糖尿病神经病变与视网膜病变的相关性研究

目的:探讨糖尿病患者发生微循环障碍时,外周神经病变(DPN)与视网膜病变之间是否有相关性,及二者在2型糖尿病中的危险指数。方法:本研究包括100例(男性51例,女性49例)门诊的糖尿病患者,均为非胰岛素依赖的糖尿病患者(NIDDM),观察患者的外周神经病变及视网膜病变进展情况,随访时间18mo。结果:视网膜病变的患者78.1%同时有外周神经病变,患有外周神经病变的患者79.1%同时有视网膜病变,统计学分析表明外周神经病变与视网膜病变之间并没有明显的相关性。但是,90.9%患有增殖性糖尿病视网膜病变的患者同时有外周神经病变,而27.8%患有视网膜病变的患者同时有外周神经病变,单因素及多因素logistic回归分析均表明它们之间有明显的相关性(r=0.42,P=0.02)。结论:严重的糖尿病视网膜病变与糖尿病性神经病变有相关性。本研究表明糖尿病神经病变可作为糖尿病视网膜病变进程的预警信号,出现神经病变的患者需要更细致广泛的眼科检查,特别是对于病程较长的糖尿病患者。

Neuropathy and retinopathy in diabetes: Is there any association?

AIM:To evaluate correlation of retinopathy and diabetic peripheral neuropathy(DPN) as microvascular complications of diabetes and also to identify their risk factors in patients with type 2 diabetes.METHODS:We conducted a cross-sectional study in an outpatient diabetes clinic during an 18-month period.100 patients(51 male and 49 female) ,all affected by non-insulin-dependent diabetes mellitus(NIDDM) ,were examined for the presence of diabetic neuropathy and diabetic retinopathy.RESULTS:78.1% of patients with retinopathy had DPN;and 79.1% of patients with DPN had retinopathy.Analysis of the association between DPN and retinopathy showed no significant correlation between them.90.9% of patients with proliferative diabetic retinopathy(PDR) had DPN;and 27.8 % of patients with DPN had PDR.Both the univariate analysis and multiple logistic regression analysis revealed significant correlation between them(r =0.42,P =0.02) .CONCLUSION:A severe diabetic retinopathy is associated with diabetic neuropathy.Our study further supports that diabetic neuropathy might be used as a tell-tale sign of diabetic retinopathy,necessitating more intensive ophthalmic care,especially in long-lasting diabetes.