云南省糖尿病视网膜病变的流行特征及其相关因素研究  

Epidemiological investigation and risk factors of diabetic retinopathy in Yunnan Province

作　　者：史丽 夏雪梅 侯旭宏[3] 刘建芳 念馨[1] 江艳[1] 宋亚贤[1] 徐玉善[1] Shi Li;Xia Xuemei;Hou Xuhong;Liu Jianfang;Nian Xin;Jiang Yan;Song Yaxian;Xu Yushan(Department of Endocrinology,the First Affiliated Hospital of Kunming Medical University,Kunming 650031,China;Kunming Medical University,Kunming 650500,China;Department of Endocrinology,the Sixth People′s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 200233,China)

机构地区：[1]昆明医科大学第一附属医院内分泌一科,昆明650031 [2]昆明医科大学,昆明650500 [3]上海交通大学医学院附属第六人民医院内分泌科,上海200233

出　　处：《中华内科杂志》2024年第6期613-617,共5页Chinese Journal of Internal Medicine

基　　金：云南省代谢性疾病临床医学研究中心(202102AA100056);云南省内分泌代谢疾病临床医学中心(YWLCYXZXXYS20221005);国家自然科学基金(82160164)。

摘　　要：了解云南省糖尿病视网膜病变(DR)的患病率和流行特征,探讨其相关危险因素,为云南省糖尿病慢性并发症的防治策略提供依据。横断面研究,2019年8至11月选取云南省16个社区和村庄登记的1524例糖尿病患者作为研究对象。通过问卷完成信息采集,测量人体形态学指标及相关生化指标,计算DR的患病率,采用logistic回归分析法筛选DR的危险因素。云南省糖尿病患者DR患病率为16.0%(244/1524),其中轻度非增殖性DR(mild-NPDR)的患病率为4.5%(69/1524),需要转诊的DR(RDR)的患病率为11.5%(175/1524)。糖化血红蛋白(HbA_(1c))≥7.0%是mild-NPDR(OR=1.872,95%CI 1.055~3.323)和RDR(OR=4.821,95%CI 2.917~7.969)的危险因素;血压≥130/80 mmHg(1 mmHg=0.133 kPa)是mild-NPDR(OR=1.933,95%CI 1.112~3.358)和RDR(OR=1.505,95%CI 1.063~2.130)的危险因素。云南省糖尿病患者中有16.0%合并DR;其中约71.7%需要转诊眼科,糖尿病患者RDR高发与血糖、血压控制较差有关。To investigate the prevalence and epidemiological characteristics of diabetic retinopathy(DR)in Yunnan Province,explore its risk factors,and provide a basis for the prevention and treatment of chronic complications of diabetes mellitus(DM).This is a large cross-sectional study,in all,1524 DM patients in 16 communities and villages of Yunnan Province who were registered in health service centers were included in this study from August to November 2019.All patients completed a uniform questionnaire,anthropometric measurements,biochemical measurements,and auxiliary examinations.Logistic regression analysis was used to screen the risk factors of DR.The prevalence rates of DR,mild non-proliferative DR(mild-NPDR),and referable DR(RDR)were 16.0%(244/1524),4.5%(69/1524),and 11.5%(175/1524),respectively.Glycated hemoglobin A_(1c)(HbA_(1c))≥7.0%was the risk factor of mild-NPDR(OR=1.872,95%CI 1.055-3.323)and RDR(OR=4.821,95%CI 2.917-7.969).Blood pressure≥130/80 mmHg(1 mmHg=0.133 kPa)was the risk factor of mild-NPDR(OR=1.933,95%CI 1.112-3.358)and RDR(OR=1.505,95%CI 1.063-2.130).In Yunnan Province,16.0%DM patients had accompanying DR,wherein about 71.7%of them required an ophthalmology referral,and the high incidence of RDR in DM patients was associated with poor control of blood glucose and blood pressure.

关 键 词：糖尿病 糖尿病视网膜病变 危险因素 流行病学特征 

分 类 号：R587.2[医药卫生—内分泌] R774.1[医药卫生—内科学] R181.3[医药卫生—临床医学]