158100,China;Department of Endocrinology,Qitaihe People′s Hospital,Qitaihe 154603,China;Department of Endocrinology,First Affiliated Hospital of Jiamusi University,Jiamusi 154003,China;Department of Endocrinology,Jiamusi Central Hospital,Jiamusi 154002,China;Department of Endocrinology,Jiamusi Hospital of Traditional Chinese Medicine,Jiamusi 154002,China;Department of Endocrinology,Daqing Longnan Hospital,Daqing 163453,China;Department of Endocrinology,Daqing Oilfield General Hospital,Daqing 163316,China;Department of Endocrinology,Daqing Hospital of Traditional Chinese Medicine,Daqing 163111,China;Department of Endocrinology,Second Affiliated Hospital of Qiqihar Medical College,Qiqihar 161006,China;Department of Endocrinology,Third Affiliated Hospital of Qiqihar Medical College,Qiqihar 161000,China;Department of Endocrinology,Qiqihar Hospital of Traditional Chinese Medicine,Qiqihar 161000,China;Department of Endocrinology,Qiqihar First Hospital,Qiqihar 161005,China;Department of Endocrinology,Qiqihar Jianhua Hospital,Qiqihar 161006,China)

机构地区：[1]哈尔滨医科大学附属第一医院内分泌科,哈尔滨150000 [2]牡丹江心血管病医院内分泌科,牡丹江157011 [3]鸡西矿业集团总医院内分泌科,鸡西158100 [4]七台河市人民医院内分泌科,七台河154603 [5]佳木斯大学附属第一医院内分泌科,佳木斯154003 [6]佳木斯市中心医院内分泌科,佳木斯154002 [7]佳木斯市中医院内分泌科,佳木斯154002 [8]大庆龙南医院内分泌科,大庆163453 [9]大庆油田总医院内分泌科,大庆163316 [10]大庆市中医院内分泌科,大庆163111 [11]齐齐哈尔医学院附属第二医院内分泌科,齐齐哈尔161006 [12]齐齐哈尔医学院附属第三医院内分泌科,齐齐哈尔161000 [13]齐齐哈尔市中医院内分泌科,齐齐哈尔161000 [14]齐齐哈尔第一医院内分泌科,齐齐哈尔161005 [15]齐齐哈尔市建华医院内分泌科,齐齐哈尔161006

出　　处：《中华糖尿病杂志》2022年第12期1396-1403,共8页CHINESE JOURNAL OF DIABETES MELLITUS

摘　　要：目的调查黑龙江省住院2型糖尿病(T2DM)患者糖尿病视网膜病变(DR)的患病率及影响因素。方法横断面研究。回顾性收集2018年1至12月在黑龙江省15家医院内分泌科住院治疗且临床资料完整的T2DM患者。收集患者的一般资料及实验室指标等相关信息,以免散瞳眼底摄片结果将研究对象分为DR组和无DR组。调查黑龙江省住院T2DM患者DR的患病率并采用logistic回归模型分析DR的相关因素。结果共纳入15418例T2DM患者。黑龙江省住院T2DM患者DR患病率为34.5%(5312例),经年龄、性别标准化后DR患病率为25.6%。与无DR组相比,DR组患者的年龄、病程、吸烟饮酒史、家族史、合并高血压的比例更高,DR组患者的空腹血糖、糖化血红蛋白(HbA_(1c))、总胆固醇、低密度脂蛋白胆固醇(LDL-C)、肌酐、钾、钠、纤维蛋白原也更高,差异有统计学意义(均P<0.05);DR组的红细胞计数、血红蛋白、血小板、空腹C肽、甘油三酯(TG)、丙氨酸转氨酶、天门冬氨酸转氨酶、总胆红素、血尿酸、钙、镁、血尿酸/肌酐比值、TG/高密度脂蛋白胆固醇(HDL-C)比值低于无DR组,差异有统计学意义(均P<0.05)。多因素logistic回归分析显示,病程(OR=1.097,95%CI为1.089~1.104)、家族史(OR=1.262,95%CI为1.150~1.384)、饮酒史(OR=1.241,95%CI为1.130~1.364)、高血压(OR=1.326,95%CI为1.214~1.447)、HbA_(1c)≥7%(OR=1.415,95%CI为1.274~1.572)为DR的独立危险因素。根据血尿酸/肌酐比值、TG/HDL-C比值的四分位数分为4组(Q1~Q_(4)组),调整年龄、病程、家族史、高血压、吸烟史、饮酒史、HbA_(1c)≥7%后,血尿酸/肌酐比值中Q_(3)、Q_(4)组患DR的风险是Q1组的0.884、0.796;TG/HDL-C比值中Q_(3)、Q_(4)组患DR的风险是Q1组的0.837、0.680。结论黑龙江省住院T2DM患者DR患病率较高。糖尿病病程、家族史、HbA_(1c)≥7%、高血压、饮酒史是DR的独立危险因素,血尿酸/肌酐比值是DR的独立保护因素。Objective To investigate the prevalence of retinopathy in hospitalized patients with type 2 diabetes mellitus(T2DM)in Heilongjiang province and analyze its related factors.Methods This study was a cross sectional study.Hospitalized T2DM patients with complete clinical data in 15 hospitals in Heilongjiang province from January to December 2018 were retrospectively enrolled.We collected the general data and laboratory indicators and divided the patients into diabetic retinopathy(DR)group and no DR group according to non-mydriatic fundus photography.We investigated the prevalence of retinopathy among hospitalized T2DM patients in Heilongjing province and logistic regression was used to conduct univariate and multivariate analyses on DR.Results Fifteen thousand four hundred and eighteen hospitalized T2DM patients were included in the study.The prevalence of DR in hospitalized T2DM patients in Heilongjiang province was 34.5%(n=5312),the age-gender-standardised prevalence of DR was 25.6%.Compared to no DR group,the DR group had more family history of diabetes,smoking and drinking history,and hypertension,older age,longer course of disease,higher fasting blood glucose,glycosylated hemoglobin A_(1c)(HbA_(1c)),total cholesterol,low-density lipoprotein cholesterol(LDL-C),creatinine(Cr),potassium,sodium,and fibrinogen,lower red blood cell count,hemoglobin,platelets,fasting C peptide,triglycerides(TG),alanine aminotransferase,aspartate aminotransferase,total bilirubin,blood uric acid(SUA),calcium and magnesium,SUA/Cr and TG/high-density lipoprotein cholesterol(HDL-C),the differences were statistically significant(P<0.05).Multivariate logistic regression analysis showed that the course of diabetes(OR=1.097,95%CI 1.089 to 1.104),family history(OR=1.262,95%CI 1.150 to 1.384),hypertension(OR=1.326,95%CI 1.214 to 1.447),drinking history(OR=1.241,95%CI 1.130 to 1.364),and HbA_(1c)≥7%(OR=1.415,95%CI 1.274 to 1.572)were independent risk factors for DR.For SUA/Cr compared with Q1,the risk of DR in patients in Q_(3) and Q_(4) groups

关 键 词：糖尿病 2型 糖尿病视网膜病变 患病率 相关因素 

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