CAJ | 학술논문

目的分析糖尿病视网膜病变(DR)和糖尿病肾病(DN)的临床特点及其相关性.方法收集2004年1月至2009年6月住院的2型糖尿病患者9237例,统计DR和DN的患病率,分析其临床特点及二者的相关性.结果住院2型糖尿病患者DR的总患病率为33.0%(3045/9237),在微量白蛋白尿、大量蛋白尿及大量蛋白尿合并肾功能损害患者中,DR患病分别为36.3%(588/1618)、53.7%(1113/2074)和70.7%(1206/1706);DN患病率为58.4%(5398/9237),与糖尿病未合并DR患者及轻度非增生性糖尿病视网膜病变(NPDR)比较,中度NPDR、重度NPDR及增生性糖尿病视网膜病变(PDR)患者尿微量白蛋白、总蛋白逐渐增加,肌酐清除率逐渐降低(P＜0.05);非条件Logistic回归分析发现与DR发病相关的危险因素包括糖尿病病程、蛋白尿、纤维蛋白原、C反应蛋白及周围神经病变,与DN发病相关的危险因素包括糖尿病病程、糖化血红蛋白、收缩压、蛋白尿、低密度脂蛋白和DR.结论 DR和DN是2型糖尿病患病率较高的慢性微血管并发症,二者具有较好的临床相关性.
목적 분석당뇨병시망막병변(DR)화당뇨병신병(DN)적림상특점급기상관성.방법 수집2004년1월지2009년6월주원적2형당뇨병환자9237례,통계DR화DN적환병솔,분석기림상특점급이자적상관성.결과 주원2형당뇨병환자DR적총환병솔위33.0%(3045/9237),재미량백단백뇨、대량단백뇨급대량단백뇨합병신공능손해환자중,DR환병분별위36.3%(588/1618)、53.7%(1113/2074)화70.7%(1206/1706);DN환병솔위58.4%(5398/9237),여당뇨병미합병DR환자급경도비증생성당뇨병시망막병변(NPDR)비교,중도NPDR、중도NPDR급증생성당뇨병시망막병변(PDR)환자뇨미량백단백、총단백축점증가,기항청제솔축점강저(P＜0.05);비조건Logistic회귀분석발현여DR발병상관적위험인소포괄당뇨병병정、단백뇨、섬유단백원、C반응단백급주위신경병변,여DN발병상관적위험인소포괄당뇨병병정、당화혈홍단백、수축압、단백뇨、저밀도지단백화DR.결론 DR화DN시2형당뇨병환병솔교고적만성미혈관병발증,이자구유교호적림상상관성.
Objective To investigate the clinical characteristics of diabetic retinopathy(DR)and diabetic nephropathy(DN)and their correlation. Methods All of 9237 hospitalized type 2 diabetes patients from January 2004 to June 2009 were collected. The prevalence and clinical of characteristics of DR and DN as well as their relationship were analyzed. Results The total prevalence of DR was 33.0%(3045/9237),and the prevalence of DR in the microalbuminuria, macroproteinuria and macroalbuminuria combined with renal dysfunction patients were 36.3%(588/1618),53.7%(1113/2074)and 70.7%(1206/1706)respectively.The prevalence of DN was 58.4%(5398/9237). Compared with that in the diabetes patients without DR, the levels of microalbumin and total protein in the urine were higher in the patients with moderate non-proliferative diabetic retinopathy(NPDR), serious NPDR and proliferative diabetic retinopathy(PDR), but the endogenous creatinine clearance rate was lower(P＜ 0.05). According to the non-conditional Logistic regression model,the risk factors of DR included diabetes duration,urinary protein,fibrinogen, C-reactive protein and peripheral neuropathy, and the risk factors of DN included diabetes duration, HbA1c, systolic blood pressure,urinary protein,low density lipoprotein and DR. Conclusions DR and DN are the chronic microvascular complications in the type 2 diabetes and have higher prevalence. There are good correlations between DR and DN.