糖尿病视网膜病变病程进展的多因素分析

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目的探讨影响糖尿病视网膜病变(diabeticretinopathy,DR)病程进展的相关因素。设计病例观察研究。研究对象90例确诊为DR并未经眼部治疗的患者。方法经眼底荧光素血管造影术(FFA)检查并分型确诊为DR患者90例,记录病史、眼部检查、全身合并症。主要指标DR类型与发病年龄、性别、病程、体重指数(BMI)、眼压、屈光度、玻璃体后脱离、血压、血糖、糖化血红蛋白、肌酐、尿素氮、及全身合并症的相关性。结果DR患者在不同的病程阶段空腹血糖、糖化血红蛋白、尿素氮、周围神经病变,是否胰岛素治疗和有无口服降糖药6个因素有显著性差异。在logistic回归检验中,糖化血红蛋白、尿素氮和周围神经病变三个因素被认为是与DR病程进展相关的三个危险因素。结论对于DR患者应注意对其糖化血红蛋白和尿素氮指标的检测。对于合并周围神经病变的患者,应采取更积极的治疗手段。 Objective To investigate the related factors that affect the progression of diabetic retinopathy (DR). Design case observation study. Ninety patients who were diagnosed as having DR without eye treatment were enrolled. Methods 90 patients with DR were diagnosed by fundus fluorescein angiography (FFA) and diagnosed as DR, and their medical history, eye examination and systemic complications were recorded. The main indicators of DR type and age of onset, gender, duration, body mass index (BMI), intraocular pressure, refraction, vitreous detachment, blood pressure, blood glucose, glycosylated hemoglobin, creatinine, urea nitrogen, and systemic complications related. Results There were significant differences in six factors of fasting blood glucose, glycosylated hemoglobin, urea nitrogen, peripheral neuropathy, whether insulin treatment and oral hypoglycemic drugs were used in DR patients at different stages of disease. In the logistic regression test, three factors of glycated hemoglobin, urea nitrogen and peripheral neuropathy were considered as the three risk factors related to the progression of DR. Conclusion DR patients should pay attention to the detection of glycosylated hemoglobin and urea nitrogen. For patients with peripheral neuropathy, should take more aggressive treatment.
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