南昌市社区糖尿病视网膜病变患病率及危险因素分析

目的　调查南昌市部分社区４０岁及以上人群中２型糖尿病患者糖尿病视网膜病变（ｄｉａｂｅｔｉｃｒｅｔｉｎｏｐａｔｈｙ，ＤＲ）的患病率和相关危险因素。方法　采用分层整群随机抽样的方法对４０岁及以上人群进行问卷调查，并进行身体质量指数、血压、血脂、２４ｈ尿蛋白等检测，同时行眼科相关检查:视力、裂隙灯、验光、眼压、直接眼底镜、眼底照相及荧光眼底血管造影，分析ＤＲ相关危险因素。结果　有９７７６名调查对象接受检查，受检率９７．７６％，８３１例确诊为２型糖尿病，其中有７８０人接受了眼科检查，除５０例屈光介质混浊较重无法看清眼底者外，７３０例患者中确诊ＤＲ者２２３例，占糖尿病患者的３０．５％，其中背景型ＤＲ患者２１１例，占糖尿病患者的２８．９％，增殖型ＤＲ患者１２例，占糖尿病患者的１．６％。多因素分析显示糖尿病病程长、高血糖、高血压、高血脂、高２４ｈ尿微量蛋白是ＤＲ的显著危险因素，而年龄、性别等与ＤＲ发病相关性不大。结论　南昌市社区４０岁及以上人群２型糖尿病患者中ＤＲ的患病率较高，糖尿病病程长、高血压、高血糖、高血脂、高２４ｈ尿微量蛋白是ＤＲ发生的危险因素。

Prevalence and risk factors of Nanchang communi diabetic retinopathy

Objective To observe the prevalence and risk factors of patients with type 2 diabetes mellitus diabetic retinopathy( DR) aged 40 - 86 years old in part of the community of Nanchang city. Methods The stratified random sampling questionnaire survey was performed in DR people aged 40 years old or above. The body mass index , blood pressure , blood lipid , 24 hours urinary small protein examination were measured , and the far and near visual. slit lamp , comprehensive optometry ,intraocular pressure . direct ophthalmoscope , eyeground photography , fluorescence fundus angiography were taken or detected. And the related risk factors of DR were analyzed. Results A total of 9776 residents underwent the exanunation with a participating rate of 97. 6% . 831 residents were diagnosed as diabetes , and 780 diabetes accepted inspection of ophthalmology ,in which 50 cases were unable to record the fundus condition due to opaque refractive media. Among the rest 730 diabetic patients ,223 cases ( 30. 5% ) were DR patients. There were 211 cases with background DR(28. g% ) and 12 cases with proliferative diabetic retinopathy( 1. 6% ) . Multivariable analysis showed that the course of diabetes, hypertension, high blood glucose , hyperlipemia and increase of 24 hours urinary small protein were the risk factors for DR , while the age , sex , and family history was not related to DR. Conclusion The prevalence of DR in Nanchang community population aged；40 years old with type 2 diabetes mellitus is high , the course of diabetes, hypertension, high blood glucose , hyperlipemia and increase of 24 hours urinary small protein are the risk factors for DR.