【摘要】 目的 探讨免散瞳眼底照相技术在社区高血压及糖尿病患者眼底病变筛查中的应用价值，分析其与病程、年龄等因素的相关性，为优化基层慢性病管理提供依据。方法 选取2022年1月至2023年12月成都市武侯区玉林社区卫生服务中心的162例慢性病患者（高血压83例，糖尿病110例），采用免散瞳眼底照相技术进行筛查，分析检出率与病程、年龄、性别等因素的关系。结果 眼底病变总检出率为64.81%(105/162)，其中轻度病变占63.81%，中重度占36.19%；高血压组检出率68.67%，糖尿病组63.63%，差异无统计学意义（P=0.465）；高血压病程≥5年者检出率显著升高（77.5%vs≤5年组47.62%,P=0.024），而糖尿病患者的病变风险与病程无显著相关性（P=0.542）；年龄与病变发生率呈显著负相关（r=-3.51,P<0.01）,80岁以上人群检出率达100%；视力检查对早期病变敏感性不足（病变组与非病变组视力无差异，P=0.247）。结论 免散瞳眼底照相技术可有效筛查社区慢性病患者的眼底病变，尤其适用于高血压病程≥5年及所有糖尿病患者。该技术应作为基层慢性病管理的常规筛查手段，弥补单纯视力检查的局限性，为早期干预提供客观依据。更多还原

【Abstract】 Objective To evaluate the application value of non-mydriatic fundus photography in screening fundus lesions among community-based patients with hypertension and diabetes mellitus,and to analyze its correlation with disease duration,age,and other factors,thereby providing evidence for optimizing the management of primary chronic diseases.Methods A total of 162 patients with chronic diseases(83 with hypertension,110 with diabetes)from the Yulin Community Health Service Center in Wuhou District,Chengdu,were enrolled between January 2022 and December 2023.Nonmydriatic fundus photography was performed,and detection rates were analyzed in relation to disease duration,age,gender,and other factors.Results The overall detection rate of fundus lesions was 64.81%(105/162),with mild lesions accounting for 63.81% and moderate-to-severe lesions for 36.19%.The detection rate was 68.67% in the hypertension group and 63.63%in the diabetes group,with no statistically significant difference(P=0.465).Patients with hypertension duration≥5 years showed a significantly higher detection rate(77.5% vs．≤5 years group:47.62%,P=0.024),while no significant correlation was observed between disease duration and lesion risk in diabetic patients(P=0.542).Age was negatively correlated with lesion incidence(r=-3.51,P<0.01),with a 100% detection rate in patients aged>80 years.Visual acuity testing demonstrated low sensitivity for early lesions(no difference between lesion and non-lesion groups,P=0.247).Conclusion Non-mydriatic fundus photography is effective for screening fundus lesions in community-based patients with chronic diseases,particularly for hypertensive patients with≥5 years’ duration and all diabetic patients.This technique should be adopted as a routine screening tool in primary chronic disease management to compensate for the limitations of visual acuity testing and provide objective evidence for early intervention.更多还原