不伴黄斑水肿的非增生型糖尿病视网膜病变的影响因素分析  

Analysis of influencing factors of non-proliferative diabetic retinopathy without macular edema

作　　者：代梦欢 李冬莉[1] 崔忆辛[1] 申璐 李齐瑞 饶玲娜 郭姝蓉 袁玲[1] Dai Menghuan;Li Dongli;Cui Yixin;Shen Lu;Li Qirui;Rao Lingna;Guo Shurong;Yuan Ling(Department of Ophthalmology,the First Affiliated Hospital of Kunming Medical University,Kunming 650032,China)

机构地区：[1]昆明医科大学第一附属医院眼科,昆明650032

出　　处：《中华眼外伤职业眼病杂志》2024年第1期1-7,共7页Chinese Journal of Ocular Trauma and Occupational Eye Disease

基　　金：国家自然科学基金资助项目(82260207);云南省科技厅科技计划项目(202201AY070001-036)。

摘　　要：目的分析不伴黄斑水肿的非增生型糖尿病视网膜病变(NPDR)的影响因素。方法回顾性病例对照研究。连续纳入2023年5月至8月昆明医科大学第一附属医院确诊的2型糖尿病71例, 其中无糖尿病视网膜病变23例作为对照组;48例不伴黄斑水肿的NPDR作为观察组。观察组包括轻度NPDR者20例, 中度NPDR者16例, 重度NPDR者12例。比较各组之间的性别、年龄、糖尿病病程及糖化血红蛋白(HbA1c)等指标, 使用多变量Logistic回归分析来探讨不伴黄斑水肿的NPDR的影响因素。结果对照组和观察组患者在性别(χ^(2) =2.37, P=0.123)、年龄(t=0.19,P=0.847)、高血压现病史(χ^(2) =1.81, P=0.179)、甘油三酯(Z=0.72, P=0.472)、低密度脂蛋白(Z=0.14, P=0.888)及高密度脂蛋白(Z=0.57, P=0.527)对比, 差异均无统计学意义;而HbA1c[(7.32±0.86)% vs (9.71±1.33)%]、总胆固醇水平[3.63(3.43, 4.02)mmol/L vs 4.53(4.01, 5.31)mmol/L]及糖尿病病程[3.00(2.00, 12.00)年vs 13.50(7.00, 17.00)年]指标对比, 差异有统计学意义(t=9.10, P<0.001;Z=4.74, P<0.001;Z=3.29, P=0.001)。其中, 轻度、中度、重度不伴黄斑水肿的NPDR患者的HbA1c、总胆固醇水平比较, 差异具有统计学意义(F=4.66, P=0.014;F=4.17, P=0.029)。采用多变量Logistic回归方程分析, HbA1c水平(OR=1.91,P=0.011)、总胆固醇水平(OR=2.24, P=0.013)是不伴黄斑水肿的NPDR发生的危险因素。结论 HbA1c水平和总胆固醇水平是不伴黄斑水肿的NPDR的危险因素;不伴黄斑水肿的NPDR的严重程度与HbA1c水平、总胆固醇水平成正相关关系。Objective To analyse the influencing factors of non-proliferative diabetic retinopathy(NPDR)without macular edema.Methods This was a retrospective case-control study.A cohort of 71 patients with typeⅡdiabetes from May to Aug.2023 in the First Affiliated Hospital of Kunming Medical University was enrolled consecutively.There were 23 non-diabetic retinopathy patients in the control group and 48 NPDR without macular edema patients in the observation group.The patients in the observation group were graded into 20 mild NPDR,16 moderate NPDR,and 12 severe NPDR cases.Comparative analyses encompassed gender,age,diabetes duration,glycated hemoglobin(HbA1c)levels,and other parameters,employing multivariate logistic regression analysis aimed to unveil influencing factors associated with NPDR without macular edema at varying severity levels.Results The difference in gender(χ^(2)=2.37,P=0.123),age(t=0.19,P=0.847),history of hypertension(χ^(2)=1.81,P=0.179),triglycerides(Z=0.72,P=0.472),low-density lipoprotein(Z=0.14,P=0.888),and high-density lipoprotein(Z=0.57,P=0.527)between the control group and the observation group was not statistically significant.Conversely,comparisons between the control group and the observation group involving HbA1c levels[(7.32±0.86)%vs(9.71±1.33)%],total cholesterol levels[3.63(3.43,4.02)mmol/L vs 4.53(4.01,5.31)mmol/L],and duration of diabetes[3.00(2.00,12.00)year vs 13.50(7.00,17.00)year]revealed statistically significant disparities(t=9.10,P<0.001;Z=4.74,P<0.001;Z=3.29,P=0.001).Specifically,comparisons of HbA1c levels and total cholesterol levels among patients with mild,moderate,and severe NPDR showed statistically significant differences(F=4.66,P=0.014;F=4.17,P=0.029).Utilizing a multivariate logistic regression analysis,HbA1c levels(OR=1.91,P=0.011)and total cholesterol levels(OR=2.24,P=0.013)were identified as risk factors for NPDR without macular edema occurrence.Conclusion HbA1c levels and total cholesterol levels are risk factors for NPDR without macular edema;NPDR without macular e

关 键 词：糖尿病视网膜病变 黄斑水肿 糖化血红蛋白 

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