摘要
目的 研究2型糖尿病(T2DM)患者发生糖尿病视网膜病变(DR)的影响因素,探讨其防治对策.方法 选择2017年7月至2019年1月本院眼科就诊的T2DM患者作为研究对象,收集患者临床资料,根据眼部检查结果将患者分为T2DM伴DR组及T2DM不伴DR组,比较两组患者临床资料,采用多元逐步logistic回归分析T2DM患者发生DR的危险因素.结果 T2DM伴DR组患者糖尿病肾脏疾病、糖尿病周围神经病变比例明显高于T2DM不伴DR患者(P<0.05);T2DM伴DR组患者T2DM病程、视网膜动脉硬化分级、收缩压(SBP)、舒张压(DBP)、糖化血红蛋白(HbA1c)、低密度脂蛋白(LDL-C)等指标明显高于T2DM不伴DR组患者(P<0.05);T2DM伴DR组患者餐后2hC肽等指标明显低于T2DM不伴DR组患者(P<0.05);多元逐步logistic回归分析示,糖尿病肾脏疾病、糖尿病周围神经病变、T2DM病程、SBP、DBP、HbA1c、LDL-C等指标是DR发生的影响因素.结论 糖尿病肾脏疾病、糖尿病周围神经病变、T2DM病程、SBP、DBP、HbA1c、LDL-C等指标与DR发生相关,在防治中应加强长病程T2DM等高危人群的健康宣教,社区管理进一步加强糖尿病患者血脂、血压、血糖的管理,避免“三高”引起DR的发生及发展.
Objective To study the influencing factors of diabetic retinopathy(DR)in patients with type 2 diabetes mellitus(T2DM),and to explore the control countermeasures.Methods The patients definitely diagnosed with T2DM in the Ophthalmology department from July 2017 to January 2019 were enrolled as subjects.The clinical data of patients were collected.According to eye examination results,they were divided into T2DM with DR group and T2DM without DR group.Clinical data of both groups were compared.Multivariate stepwise logistic regression analysis was performed to analyze the risk factors for DR in T2DM patients.Results The proportion of diabetic nephropathy and diabetic peripheral neuropathy in T2DM with DR group was significantly higher than that in patients with T2DM without DR(P<0.05).The T2DM duration,retinal arteriosclerosis,diastolic blood pressure(DBP),systolic blood pressure(SBP),glycosylated hemoglobin(HbA1c)and low-density lipoprotein cholesterol(LDL-C)in T2DM with DR group were significantly higher than those in T2DM without DR group(P<0.05).The postprandial 2h C-peptide in T2DM with DR group was significantly lower than that in T2DM without DR group(P<0.05).Multivariate stepwise logistic regression analysis showed that diabetic nephropathy,diabetic peripheral neuropathy,T2DM duration,SBP,DBP,HbA1c and LDL-C were the influencing factor of DR.Conclusions Diabetic nephropathy,diabetic peripheral neuropathy,T2DM duration,SBP,DBP,HbA1c and LDL-C are related to occurrence of DR.In the control,health education should be strengthened for high-risk populations with long T2DM duration.In the community management,the management for blood lipids,blood pressure and blood glucose in diabetic patients should be further strengthened.
作者
吴丽萍
胡春玲
张悦
张玮
Wu Liping;Hu Chunling;Zhang Yue;Zhang Wei(Department of Ophthalmology,Renhe Hospital of Baoshan District,Shanghai 200431,China)
出处
《中国医师杂志》
CAS
2020年第7期1049-1052,1059,共5页
Journal of Chinese Physician
关键词
糖尿病
2型
糖尿病视网膜病变
因素分析
统计学
Diabetes mellitus
type 2
Diabetic retinopathy
Factor analysis
statistical
