CAJ | 학술논문

目的调查分析上海市淞南社区糖尿病(DM)居民中糖尿病视网膜病变(DR)患病率及其影响因素.方法根据社区DM管理档案数据库,整群抽样法随机抽取DM患者1177例进行问卷调查、常规全身检查、视力及免散瞳眼底数码照相检查.剔除无效问卷,提供有效问卷并配合完成免散瞳眼底数码照相检查的1120例DM患者纳入最终统计分析.DR诊断及分型参照2002年国际DR分型标准;单眼或双眼发现DR者均作为1例纳入DR患病率统计;双眼DR以程度较重者进行DR分级.按有、无DR (NDR)分组进行统计分析.因增生型DR(PDR)患者较少,在进行两组间年龄、DM病程、空腹血糖、使用胰岛素比率比较时,将非增生型重度DR与PDR统一作为重度DR进行统计学分析.采用x2检验统计分析与患病率相关的影响因素;通过logistic回归分析,筛选DR的影响因素.结果 1120例DM患者中,检出DR者264例(DR组),DR患病率为23.57％;NDR 856例(NDR组),占76.43％.DR组与NDR组患者年龄、DM病程、收缩压、空腹血糖、使用胰岛素比率比较,差异有统计学意义(t=-2.647、2.688、2.204、2.291,x2 =12.527;P=0.008、0.007、0.028、0.022、0.000).DR组中,轻、中、重度非增生型DR和PDR患病率分别为17.05％、5.09％、1.16％、0.27％.轻、中、重度DR患者间,空腹血糖水平和使用胰岛素比率比较,差异有统计学意义(t=21.964,x2=14.996;P=0.000、0.001).Logistic回归分析结果显示,年龄、DM病程、使用胰岛素是DR的影响因素(比值比=0.769、1.239、1.682,P=0.001、0.043、0.005).结论上海淞南社区DM居民中DR患病率为23.57％;DR发生与年龄、DM病程、使用胰岛素有关.
목적 조사분석상해시송남사구당뇨병(DM)거민중당뇨병시망막병변(DR)환병솔급기영향인소.방법 근거사구DM관리당안수거고,정군추양법수궤추취DM환자1177례진행문권조사、상규전신검사、시력급면산동안저수마조상검사.척제무효문권,제공유효문권병배합완성면산동안저수마조상검사적1120례DM환자납입최종통계분석.DR진단급분형삼조2002년국제DR분형표준;단안혹쌍안발현DR자균작위1례납입DR환병솔통계;쌍안DR이정도교중자진행DR분급.안유、무DR (NDR)분조진행통계분석.인증생형DR(PDR)환자교소,재진행량조간년령、DM병정、공복혈당、사용이도소비솔비교시,장비증생형중도DR여PDR통일작위중도DR진행통계학분석.채용x2검험통계분석여환병솔상관적영향인소;통과logistic회귀분석,사선DR적영향인소.결과 1120례DM환자중,검출DR자264례(DR조),DR환병솔위23.57％;NDR 856례(NDR조),점76.43％.DR조여NDR조환자년령、DM병정、수축압、공복혈당、사용이도소비솔비교,차이유통계학의의(t=-2.647、2.688、2.204、2.291,x2 =12.527;P=0.008、0.007、0.028、0.022、0.000).DR조중,경、중、중도비증생형DR화PDR환병솔분별위17.05％、5.09％、1.16％、0.27％.경、중、중도DR환자간,공복혈당수평화사용이도소비솔비교,차이유통계학의의(t=21.964,x2=14.996;P=0.000、0.001).Logistic회귀분석결과현시,년령、DM병정、사용이도소시DR적영향인소(비치비=0.769、1.239、1.682,P=0.001、0.043、0.005).결론 상해송남사구DM거민중DR환병솔위23.57％;DR발생여년령、DM병정、사용이도소유관.
Objective In order to provide guidance for early interference of diabetic retinopathy (DR) in patients with diabetes mellitus (DM),we surveyed the prevalence and analysis the related factors of DR in Shanghai Songnan community.Methods Based on an established resident health database,an epidemiology study was performed on the residents with DM in Shanghai Songnan community.1177 patients completed questionnaire survey,and received physical examination and laboratory tests.The diagnosis and grading of DR were established based on the ocular fundus images acquired by digital non-mydriasis fundus camera.Patients with incomplete questionnaires were excluded.Results There were 1120 DM patients with valid questionnaires.DR was found in 264 (23.57％) patients.The prevalence of mild,moderate,severe nonproliferative DR and proliferative DR was 17.05％,5.09％,1.16％ and 0.27％ respectively.There was significant differences in age,disease course,systolic blood pressure,insulin usage between the DR group and NDR group(t=-2.647,2.688,2.204,2.291;x2 =12.527;P=0.008,0.007,0.028,0.022,0.000).There was significant differences in fasting blood-glucose and insulin usage between the mild,the moderate and the severe DR group(t =21.964,x2 =14.996;P =0.000,0.001).Stepwise logistic analysis identified that age,DM course,and insulin usage were the related factors of DR (OR=0.769,1.239,1.100,1.071,1.682;P=0.001,0.043,0.176,0.097,0.005).Conclusion The age,DM course,and insulin usage were the related factors of DR.The high prevalence of DR indicated the importance of the management of diabetic patients.