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目的了解北京崔各庄社区2型糖尿病(T2DM)患者合并糖尿病视网膜病变(DR)及其危险因素,为预防糖尿病引起失明提供依据。方法 2008年8月<三甲医院与多社区中心联合管理2型糖尿病项目>,对崔各庄社区采用整群抽样的方法,遵循T2DM患者自愿参加的原则,本研究共纳入329例T2DM患者;医师经过专门培训,按统一要求调查并填写调查表,并对患者进行体格检查及相关的实验室检查。结果 (1)329例T2DM患者中,合并DR者74例,患病率为22.49%[95%CI(17.98%,27.00%)],其中非增殖性、增殖性视网膜病变分别占89.2%和10.8%;(2)T2DM患者经济收入增高,DR的患病率降低(P=0.031);糖尿病程延长,DR的患病率增加(P<0.01);糖化血红蛋白(HbA1 c)水平增高,DR的患病率增加(P<0.01)。(3)调整多个因素间的影响,相对于经济收入<1 000元/月的患者,收入为1 000~2 000元/月、>2 000元/月的患者发生DR的风险分别为0.470[95%CI(0.240,0.920)]和0.281[95%CI(0.060,1.327)];相对于糖尿病病程<5年的患者,5~10年、>10年的患者发生DR的风险分别为1.644[95%CI(0.764,3.536)]和3.246[95%CI(1.447,7.283)];相对于HbA1 c水平<6.5%的患者,6.5%~7.5%、>7.5%的患者发生DR的发生风险分别为1.490[95%CI(0.653,3.399)]和3.192[95%CI(1.562,6.526)]。结论经济收入、HbA1 c水平、病程长短是影响糖尿病患者发生DR的独立危险因素。应提倡早诊断、早治疗及血糖控制达标,才能有效遏制DR的发生、发展,预防失明。
Objective To understand the association between diabetic retinopathy (DR) and its risk factors in patients with type 2 diabetes mellitus (T2DM) in Cuigezhuang community in Beijing, and to provide evidence for prevention of diabetes-induced blindness. Methods In August 2008, the “Type A diabetes project was jointly managed by the top three hospitals and multi-community centers”, and the method of cluster sampling was adopted in the community of Cuigezhuang and follow the principle of voluntary participation of T2DM patients. A total of 329 T2DM patients were included in this study. After specialized training, according to uniform requirements of investigation and fill in the questionnaire, and physical examination of patients and related laboratory tests. Results (1) Of the 329 patients with T2DM, 74 were associated with DR, with a prevalence of 22.49% [95% CI (17.98%, 27.00%]], of which non-proliferative proliferative retinopathy accounted for 89.2% and 10.8 (2) The economic income of T2DM increased, the prevalence of DR decreased (P = 0.031), the duration of diabetes increased, the prevalence of DR increased (P <0.01), the level of HbA1c increased, while DR The prevalence increased (P <0.01). (3) To adjust the influence of many factors, the risk of DR in patients with income <1000 Yuan / month and income of 1000 ~ 2000 Yuan / month and> 2000 Yuan / month were 0.470 [95% CI (0.240,0.920)] and 0.281 [95% CI (0.060,1.327)]; patients with 5-year and 10-year diabetes have a DR risk of 1.644 [95% CI (0.764, 3.536)] and 3.246 [95% CI (1.447, 7.283)], with a risk of developing DR in 6.5% -7.5%,> 7.5% of patients with HbA1c levels <6.5% 1.490 [95% CI (0.653, 3.399)] and 3.192 [95% CI (1.562, 6.526)], respectively. Conclusion The economic income, HbA1c level and duration of disease are independent risk factors of DR in diabetic patients. Should be promoted early diagnosis, early treatment and blood glucose control standards, can effectively curb the occurrence of DR, development, prevention of blindness.