2型糖尿病住院患者2 454例视网膜病变的危险因素分析

Risk factors of diabetic retinopathy in type 2 diabetes mellitus inpatients: 2454 cases analysis

摘要:

目的 调查上海地区2型糖尿病住院患者糖尿病视网膜病变（DR）的患病率及其特点，并探讨影响DR的危险因素。方法 入选2型糖尿病住院患者共2454例，收集详细临床资料，并对其进行免散瞳眼底摄片以确定DR及其分级。应用趋势检验及logistic 逐步回归等方法分析DR患者分布特点及危险因素。结果 2型糖尿病住院患者DR的患病率为32.7%。随着年龄的增长、病程的延长及HbA1c水平的增高，DR患者比率逐渐增高（P＜0.05）。糖尿病病程（OR＝1.107，95% CI 1.089～1.125，P＜0.0001），HbA1c水平（OR＝1.071，95% CI 1.024～1.119，P＝0.0026），收缩压水平（OR＝1.016，95% CI 1.010～1.022，P＜0.0001）是2型糖尿病患者发生DR的独立危险因素，诊断年龄与DR发生风险也具有关联趋势（OR＝0.991，95% CI 0.981～1.000，P＝0.0556）。结论 住院患者DR患病率较高。病程长、血糖情况控制差及高血压是影响2型糖尿病住院患者发生DR的独立危险因素。

Abstract:

Objective To investigate the prevalence of diabetic retinopathy (DR) and its risk factors in type 2 diabetes mellitus (T2DM) inpatients of Shanghai region. Methods A total of 2454 T2DM inpatients were included. Clinical data were collected and the levels of DR were assessed with non-mydriatic retinal photographs according to the Diabetic Retinopathy Disease Severity Scale. The prevalence of DR and its risk factors were analyzed using trend analysis and logistic stepwise regression analysis. Results The prevalence of DR in T2DM inpatients was 32.7%. With the increment of age, diabetes duration and HbA1c levels, the prevalence of DR increased consequently (P＜0.05). The risk factors of retinopathy in T2DM patients included diabetes duration (OR＝1.107, 95% CI 1.089-1.125, P＜0.0001), glycated hemoglobin (OR＝1.071, 95% CI 1.024-1.119, P＝0.0026) and systolic blood pressure levels (OR＝1.016, 95% CI 1.010-1.022, P＜0.0001). The age of T2MD onset was also associated with DR(OR＝0.991, 95% CI＝0.981～1.000, P＝0.0556). Conclusions The prevalence of DR is relatively high in T2DM inpatients. Duration of T2DM, status of glycemic control and hypertension are independent risk factors for T2DM patients.