CAJ | 학술논문

目的对比分析不同病程2型糖尿病(DM)并发严重增殖型糖尿病视网膜病变(PDR)的全身危险因素及眼部生物学结构.方法临床病例对照研究.回顾性分析2010年3月至2014年5月在天津市眼科医院就诊的186例严重PDR患者住院资料,按DM病程分为两组,A组:DM病程＜10年,B组:DM病程≥10年,采用t检验、x2检验统计学方法分析两组患者全身资料、实验室检查结果之间的差异;同时以100例无明显DR的2型DM患者(C组)的临床资料进行对比,采用单因素方差分析PDR患者眼轴、前房深度、晶状体厚度的变化.将P＜0.05的指标纳入多因素Logistic回归分析.结果 186例PDR患者中,男性96例(51.6％),女性90例(48.4％);A组61例(32.8％),B组125例(67.2％),两组患者全身因素比较年龄、DM发病年龄、空腹血糖、餐后2h血糖、血糖波动值、胰岛素使用差异有统计学意义(P＜0.05);A组患者收缩压、舒张压均较B组患者偏高,但差异均无统计学意义(P＞0.05).眼部各变量因素分析显示,A组、B组患者与C组患者眼轴长度,前房深度,晶状体厚度差异均有统计学意义(F =41.797,7.449,19.271,P＜0.05).PDR患者组间比较,A组患者眼轴明显短于B组患者眼轴,差异有统计学意义(P＜0.05).多因素Logistic回归分析显示DM发病年龄、短眼轴是10年内2型DM患者并发严重PDR的独立危险因素(OR =0.366,2.909,P＜0.05).结论不同病程2型DM患者并发严重PDR的DM发病年龄和眼轴存在差异,DM发病年龄晚、眼轴较短是2型DM患者10年内并发严重PDR中的独立危险因素.
목적 대비분석불동병정2형당뇨병(DM)병발엄중증식형당뇨병시망막병변(PDR)적전신위험인소급안부생물학결구.방법 림상병례대조연구.회고성분석2010년3월지2014년5월재천진시안과의원취진적186례엄중PDR환자주원자료,안DM병정분위량조,A조:DM병정＜10년,B조:DM병정≥10년,채용t검험、x2검험통계학방법분석량조환자전신자료、실험실검사결과지간적차이;동시이100례무명현DR적2형DM환자(C조)적림상자료진행대비,채용단인소방차분석PDR환자안축、전방심도、정상체후도적변화.장P＜0.05적지표납입다인소Logistic회귀분석.결과 186례PDR환자중,남성96례(51.6％),녀성90례(48.4％);A조61례(32.8％),B조125례(67.2％),량조환자전신인소비교년령、DM발병년령、공복혈당、찬후2h혈당、혈당파동치、이도소사용차이유통계학의의(P＜0.05);A조환자수축압、서장압균교B조환자편고,단차이균무통계학의의(P＞0.05).안부각변량인소분석현시,A조、B조환자여C조환자안축장도,전방심도,정상체후도차이균유통계학의의(F =41.797,7.449,19.271,P＜0.05).PDR환자조간비교,A조환자안축명현단우B조환자안축,차이유통계학의의(P＜0.05).다인소Logistic회귀분석현시DM발병년령、단안축시10년내2형DM환자병발엄중PDR적독립위험인소(OR =0.366,2.909,P＜0.05).결론 불동병정2형DM환자병발엄중PDR적DM발병년령화안축존재차이,DM발병년령만、안축교단시2형DM환자10년내병발엄중PDR중적독립위험인소.
Objective To investigate the different risk factors and biological ocular structures between the diabetes duration less than 10 years and more than 10 years in type 2 diabetes with severe proliferative diabetic retinopathy (PDR).Methods The clinical data of 186 severe PDR patients were analyzed retrospectively.Systemic condition,results of laboratory examination,fundus examination and the characteristics of ocular biometry structures that collected from group A (61 type 2 diabetic patients with diabetes less than 10 years) and group B (125 type 2 diabetic patients with diabetes more than 10 years) were comparatively analyzed.Ocular biometry,including axial length (AL),anterior chamber depth (ACD) and lens thickness (LT) were comparatively analyzed among group A,group B and group C (100 type 2 diabetic patients without DR).Factors with P＜0.05 were included in multivariate logistic regression models.Results In the systemic factors,there were significant differences of the diagnosis age,use of insulin,fasting plasma glucose and postprandial blood glucose between group A and group B (P ＜0.05).In the ocular factors,there were significant differences of AL,ACD and LT between the severe PDR and control groups (P ＜0.05).Type 2 diabetic patients occurred severe PDR with diabetes duration less than 10 years attended to have a shorter AL than diabetes duration more than 10 years,the differences was significant (P ＜0.05).Multivariate Logistic regression analysis showed the diagnosis age and axial length were independent risk factors (OR=0.366,2.909,P ＜0.05).Conclusions There are differences risk factors between the diabetes duration less than 10 years and more than 10 years in type 2 diabetes with severe PDR.The diagnosis age and axial length play an important role in type 2 diabetes with severe PDR less than 10 years since diagnosis.