唐山地区糖尿病患者糖尿病性黄斑水肿和视网膜病变患病率及其影响因素分析
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摘要
目的:分析河北省唐山地区糖尿病患者糖尿病视网膜病变(DR)和糖尿病黄斑水肿(DME)的影响因素。方法:于2016年1—12月,按随机抽样方法对河北省唐山地区共1 764例糖尿病患者进行调查,分为DME组(324例)和DR组(264例),无DME和DR的一般糖尿病患者为对照组(1 176例)。收集患者的一般资料和心血管疾病史,对其进行血压、血糖以及眼科检查并进行诊断。采用单因素及多因素Logistic回归分析法分析DR和DME的危险因素。结果:DME的患病率为18.37%,DR的患病率为14.97%。单因素分析显示:体重指数(Ibm)、冠心病、心绞痛、心肌梗死、脑梗死、高脂血症、高血压病及吸烟史是DME患病的相关因素(P<0.05);多因素Logistic回归分析结果显示:冠心病、心绞痛、心肌梗死、脑梗死、高脂血症、高血压病和吸烟史是DME的独立危险因素(P<0.05)。单因素分析显示:Ibm、心率、冠心病、心绞痛、心肌梗死、脑梗死、高脂血症及高血压病是DR患病的相关因素(P<0.05);多因素Logistic回归分析结果显示:Ibm、冠心病、心绞痛、心肌梗死、脑梗死、高脂血症和高血压病是DR的独立危险因素(P<0.05)。结论:糖尿病患者的冠心病、心绞痛、心肌梗死、脑梗死、高脂血症和高血压病是DR和DME的独立危险因素。
Objective:To investigate the prevalence and influencing factors of diabetic macular edema(DME)and diabetic retinopathy(DR)in diabetes mellitus patients in Tangshan District.Methods:From January2016 to December 2016,a total of 1 764 diabetes mellitus patients in Tangshan were selected and divide into DME group(n=324)and DR group(n=264),and 1 176 cases without DME and DR were defined as a control group.The clinical data were collected,and the risk factors for DR and DME were analyzed by univariate and multivariate logistic regression analysis.Results:The morbidity rates of DME and DR were18.37%and 14.97%,respectively.Body mass index,coronary heart disease,angina pectoris,myocardial infarction,cerebral infarction,cerebral hemorrhage,hyperlipemia and histories of hypertension and smoking were factors affecting DME(P<0.05).The multivariate logistic regression analysis showed that except for body mass index,the coronary heart disease,angina pectoris,myocardial infarction,cerebral infarction,cerebral hemorrhage,hyperlipemia and histories of hypertension and smoking were independent risk factors for DME(P<0.05).Body mass index,heart rate,coronary heart disease,angina pectoris,myocardial infarction,cerebral infarction,cerebral hemorrhage,hyperlipidemia and hypertension were related factors of DR(P<0.05).Multivariate logistic regression analysis showed that the body mass index,coronary heart disease,angina pectoris,myocardial infarction,cerebral infarction,cerebral hemorrhage,hyperlipidemia and hypertension were independent risk factors for DR(P<0.05).Conclusion:Coronary heart disease,angina pectoris,myocardial infarction,cerebral infarction,cerebral hemorrhage,hyperlipidemia and hypertension were independent risk factors for DR and DME in diabetic patients.
Objective:To investigate the prevalence and influencing factors of diabetic macular edema(DME)and diabetic retinopathy(DR)in diabetes mellitus patients in Tangshan District.Methods:From January2016 to December 2016,a total of 1 764 diabetes mellitus patients in Tangshan were selected and divide into DME group(n=324)and DR group(n=264),and 1 176 cases without DME and DR were defined as a control group.The clinical data were collected,and the risk factors for DR and DME were analyzed by univariate and multivariate logistic regression analysis.Results:The morbidity rates of DME and DR were18.37%and 14.97%,respectively.Body mass index,coronary heart disease,angina pectoris,myocardial infarction,cerebral infarction,cerebral hemorrhage,hyperlipemia and histories of hypertension and smoking were factors affecting DME(P<0.05).The multivariate logistic regression analysis showed that except for body mass index,the coronary heart disease,angina pectoris,myocardial infarction,cerebral infarction,cerebral hemorrhage,hyperlipemia and histories of hypertension and smoking were independent risk factors for DME(P<0.05).Body mass index,heart rate,coronary heart disease,angina pectoris,myocardial infarction,cerebral infarction,cerebral hemorrhage,hyperlipidemia and hypertension were related factors of DR(P<0.05).Multivariate logistic regression analysis showed that the body mass index,coronary heart disease,angina pectoris,myocardial infarction,cerebral infarction,cerebral hemorrhage,hyperlipidemia and hypertension were independent risk factors for DR(P<0.05).Conclusion:Coronary heart disease,angina pectoris,myocardial infarction,cerebral infarction,cerebral hemorrhage,hyperlipidemia and hypertension were independent risk factors for DR and DME in diabetic patients.
引文
[1]张志月,房辉,李玉凯,等.糖尿病视网膜病变患者血清脂氧素A4和血管内皮生长因子的相关性研究[J].中国现代医学杂志,2016,26(7):15-19.
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[9]廖丁莹,吕莎莎,郑玉萍,等.Ⅱ型糖尿病尿蛋白含量与黄斑区视网膜厚度的相关性研究[J].中国实用眼科杂志,2016,34(9):936-940.
