某区2型糖尿病视网膜病变不同分期与踝肱指数ABI的关系

目的观察2型糖尿病患者视网膜微血管病变不同分期与踝肱指数ABI之间的相互关系。方法收集我院内分泌科2010年6月至2012年9月经确诊的203例2型糖尿病住院患者,经踝肱比值(ABI)测定,将其分为ABI正常组(1.01.3),观察糖尿病视网膜病变(DR)不同分期情况下与ABI之间的关系。结果 ABI异常组的2型糖尿病患者中,DR检出率为94.1%,约是正常组的1.6倍,两者比较差异有显著性(P=0.000);单因素Logistic回归分析显示,DR I期(P=0.01,OR=0.04,95%CI:0.00～0.38);DR II期(P=0.22,OR=0.28,95%CI:0.04～2.18);DR III期(P=0.91,OR=0.89,95%CI:0.11～6.93)。结论 DR I期对ABI来说,是其微弱的保护因素(95%CI<1),DR II-III期与ABI之间无统计学差异(P值>0.05),即DR II、III期不是ABI的危险因素(尽管III期时95%CI>1)。尽管本实验,未能发现2型糖尿病视网膜病变不同分期与ABI之间有直接线性关系,但在2TDM患者中DR的检出率仍偏高,建议行ABI检测的糖尿病患者,尽早行眼底病变筛查,这对预防糖尿病大血管及微血管并发症均有重要意义。

The Relationship Between Different Stages of Diabetic Retinopathy with Type 2 Diabetes Mellitus and Ankle Brachial Index A Region

Objective To observe the relationship between T2DM with diabetic retinopathy （DR） at the different stages and the ankle-brachial index （ABI） . Methods To Collect 203 cases which had diagnosed T2DM patients from June 2010 to September 2012 at department of Endocrinology in our hospital, divided into normal ABI group （ 1.0 〈 AB] 〈 1.3 ） which was measured by ABI and abnormal ABI group ABI 〈 1.0 or ABI 〉 1.3 ） , and to observe the relationship between each other .Results In AB1 abnormal group of patients with type 2 diabetes, the detection rate of diabetic retinopathy was 94.1% ,which about 1.6 times more than the normal group. And the difference had a statistically significant （P=0.000） ; the Univariate Logistic regression analysis showed that DR I （P=0.01, OR=0.04, 95% CI： 0.00--0.38） ; DR II （P=0.22, OR=0.28, 95% CI： 0.04~2.18） ; DR III （P=0.91, OR = 0.89, 95% CI： 0.11- 6.93 ） . Conclusion For the ABI,DR I was a weak protection factors （ 95% CI 〈 1 ） ;there was no statistically significant difference between the DR II, III with the ABI （P 〉 0.05 ） . Namely, DR II, II] did not the the risk factors to ABI （although DR III, 95 % CI 〉 1 ） . Although the experiment failed to find a direct linear relationship between T2DM with DR at the different stages and the ABI, DR＇s detection rate is still high in T2DM patients, Therefore, we proposed that retinopathy screening as early as possible in the ABI detection of diabetes patients,which has a great significance for the prevention of macrovascular and microvascular complications.