初诊2型糖尿病患者血糖代谢指标与视网膜病变的相关性分析
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摘要
目的探讨初诊2型糖尿病(T2DM)患者血糖代谢指标与视网膜病变(DR)的相关性。方法纳入180例初诊T2DM患者,检测空腹血糖(FPG)、餐后2 h血糖(2hPG)和糖化血红蛋白(HbA1c),依据免散瞳眼底照相检查结果将患者分为视网膜病变组(DR组)和未发现视网膜病变组(非DR组),再将DR组分为增殖期DR组和非增殖期DR组。比较DR组和非DR组之间,以及增殖期DR组和非增殖期DR组之间临床资料、FPG、2hPG和HbA1c水平的差异。结果 DR检出率为17. 78%(32/180)。DR组和非DR组之间,以及增殖期DR组和非增殖期DR组之间性别、年龄比较,差异均无统计学意义(P> 0. 05)。DR组FPG、2hPG和Hb A1c水平均显著高于非DR组(P <0. 01)。增殖期DR组Hb A1c水平显著高于非增殖期DR组(P <0. 05),但两组FPG和2hPG水平差异无统计学意义(P> 0. 05)。结论初诊T2DM患者中可能存在不同程度的DR者,对于FPG、2hPG水平较高,尤其是Hb A1c> 9%者应当同时进行DR的早期筛查。
Objective To probe into the the correlation between blood glucose metabolism and retinopathy( DR) in patients with newly diagnosed type 2 diabetes mellitus( T2DM). Methods 180 cases of newly diagnosed T2DM patients were included,and the fasting blood glucose( FPG),postprandial 2H blood glucose( 2hPG) and glycosylated hemoglobin( HbA1c) were detected. And according to the results of fundus photography,the patients were divided into two groups: retinopathy group( DR group) and non-DR group( non-DR group),and then the DR group were divided into proliferative phase DR group and non proliferative DR group. Then,the DR group and non DR group were compared,and the difference of clinical data,FPG,2hPG and HbA1c between proliferative DR group and non proliferative DR group were compared. Results The detection rate of DR was 17. 78%( 32/180). There were no significant differences in gender and age between DR and non-DR groups,and between proliferative DR and non-proliferative DR groups( P > 0. 05). The levels of FPG,2hPG and HbA1c in group DR were significantly higher than those in non DR group( P < 0. 01). The HbA1c level in proliferative DR group was significantly higher than that in non-proliferative DR group( P < 0. 05),but there was no significant difference in FPG and 2hPG levels between the two groups( P > 0. 05). Conclusion The patients with newly diagnosed T2DM may have different degrees of DR,and for FPG and 2hPG levels,especially HbA1c > 9%,DR should be screened at the same time.
Objective To probe into the the correlation between blood glucose metabolism and retinopathy( DR) in patients with newly diagnosed type 2 diabetes mellitus( T2DM). Methods 180 cases of newly diagnosed T2DM patients were included,and the fasting blood glucose( FPG),postprandial 2H blood glucose( 2hPG) and glycosylated hemoglobin( HbA1c) were detected. And according to the results of fundus photography,the patients were divided into two groups: retinopathy group( DR group) and non-DR group( non-DR group),and then the DR group were divided into proliferative phase DR group and non proliferative DR group. Then,the DR group and non DR group were compared,and the difference of clinical data,FPG,2hPG and HbA1c between proliferative DR group and non proliferative DR group were compared. Results The detection rate of DR was 17. 78%( 32/180). There were no significant differences in gender and age between DR and non-DR groups,and between proliferative DR and non-proliferative DR groups( P > 0. 05). The levels of FPG,2hPG and HbA1c in group DR were significantly higher than those in non DR group( P < 0. 01). The HbA1c level in proliferative DR group was significantly higher than that in non-proliferative DR group( P < 0. 05),but there was no significant difference in FPG and 2hPG levels between the two groups( P > 0. 05). Conclusion The patients with newly diagnosed T2DM may have different degrees of DR,and for FPG and 2hPG levels,especially HbA1c > 9%,DR should be screened at the same time.
