山东省农村人群糖尿病视网膜病变的流行病学调查

目的　调查山东省8个地区农村自然人群中糖尿病视网膜病变(DR)患病率及DR危险因素。方法　采用多阶段分层次整群随机抽样方法，参照1999年WHO推荐的糖尿病诊断标准，对济南、莱芜、德州、泰安、临沂、潍坊、东营、淄博8个地区的25岁以上农村人群共16 330人进行了糖尿病的筛查。对确诊为糖尿病的707例患者进行DR问卷调查、空腹血糖、尿蛋白以及视力、裂隙灯显微镜、直接检眼镜检查，DR的筛查诊断标准参照2002年国际分级标准。采用统计软件SPSS 11.5 对观察数据进行统计学分析。结果　16 330人中，糖尿病患者707例，占4.33%；DR患者181例，占糖尿病患者总数的26.30%，占所有受检者的1.11%。多因素分析结果显示，肾脏并发症、高血压、高血糖是DR发病的危险因素；其余年龄、性别、家族史等因素与DR发病相关性不大。结论　山东省农村人群中DR患病率较高，肾损害、高血压、高血糖是DR的危险因素。

Epidemiology study on the prevalence rate and risk factors of diabetic retinopathy in rural residents in Shandong Province

Objective To estimate the prevalence rate and risk factors of diabetic retinopathy (DR) in rural residents in Shandong. Methods A total of 16 330 residents in 8 counties in Shandong province underwent the screening of diabetes by multi-stage randomized cluster-sampling; while the standard of diagnosis of diabetes was in accordance with the WHO standard (1990). Diabetes was diagnosed in 707 residents who then underwent questionnaire survey and examinations of fasting blood-glucose, urine protein, visual acuity, slit-lamp microscope, and direct opthalmoscope. The standard of DR screening was drawn according to the international DR classification (2002). The data were statistically analyzed with SPSS 11.5 software. Results In 16 330 residents, 707 were with diabetes (4. 33%), 26.30% of them (181 cases) had DR (1.11% of all the residents). Multivariable analysis showed that kidney damage, hypertension and high blood glucose were the risk factors for DR; while the age, sex, and family history were not related much to DR. Conclusion The prevalence rate of DR in rural residents of Shandong is high. Kidney involvement, hypertension and high blood glucose are the risk factors of DR.