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[11]金佩瑶,彭金娟,邹海东,等.上海市新泾社区2型糖尿病居民5年随访的前瞻性调查研究1.糖尿病视网膜病变和糖尿病黄斑水肿的发病率及危险因素[J].中华实验眼科杂志,2016,34(4):363-367.
[12]周莉,周正,韦晓丹,等.唐山地区糖尿病低视力患者的现状调查及相关危险因素研究[J].国际眼科杂志,2017(11):2167-2169.
[13]HAMMES H P,WELP R,KEMPE H P,et al.Risk factors for retinopathy and DME in type 2diabetes-results from the German/Austrian DPV Database[J].PLoS One,2015,10(7):e0132492.
[14]AL-SHUDIFAT A E,AZAB M,JOHANNESSEN A,et al.Elevated fasting blood glucose,but not obesity,is associated with coronary artery disease in patients undergoing elective coronary angiography in a referral hospital in Jordan[J].Ann Saudi Med,2018,38(2):111-117.
[15]STRAM D A,JIANG X,VARMA R,et al.Factors associated with prevalent diabetic retinopathy in Chinese Americans:The Chinese American Eye Study[J].Ophthalmol Retina,2018,2(2):96-105.
[16]唐晓娟,刘琼,于健,等.糖尿病性视网膜病变以及黄斑水肿和黄斑中心凹下脉络膜厚度的关系[J].实用医学杂志,2016,32(8):1302-1305.
[17]GALINA DIMITROVA,SATOSHI KATO.Association of systemic cardiovasculature status with retinal vascular endothelium in diabetes[J].Int Eye Sci,2017,17(1):21-25.
[18]赵梦雅.伴脂代谢紊乱的糖尿病视网膜病变研究进展[J].中华实验眼科杂志,2017,35(7):655-659.
[2]韩俊莹,成杰,冯玉如,等.糖尿病视网膜病变患者睡眠质量的影响因素分析[J].中国煤炭工业医学杂志,2015,18(12):1960-1963.
[3]金佩瑶,彭金娟,邹海东,等.上海市新泾社区2型糖尿病居民5年随访的前瞻性调查研究2.血糖稳定的患者中糖尿病视网膜病变进展的危险因素研究[J].中华实验眼科杂志,2016,34(8):750-755.
[4]周荣乐,汪晓瑜,雷晓琴.糖尿病性黄斑水肿的心血管危险因素研究[J].医学研究杂志,2016,45(4):62-65.
[5] WILKINSON C P,FERRIS F L,KLEIN R E,et al.Global Diabetic Retinopathy project Group.Proposed international clinical diabetic retinopathy and diabetic macular edema disease severity scales[J].Ophthalmology,2003,110(9):1677-1682.
[6]周荣乐,汪晓瑜,雷晓琴.胰岛素抵抗与糖尿病性黄斑水肿的相关性研究[J].中国医药导报,2015,12(34):75-77.
[7]杜颖红,郑海华.血小板平均体积与糖尿病性视网膜病变的相关性研究[J].浙江医学,2016,38(6):393-397.
[8]宋一帆,蔡宏媛,王新,等.糖尿病视网膜病变患者白内障超声乳化术后黄斑水肿的分析[J].眼科新进展,2016,36(7):658-661.
[9]廖丁莹,吕莎莎,郑玉萍,等.Ⅱ型糖尿病尿蛋白含量与黄斑区视网膜厚度的相关性研究[J].中国实用眼科杂志,2016,34(9):936-940.
[10]喻建锋,宋愈,朱妍,等.2型糖尿病患者干眼与糖尿病视网膜病变的相关分析[J].国际眼科杂志,2016,16(6):1187-1189.
[11]金佩瑶,彭金娟,邹海东,等.上海市新泾社区2型糖尿病居民5年随访的前瞻性调查研究1.糖尿病视网膜病变和糖尿病黄斑水肿的发病率及危险因素[J].中华实验眼科杂志,2016,34(4):363-367.
[12]周莉,周正,韦晓丹,等.唐山地区糖尿病低视力患者的现状调查及相关危险因素研究[J].国际眼科杂志,2017(11):2167-2169.
[13]HAMMES H P,WELP R,KEMPE H P,et al.Risk factors for retinopathy and DME in type 2diabetes-results from the German/Austrian DPV Database[J].PLoS One,2015,10(7):e0132492.
[14]AL-SHUDIFAT A E,AZAB M,JOHANNESSEN A,et al.Elevated fasting blood glucose,but not obesity,is associated with coronary artery disease in patients undergoing elective coronary angiography in a referral hospital in Jordan[J].Ann Saudi Med,2018,38(2):111-117.
[15]STRAM D A,JIANG X,VARMA R,et al.Factors associated with prevalent diabetic retinopathy in Chinese Americans:The Chinese American Eye Study[J].Ophthalmol Retina,2018,2(2):96-105.
[16]唐晓娟,刘琼,于健,等.糖尿病性视网膜病变以及黄斑水肿和黄斑中心凹下脉络膜厚度的关系[J].实用医学杂志,2016,32(8):1302-1305.
[17]GALINA DIMITROVA,SATOSHI KATO.Association of systemic cardiovasculature status with retinal vascular endothelium in diabetes[J].Int Eye Sci,2017,17(1):21-25.
[18]赵梦雅.伴脂代谢紊乱的糖尿病视网膜病变研究进展[J].中华实验眼科杂志,2017,35(7):655-659.