糖尿病视网膜病变病程进展的多因素分析

目的探讨影响糖尿病视网膜病变（diabetic retinopathy，DR）病程进展的相关因素。设计病例观察研究。研究对象90例确诊为DR并未经眼部治疗的患者。方法经眼底荧光素血管造影术（FFA）检查并分型确诊为DR患者90例，记录病史、眼部检查、全身合并症。主要指标DR类型与发病年龄、性别、病程、体重指数（BMI）、眼压、屈光度、玻璃体后脱离、血压、血糖、糖化血红蛋白、肌酐、尿素氮、及全身合并症的相关性。结果DR患者在不同的病程阶段空腹血糖、糖化血红蛋白、尿素氮、周围神经病变，是否胰岛素治疗和有无口服降糖药6个因素有显著性差异。在logistic回归检验中，糖化血红蛋白、尿素氮和周围神经病变三个因素被认为是与DR病程进展相关的三个危险因素。结论对于DR患者应注意对其糖化血红蛋白和尿素氮指标的检测。对于合并周围神经病变的患者，应采取更积极的治疗手段。

Multiple factors analysis on progression of diabetic retinopathy

Objective To investigate the risk factors of diabetic retinopathy(DR) progression.Design Observational case series.Participants 90 patients diagnosed as DR without been treated.Methods Patients were performed by FFA,diagnosed as DR and graded.Ophthalmic examinations,system complications and medical histories were recorded.Main Outcome Measures Correlation between DR and some factors such as episode age,sex,progress,body mass index(BMI),intraocular pressures,refractive diopter,posterior vitreous detachment (PVD),blood pressure,blood glucose,GHb,Cr,BUN,system complications.Results In the different progress stage,six factors had statistically significant relationship with DR.The factors included blood glucose,GHb,BUN,peripheral neuropathy,treated with insulin,oral drugs to control blood glucose or not.In the logistic analysis,peripheral neuropathy,GHb and BUN were confirmed as risk factors associated with DR progression.Conclusions Peripheral neuropathy,GHb and BUN are risk factors associated with DR progression.More monitoring for GHb and BUN should be done for DR patient.More positive treatment is necessary for DR patients combined with peripheral neuropathy.