2型糖尿病强化治疗中视网膜变坏的危险因素分析

目的 探讨2型糖尿病患者强化治疗过程中视网膜变坏的相关危险因素.方法 对空腹血糖＞11.1 mmol/1或随机血糖＞13mmol/l的50例2型糖尿病患者进行强化治疗,强化治疗前和治疗后血糖达标进行眼科检查,糖尿病视网膜病变(diabetic retinopathyDR)程度采用Wisconsin scale分级,DR加重2级及以上定义为糖尿病视网膜病变变坏,分析比较视网膜变坏组和无视网膜变坏组相关临床指标.结果 强化治疗显示出快速稳定的降血糖效果.与无视网膜变坏组比较,视网膜变坏组糖尿病病程长,合并糖尿病肾病和糖尿病视网膜病变严重.多因素Logistic回归分析显示强化治疗前糖尿病视网膜病变与视网膜变坏的发生呈正相关.结论 强化治疗前存在糖尿病视网膜病变是强化治疗过程中发生视网膜变坏的独立危险因素,其严重程度与视网膜变坏呈正相关.

Risk factors for the worsening of diabetic retinopathy during the intensive treatment in type 2 diabetes mellitus

Objective To evaluate the risk factors that lead to worsening of retinopathy in subjects with type 2 diabetes mellitus during the period of intensive treatment.Methods Diabetic retinopathy(DR)patient score of DR by two or more levels was considered to be worsening of retinopathy.Related risk factors were analyzed in 39 without worsening of retinopathy and in 9 worsening of retinopathy.Results After intensive treatment,desired glycemic control was achieved in almost all participated diabetic individuals except two patients.The incidence of worsening of retinopathy was higher in patients who had mild or moderate NPDR,higher AER and a longer duration of diabetes.Multivariate regression analysis showed DR at baseline was independent risk factor for worsening of retinopathy in type 2 diabetes.Conclusions DR at baseline was only independent risk factor for worsening of retinopathy.