引文
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[8]杨敏,罗向霞,康莉,等.磷脂酰肌醇3-激酶/蛋白激酶B信号通路在糖尿病视网膜病变与动脉粥样硬化发病机制中的作用[J].中华糖尿病杂志,2018,10(5):373-376.
[9]温良,孙笑,王凤华,等.抚顺城市社区糖尿病患者糖尿病视网膜病变诊断和治疗现况调查[J].中华眼科杂志,2018,54(8):599-604.
[10]沈旻倩,杨华,袁源智,等.上海市嘉定区社区2型糖尿病患者糖尿病视网膜病变的流行病学调查[J].中国临床医学,2017,24(5):723-727.
[11]黄黎黎,宋愈,喻建锋,等.南通市区患者初诊糖尿病视网膜病变严重程度的相关因素分析[J].临床眼科杂志,2016,24(1):21-23.
[12]樊艳婷,张志芳,高青,等.新诊断2型糖尿病患者视网膜病变与维生素D水平的关系及其危险因素[J].中国医药,2018,13(1):77-80.
[13]银孟卓,卢建文,黄春苓.2型糖尿病并视网膜病变患者血浆趋化素水平与骨密度的关系[J].广州医药,2017,48(3):29-33.
[2]TAO,TAO,PEIHONG,WU,YUYING,WANG,et al.Comparison of glycemic control andβ-cell function in new onset T2DMpatients with PCOS of metformin and saxagliptin monotherapy or combination treatment[J].BMC endocrine disorders,2018,18(1):14.
[3]殷晓雯,邵珺,邹健,等.糖尿病视网膜病变患者血浆miR-1470表达变化及可能机制探讨[J].中华眼底病杂志,2018,34(4):348-351.
[4]中华医学会糖尿病学分会.中国2型糖尿病防治指南(2013年版)[J].中华糖尿病杂志,2014,6(7):447-498.
[5]中华医学会眼科学会眼底病学组.我国糖尿病视网膜病变临床诊疗指南(2014年)[J].中华眼科杂志,2014,50(11):851-865.
[6]ALIREZA,ESTEGHAMATI,ALIREZA,MOMENI,ALI,AB-DOLLAHI,et al.Serum fibroblast growth factor 21 concentrations in type 2 diabetic retinopathy patients[J].Annales d’endocrinologie,2016,77(5):586-592.
[7]陈丹丹,帅天姣,李娟,等.糖尿病视网膜病变微血管神经病变发病机制的研究进展[J].国际眼科杂志,2018,18(5):844-846.
[8]杨敏,罗向霞,康莉,等.磷脂酰肌醇3-激酶/蛋白激酶B信号通路在糖尿病视网膜病变与动脉粥样硬化发病机制中的作用[J].中华糖尿病杂志,2018,10(5):373-376.
[9]温良,孙笑,王凤华,等.抚顺城市社区糖尿病患者糖尿病视网膜病变诊断和治疗现况调查[J].中华眼科杂志,2018,54(8):599-604.
[10]沈旻倩,杨华,袁源智,等.上海市嘉定区社区2型糖尿病患者糖尿病视网膜病变的流行病学调查[J].中国临床医学,2017,24(5):723-727.
[11]黄黎黎,宋愈,喻建锋,等.南通市区患者初诊糖尿病视网膜病变严重程度的相关因素分析[J].临床眼科杂志,2016,24(1):21-23.
[12]樊艳婷,张志芳,高青,等.新诊断2型糖尿病患者视网膜病变与维生素D水平的关系及其危险因素[J].中国医药,2018,13(1):77-80.
[13]银孟卓,卢建文,黄春苓.2型糖尿病并视网膜病变患者血浆趋化素水平与骨密度的关系[J].广州医药,2017,48(3):29-33.