糖尿病患者视网膜病变的筛查分析

目的 了解糖尿病(diabetes mellitus,DM)住院患者中糖尿病视网膜病变(diabetic retinopathy,DR)的发生情况,并探讨其相关危险因素.方法 回顾性临床调查研究.对2007年9月至2010年7月期间,在广西医科大学第一附属医院眼科住院的1610例DM患者采用眼底照相方法确立DR诊断,部分患者进行眼底血管荧光造影检查,计算DR发病率,并分析病程、年龄、发病年龄及血压对发病率的影响.结果 1610例(3201只眼)DM患者中DR发病率为30.2%,其中男性为27.3%,女性为35.0%.新确诊的340例DM患者中DR发病率为12.6%.3201只眼中,背景型DR 797只眼,占24.9%,增殖型124只眼,占3.9%.51～60岁年龄组以及在41～50岁间发病的DM患者,DR的发病率最高.45°眼底彩照与FFA检查结果比较,符率为78.1%.结论 以黄斑为中心单视野眼底照像作为早期DR的筛查方法是有效、实用且简便易行的.病程、年龄及发病年龄是DR发病的危险因素,随着病程延长其发病率显著增高.早期对DM 患者进行筛查、定期眼科检查,能及时发现病变、把握治疗时机,降低DR致盲率有着极其重要的意义.

Abstract：

Objective To determine the prevalence of diabetic retinopathy (DR) and to investigate the associated risk factors in patients with diabetes mellitus (DM).Methods Totally 1610 patients diagnosed DM by the WHO diagnostic criteria attending at the First Affiliated Hospital of Guangxi Medical University from 2007 to 2010.The data of disease history, visual acuity, eye disease and intraocular pressure were collected by inquiry and examination.Photography of ocular fundus was used to confirm the diagnosis of DR.According to the criteria of DR, diagnosis and statistics of DR were made and the relationship between the prevalence of DR and duration, age, the age of onset and blood pressure were analyzed.Results The prevalence of DR was 30.2% in 1610 diabetic patients,27.3% for male and 35.0% for female.The prevalence of DR of 340 newly onset diabetes was 12.6%.In 3201 eyes, the incidence of nonproliferative and proliferative DR (PDR) was 24.9% and 3.9%, respectively.The highest prevalence of DR was in the age group of 51 to 60 and the age of onset was 41 to 50 in patients with DM.Compared with FFA, the agreement rate of 45° fudus photography was 78.1%.Conclusions One-field mydriatic digital fudus photography centered at fovea is feasible and handy for screening of early diabetic retinopathy.Age, the age of onset and duration of disease are the risk factors of DR, longer the duration of DM, higher the incidence of DR.For early diagnosis and management of DR, the patient with DM should be examined regularly.It is very important to decrease the rate of blindness of DR.

Analysis on screening of diabetic retinopathy in 1610 patients with diabetes

Objective To determine the prevalence of diabetic retinopathy (DR) and to investigate the associated risk factors in patients with diabetes mellitus (DM).Methods Totally 1610 patients diagnosed DM by the WHO diagnostic criteria attending at the First Affiliated Hospital of Guangxi Medical University from 2007 to 2010.The data of disease history, visual acuity, eye disease and intraocular pressure were collected by inquiry and examination.Photography of ocular fundus was used to confirm the diagnosis of DR.According to the criteria of DR, diagnosis and statistics of DR were made and the relationship between the prevalence of DR and duration, age, the age of onset and blood pressure were analyzed.Results The prevalence of DR was 30.2% in 1610 diabetic patients,27.3% for male and 35.0% for female.The prevalence of DR of 340 newly onset diabetes was 12.6%.In 3201 eyes, the incidence of nonproliferative and proliferative DR (PDR) was 24.9% and 3.9%, respectively.The highest prevalence of DR was in the age group of 51 to 60 and the age of onset was 41 to 50 in patients with DM.Compared with FFA, the agreement rate of 45° fudus photography was 78.1%.Conclusions One-field mydriatic digital fudus photography centered at fovea is feasible and handy for screening of early diabetic retinopathy.Age, the age of onset and duration of disease are the risk factors of DR, longer the duration of DM, higher the incidence of DR.For early diagnosis and management of DR, the patient with DM should be examined regularly.It is very important to decrease the rate of blindness of DR.