标题：糖尿病视网膜病变的相关危险因素分析

      作者：郭学龙，陈晓霞，邓辉琳    (佛山市第五人民医院眼科，广东 佛山 528211)

      卷次： 2018年29卷17期

      【摘要】 目的 研究糖尿病视网膜病变的发病率及其危险因素。方法 回顾性分析2015年2月至2017年2月于佛山市第五人民医院眼科接受全面眼科检查的1 200例糖尿病患者的临床资料，分别比较不同糖尿病病程患者的视网膜病变发生情况，同时将糖尿病视网膜病变患者记为研究组，将糖尿病无视网膜病变患者记为对照组。比较两组患者的性别、年龄、空腹血糖、高血压病史、高血脂病史、胰岛素治疗史、口服药物治疗史以及最佳矫正视力等情况，并做多因素Logistics回归分析。结果 糖尿病病程<5年、5~15年、16~25年及>26年患者的视网膜病变发生率分别为21.09% (58/275)、32.93% (108/328)、49.42% (171/346)、61.75% (155/251)，呈逐渐上升趋势，且各组间比较差异均有统计学意义(P<0.05)；研究组患者的空腹血糖、胰岛素治疗史人数占比分别为(8.74±1.12) mmol/L、84.15% (414/492)，均明显高于对照组的(5.29±0.91) mmol/L、19.49% (138/708)，而口服药物治疗史人数占比为13.82% (68/492)，明显低于对照组的78.67% (557/708)，组间比较差异均有统计学意义(P<0.05)；经多因素Logistic回归分析结果显示，影响糖尿病视网膜病变的危险因素包括糖尿病病程、空腹血糖、胰岛素治疗史(OR=1.785，P=0.000；OR=1.474，P=0.003；OR=1.356，P=0.000)，而口服药物治疗为保护因素(OR=0.581，P=0.002)。结论 糖尿病患者具有一定的视网膜病变发生率，且糖尿病病程、空腹血糖、胰岛素治疗史均是糖尿病视网膜病变发生的危险因素，而口服药物治疗为保护因素。
      【关键词】 糖尿病；视网膜病变；危险因素；多因素Logistics回归分析；病程
      【中图分类号】 R587.2 【文献标识码】 A 【文章编号】 1003—6350（2018）17—2394—03

Analysis of risk factors associated with diabetic retinopathy.
GUO Xue-long, CHEN Xiao-xia, DENG Hui-lin.Department of Ophthalmology, the Fifth People's Hospital of Foshan City, Foshan 528211, Guangdong, CHINA
【Abstract】 Objective To explore the incidence and risk factors of diabetic retinopathy. Methods A retrospec-tive analysis was conducted on the clinical data of 1 200 diabetic patients who underwent comprehensive ophthalmolog-ic examination in the Department of Ophthalmology in the Fifth People's Hospital of Foshan city from February 2015 toFebruary 2017. The occurrence of retinopathy in patients with different diabetes courses was compared. The patientswith diabetic retinopathy were recorded as the research group, and the diabetic patients without retinopathy were record-ed as the control group. The gender, age, fasting blood glucose, history of hypertension, history of hyperlipidemia, histo-ry of insulin treatment, history of oral medication, and the best corrected visual acuity were compared between the twogroups. Multivariate logistic regression analysis was then conducted. Results The incidence of retinopathy in patientswith diabetes mellitus<5 years, 5-15 years, 16-25 years, and >26 years, respectively, was 21.09% (58/275), 32.93%(108/328), 49.42% (171/346), and 61.75% (155/251), showing a gradual upward trend, and the differences between thegroups were statistically significant (P<0.05). The proportion of fasting blood glucose and insulin treatment in the re-search group was (8.74±1.12) mmol/L and 84.15% (414/492), respectively, which was significantly higher than (5.29±0.91) mmol/L and 19.49% (138/708) for the control group, respectively; while the proportion of oral medication historywas 13.82% (68/492), significantly lower than 78.67% (557/708) for the control group; the differences between thegroups were statistically significant (P<0.05). Multivariate logistic regression analysis showed that the risk factors affect-ing diabetic retinopathy included diabetes course, fasting blood glucose, and insulin treatment history (OR=1.785, P=0.000; OR=1.474, P=0.003; OR=1.356, P=0.000; respectively), while oral medication was a protective factor (OR=0.581,P=0.002). Conclusion Diabetes patients have a certain incidence of retinopathy. Diabetes course, fasting blood glucose,insulin treatment history are risk factors for diabetic retinopathy, while oral medication is a protect factor.
      【Key words】 Diabetes; Retinopathy; Risk factor; Multivariate logistic regression analysis; Course·论 著·doi:10.3969/j.issn.1003-6350.2018.17.008基金项目：广东省佛山市自筹经费类科技计划项目(编号：2017AB000732)