【摘要】 目的了解上海市浦东新区社区2型糖尿病患者糖尿病性视网膜病变(DR)的患病情况,并探讨其影响因素。方法于2014年5月—2015年2月,在上海市浦东新区抽取社区卫生服务中心纳入管理的2型糖尿病患者2 083例。根据数字免散瞳眼底摄片,将患者的眼底病变分为无明显视网膜病变(NDR)、非增殖期视网膜病变(NPDR)轻度、NPDR中度、NPDR重度与增殖期糖尿病性视网膜病变(PDR)4类。比较并分析不同DR患病情况患者的基本资料、体格检查指标及实验室检查指标。结果 2 083例患者的DR患病率为21.4%(445/2 083),其中NPDR轻度、NPDR中度、NPDR重度和PDR的患病率分别为14.3(297/2 083),2.9%(60/2 083)、4.2%(88/2 083)。不同街道患者DR患病情况比较,差异无统计学意义(P>0.05)。不同DR患病情况患者的性别、体质指数(BMI)、腰臀比(WHR)、收缩压(SBP)、舒张压(DBP)、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)及尿肌酐(UCr)比较,差异无统计学意义(P>0.05);而平均年龄、平均病程、平均发病年龄、空腹血糖(FPG)、餐后2 h血糖(2 hPG)、糖化血红蛋白(HbA1c)、尿微量清蛋白(UMA)及尿清蛋白与肌酐比值(ACR)比较,差异有统计学意义(P<0.05)。Logistic逐步回归分析显示,病程、发病年龄、2 hPG及HbA1c对2型糖尿病患者并发DR的影响有统计学意义(P<0.05)。结论上海市浦东新区社区2型糖尿病患者的DR患病率低于既往研究,且主要为非增殖期轻度病变。病程、发病年龄、2 hPG及HbA1c是2型糖尿病患者并发DR的影响因素。更多还原

【Abstract】 Objective To investigate the prevalence of diabetic retinopathy( DR) of type 2 diabetes mellitus( T2DM) patients in Shanghai Pudong New Area community and its influencing factors. Methods A total of 2 083 T2DM patients included in the management of community health service centers selected in Shanghai Pudong New Area were enrolled from May2014 to February 2015. The fundus lesions of patients were classified into non-obvious diabetic retinopathy( NDR),mild non-proliferative diabetic retinopathy( NPDR),moderate NPDR and severe NPDR and proliferation diabetic retinopathy( PDR) by figure nonmydriatic fundus photographs. Basic information,physical examination indicators and laboratory examination indexes of different DR patients were compared and analysed. Results The DR prevalence of 2 083 patients was 21. 4%( 445 /2 083);and the prevalence of patients with mild NPDR,moderate NPDR and severe NPDR and PDR were 14. 3( 297 /2 083),2. 9%( 60 /2 083),4. 2%( 88 /2 083) respectively. The difference of DR prevalence among different streets was not significant( P >0. 05). Patients with different DR conditions were not significantly different in gender,body mass index( BMI),waist-hip ratio( WHR), systolic blood pressure( SBP), diastolic blood pressure( DBP), total cholesterol( TC), triacylglycerol( TG),low density lipoprotein cholesterin( LDL-C),high density lipoprotein cholesterol( HDL-C) and urine creatinine( UCr)( P > 0. 05); while patients with different DR conditions were significantly different in average age,average disease duration,average onset age, fasting blood-glucose( FPG), postprandial blood glucose 2 h( 2 hPG), glycosylated hemoglobin( HbA1c),urine microalbumin( UMA) and urinary albumin to creatinine ratio( ACR)( P < 0. 05). Logistic stepwise regression analysis showed that the effect of disease course,onset age,2 hPG and HbA1 con DR in T2 DM patients was significant( P < 0. 05). Conclusion The DR prevalence rate of T2 DM patients in Shanghai Pudong New Area community is lower than that of previous studies,with non-proliferative diabetic retinopathy as the main lesion. Disease course,onset age,2hPG and HbA1 care influencing factors for DR in T2 DM patients.更多还原