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目的：:评估伴有糖尿病黄斑水肿（DME）的2型糖尿病患者的视觉相关生活质量（VRQoL）。方法：:横断面调查研究。将2017年6月至2019年5月从抚顺市眼病医院门诊招募的伴有DME的2型糖尿病患者（187例）纳入研究。采用美国国立眼科研究院视功能问卷（NEI-VFQ-25）中文版量表来评估患者的VRQoL。不同人口学特征、临床特征的DME患者间NEI-VFQ-25分数比较采用Wilcoxon秩和检验。根据眼底照相将DME分为轻度、中度和重度。采用广义估计方程探讨DME严重程度与VRQoL的相关性。结果：:最终纳入DME患者159例。伴视力损害患者的一般视力、近距离活动、远距离活动、社交功能、依赖性、心理健康、角色困难、色觉、周边视觉和NEI-VFQ-25总分分数较无视力损害（小数视力>0.3）患者低（均n P<0.001）。双眼受累患者的一般健康、一般视力、近距离活动、远距离活动、依赖性、心理健康、角色困难、驾驶、色觉、周边视野和NEI-VFQ-25总分分数较单眼受累患者低（均n P<0.05）。随着DME严重程度的增加，一般健康（n P趋势=0.013）、总体视力（n P趋势<0.001）、近距离活动（n P趋势=0.001）、远距离活动（n P趋势=0.002）、依赖性（n P趋势=0.023）、心理健康（n P趋势=0.001）、社会角色（n P趋势=0.022）、周边视野（n P趋势=0.041）、NEI-VFQ-25总分（n P趋势=0.001）的得分逐渐降低。NEI-VFQ-25问卷中得分下降最多的是心理健康（n β=-15.01，95%n CI：-26.73~-3.30，n P=0.012）和总体视力（n β=-13.66，95%n CI：-19.86~-7.47，n P0.3), those with visual impairment showed statistically significant compromises in terms of general vision, near activities, distance activities, social functioning, dependency, mental health, role difficulties, color vision, peripheral vision, and NEI-VFQ-25 composite scores ( n P<0.001). Compared with unilateral DME, bilateral DME was associated with greater dependency and role difficulties, compromised near and distance activities, and poorer general health, general vision, color vision, peripheral vision, mental health, and NEI-VFQ-25 composite scores (n P<0.05). Scores for NEI-VFQ-25 on general health (n Ptrend=0.013), general vision (n Ptrend<0.001), near activities (n Ptrend=0.001), distance activities (n Ptrend=0.002), mental health (n Ptrend=0.001), role difficulties (n Ptrend=0.022), dependency (n Ptrend=0.023), peripheral vision (n Ptrend=0.041) and NEI-VFQ-25 composite (n Ptrend=0.001) decreased gradually as DME severity increased. n β coefficients were the largest for mental health (n β=-15.01, 95%n CI: -26.73- -3.30, n P=0.012) and general vision (n β=-13.66, 95%n CI: -19.86- -7.47, n P<0.001).n Conclusions::DME severity significantly affects patients\' VRQoL, particularly their general vision and mental health. NEI-VFQ-25 should be widely used to assess overall health in patients.