CAJ | 학술논문

目的探讨广东地区病程10年及以上的2型糖尿病(DM)患者发生增殖性糖尿病视网膜病变( PDR)的危险因素。方法收集中山大学中山眼科中心和中山大学附属第一医院内分泌科就诊的144例病程10年及以上的2型DM患者，分为PDR组和非增殖性糖尿病视网膜病变(NPDR)组，进行病例对照研究。通过x2检验及多因素logistic回归分析人群特征、生活行为习惯、既往病史、糖尿病家族史、血压及糖化血红蛋白等因素中与发展成PDR相关的因素。结果单因素分析提示，年龄轻(OR=0.25，P =0.000)、教育程度低（OR=2.42,P=0.013）、糖尿病肾病(OR=2.80,P=0.01)、糖尿病周围神经病变(DPN)(OR=2.56,P=0.008)、运动少(OR=2.55,P=0.006)、高血压(OR=2.31,P=0.014)及吸烟(OR=3.96，P =0.001)与PDR相关。多因素logistic回归分析显示年龄轻(OR=0.92,P=0.000)、教育程度低(OR=2.64，P =0.021)、DPN (OR=2.36,P=0.036)及吸烟(OR=3.27，P=0.013)与PDR相关。结论年龄轻、教育程度低、吸烟及DPN是广东地区病程10年及以上的2型DM患者发生PDR的危险因素。眼科医生应加大对年龄轻、教育程度低、吸烟及有DPN病史的DM患者的随访密度，并教育患者重视生活习惯。
목적 탐토엄동지구병정10년급이상적2형당뇨병(DM)환자발생증식성당뇨병시망막병변( PDR)적위험인소。방법 수집중산대학중산안과중심화중산대학부속제일의원내분비과취진적144례병정10년급이상적2형DM환자，분위PDR조화비증식성당뇨병시망막병변(NPDR)조，진행병례대조연구。통과x2검험급다인소logistic회귀분석인군특정、생활행위습관、기왕병사、당뇨병가족사、혈압급당화혈홍단백등인소중여발전성PDR상관적인소。결과 단인소분석제시，년령경(OR=0.25，P =0.000)、교육정도저（OR=2.42,P=0.013）、당뇨병신병(OR=2.80,P=0.01)、당뇨병주위신경병변(DPN)(OR=2.56,P=0.008)、운동소(OR=2.55,P=0.006)、고혈압(OR=2.31,P=0.014)급흡연(OR=3.96，P =0.001)여PDR상관。다인소logistic회귀분석현시년령경(OR=0.92,P=0.000)、교육정도저(OR=2.64，P =0.021)、DPN (OR=2.36,P=0.036)급흡연(OR=3.27，P=0.013)여PDR상관。결론 년령경、교육정도저、흡연급DPN시엄동지구병정10년급이상적2형DM환자발생PDR적위험인소。안과의생응가대대년령경、교육정도저、흡연급유DPN병사적DM환자적수방밀도，병교육환자중시생활습관。
Objective To investigate the risk factors of proliferative diabetic retinopathy (PDR) in type 2 diabetes mellitus (DM) patients of 10 years or more duration in Guangdong province. Methods A total of 144 type 2 DM of 10 years or more duration from Zhongshan Ophthalmic Center and the Department of Endocrinology of the First Affiliated Hospital of Sun Yat-sen University were divided into PDR group and non-proliferative diabetic retinopathy (NPDR) group, and then investigated by case-control study. To analyze the factors associated with PDR from the factors of demographic characteristics, behavioral habits, past disease history, diabetes family history, blood pressure and glycated hemoglobin by X 2 test and multivariate logistic regression analysis. Results Univariate analysis showed that younger age (OR=0.25, P=0.000), lower educated (OR=2.42, P=0.013), diabetic nephropathy (OR=2.80, P=0.01), diabetic peripheral neuropathy (DPN) (OR=2.56, P=0.008), less exercise (OR=2.55, P=0.006), hypertension (OR=2.31, P=0.014) and smoking (OR=3.96, P=0.001) were associated with PDR. Multivariate logistic regression analysis showed younger age (OR=0.92, P=0.000), lower educated (OR=2.64, P=0.021), DPN (OR=2.36, P=0.036) and smoking (OR=3.27, P=0.013) were associated with PDR. Conclusions Young age, low education, smoking and DPN are the risk factors of PDR in type 2 DM patients of 10 years or more duration. Ophthalmologists should follow up DM patients of young age, less educated, smoking and DPN frequently and let patients pay more attention to lifestyle.