CAJ | 학술논문

目的了解黑龙江省双城市农村50岁以上人群中糖尿病视网膜病变(DR)的患病和防治情况.方法采用整群随机抽样法,有5053名调查对象进行检测和问卷调查.采用SPSS13.0软件进行X2和Fisher确切概率法检验.结果 5053名调查对象接受检查,受检率为91.8%.诊断DR有56例(112眼),患病率为1.108%(95%CI:0.819%～1.397%).其中非增生性49例(87.50%),增生性7例(12.50%);玻璃体积血7眼(6.25%),黄斑水肿9眼(8.04%).DR患病率的性别差异无统计学意义(P＞0.05),按每10岁分组,以60～69岁年龄组患病率显著增高(P=0.045).56例DR的112眼中,低视力34眼(30.4%),盲6眼(5.4%).空腹血糖＞11.1 mmol/L和增生性DR患者其低视力和盲的比例高于空腹血糖＜11.1 mmol/L和非增生性DR患者(P=0.000);空腹血糖＞11.1 mmol/L和病程＞5年的患者,患增生性DR的比例高于空腹血糖＜11.1 mmol/L和短病程者(P=0.015,0.006).56例有38例(67.9%)未经任何治疗,在药物治疗者中应用胰岛素或坚持规律用药者仅8例(14.3%),而针对DR的治疗者仅1例(1.8%).调查问卷表明,DR患者对该病防治知识了解状况较差.结论病程长、高血糖是影响DR患者视力及眼底病变程度的重要危险因素,农村人群对DR防治知识匮乏.
목적 료해흑룡강성쌍성시농촌50세이상인군중당뇨병시망막병변(DR)적환병화방치정황.방법 채용정군수궤추양법,유5053명조사대상진행검측화문권조사.채용SPSS13.0연건진행X2화Fisher학절개솔법검험.결과 5053명조사대상접수검사,수검솔위91.8%.진단DR유56례(112안),환병솔위1.108%(95%CI:0.819%～1.397%).기중비증생성49례(87.50%),증생성7례(12.50%);파리체적혈7안(6.25%),황반수종9안(8.04%).DR환병솔적성별차이무통계학의의(P＞0.05),안매10세분조,이60～69세년령조환병솔현저증고(P=0.045).56례DR적112안중,저시력34안(30.4%),맹6안(5.4%).공복혈당＞11.1 mmol/L화증생성DR환자기저시력화맹적비례고우공복혈당＜11.1 mmol/L화비증생성DR환자(P=0.000);공복혈당＞11.1 mmol/L화병정＞5년적환자,환증생성DR적비례고우공복혈당＜11.1 mmol/L화단병정자(P=0.015,0.006).56례유38례(67.9%)미경임하치료,재약물치료자중응용이도소혹견지규률용약자부8례(14.3%),이침대DR적치료자부1례(1.8%).조사문권표명,DR환자대해병방치지식료해상황교차.결론 병정장、고혈당시영향DR환자시력급안저병변정도적중요위험인소,농촌인군대DR방치지식궤핍.
Objective The purpose of this study was to understand the awareness, prevalence of diabetic retinopathy and treatment status of people aged over 50 and living in the rural areas of Shuangcheng city, Heilongjiang province, China. Methods Cluster sampling was used in randomly selected 5504 survey for ophthalmic clinical examination, in patients with diabetic retinopathy. A questionnaire in the state of knowledge about prevention and treatment was developed. Results Among the 5504 persons entering in the project, 5053 were examined on their eyes (91.8%). In this selected population, 56 persons (112 eyes) were diagnosed as diabetic retinopathy (1.108%), with 95% confidence interval (CI) as: 0.819% to 1.397%. Of 56 patients, 49 cases were non-proliferative diabetic retinopathy, accounting for 87.50% of the total number of patients with diabetic retinopathy;proliferative diabetic retinopathy 7 cases, accounting for 12.50% of the 112 eyes, 6.25% (7/112)having vitreous hemorrhage, 8.04% (9/112) having macular edema. For diabetic retinopathy prevalence rates, there was no significant difference in males and females. Between the per differential 10-year-old division, the difference was significant. Among the 60 to 69 group, a significantly higher prevalence rate was seen. Of the 112 eyes with diabetic retinopathy, 34 eyes(30.4%) were low vision [visual acuity ＜20/60 (0.3) to ≥ 20/400 (0.05) ]; 6 eyes (5.4%) were blind [visual acuity ＜20/400 (0.05) to NLP]. The rate in the patients with PDR and fasting blood glucose was above 11.1 mmol/L was higher than having NPDR and fasting blood glucose below 11.1 mmol/L. Having fasting blood glucose 11.1 mmol/L and above with the course over five years among patients with PDR, the proportion of fasting blood glucose was higher than those with less than 11.1 mmol/L and diabetic retinopathy duration of less than five years. Of 56 patients with diabetic retinopathy, 38 cases (67.9%) did not receive any treatment. Among 18 cases (32.1%) with insulin or oral drug therapy,regularly using insulin or other medication (14.3%), only 1 (1.8%) case was given the treatment for diabetic retinopathy. Results from our survey showed that patients with diabetic retinopathy had a poor understanding about prevention and treatment of the disease. Conclusion Long duration and high blood glucose in patients with diabetic retinopathy seemed to be the important risk factor. Early systematic drug use for prevention and blood glucose control was the key to prevent diabetic retinopathy. Patients with diabetic retinopathy in China had poor understanding about the prevention measures of the disease and lack of knowledge.