社区糖尿病性视网膜病变的患病率及其影响因素研究  

Prevalence and influencing factors of diabetes retinopathy in community

作　　者：谢奎 陈可祺 王思佳 邓珊 王瑞 吕德良[3] 马万成 XIE Kui;CHEN Ke-qi;WANG Si-jia;DENG Shan;WANG Rui;LYU De-liang;MA Wan-cheng(Luohu District Chronic Disease Hospital,Shenzhen,Guangdong 518023,China;不详)

机构地区：[1]深圳市罗湖区慢性病防治院,广东518023 [2]深圳市疾病预防控制中心 [3]深圳市慢性病防治中心

出　　处：《慢性病学杂志》2024年第9期1299-1303,共5页Chronic Pathematology Journal

基　　金：深圳市科技计划资助(KCXFZ20211020165803006)

摘　　要：目的了解深圳市罗湖区社区糖尿病性视网膜病变(diabetic retinopathy,DR)的患病情况,分析其影响因素,掌握社区服务可及性,为开展社区糖尿病眼病防控提供参考。方法进行横断面调查,采用概率比例规模抽样法(probability proportionate to size sampling,PPS),分层随机抽取480例2型糖尿病患者作为研究对象。通过问卷调查糖尿病眼病的患病情况、糖尿病眼病防治的知识知晓情况、防治服务需求现况、糖尿病眼病的定期检查情况、血糖控制、血压控制和服药等健康行为信息,开展医学体检并收集样本进行实验室检测。多因素分析采用非条件logistic回归模型。结果深圳市罗湖区社区在管2型糖尿病患者DR筛检患病率为24.56%。年龄大、糖尿病病程长、无眼科就诊史、经常吸烟、经常饮酒、肥胖、不良饮食习惯在DR组和非DR组中比较,差异均有统计学意义(χ^(2)=49.851、15.961、19.188、15.155、35.760、12.459、10.621,P<0.05)。DR组的糖化血红蛋白(hemoglobin A_(1)c,HbA_(1)c)水平高于非DR组,差异有统计学意义(Z=-1.99,P<0.05)。logistic回归分析结果显示,饮酒是DR的危险因素,总胆固醇(total cholesterol,TC)控制好是DR的保护因素,OR值分别为4.28(95%CI为1.32~13.84)、0.47(95%CI为0.26~0.85)。结论对糖尿病患者进行定期眼底筛查极为必要,需要正确控制患者的血糖、血压、血脂水平,戒烟戒酒,避免微血管损伤,做到早发现、早干预,可以有效预防DR。Objective To understand the prevalence of diabetes retinopathy(DR)in the community of Luohu District,Shenzhen,analyze its influencing factors,grasp the accessibility of community services,and provide reference for the prevention and control of diabetes eye disease in the community.Methods A cross-sectional survey was conducted,adopt probability proportionate to size sampling(PPS),480 patients with type 2 diabetes were stratified as study subjects.By questionnaire on the disease of diabetic eye disease,the knowledge of prevention and treatment of diabetic eye disease,the current situation of prevention and treatment services,the regular examination of diabetic eye disease,the health behavior of blood sugar control,blood pressure control and medication,medical physical examination was carried out and samples were collected for laboratory testing.A nonconditional logistic regression model was used for the multivariate analysis.Results The prevalence rate of DR screening for type 2 diabetes patients in the community of Luohu District,Shenzhen City was 24.56%.Age,long course of diabetes,no history of ophthal-mology,frequent smoking,frequent drinking,obesity,and bad eating habits were different between DR and non DR(χ^(2)=49.851,15.961,19.188,15.155,35.760,12.459,10.621,P<0.05).The HbA_(1)c in the DR group was significantly higher than that in the non DR group(Z=-1.99,P<0.05).Logistic regression analysis showed that alcohol consumption was a risk factor for DR,and good TC control was a protective factor for DR.The odds ratios(OR)were 4.28(95%CI 1.32-13.84)and 0.47(95%CI 0.26-0.85),respectively.Conclusions Regular fundus screening for patients with diabetes is very necessary.Correct control of blood sugar,blood pressure,blood lipids,smoking and drinking cessation,avoidance of microvascular damage,early detection and early intervention can effectively prevent DR.

关 键 词：糖尿病性视网膜病变 患病率 影响因素 

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