北京市德胜社区糖尿病患者视功能损伤调查

目的探讨糖尿病患者视功能损害状况及其相关影响因素。方法横断面调查研究。对北京市德胜社区卫生服务中心管理的社区糖尿病患者进行调查。通过现场问卷调查、视功能检查、裂隙灯检查、免散瞳眼底照相检查、血压、体重、身高、随机血糖等检查，获得糖尿病患者的相关数据资料。连续变量采用t检验或秩和检验，分类变量采用卡方检验进行分析，并应用Logistic多因素分析评价糖尿病患者视力损伤的相关因素。结果德胜社区管理的720例糖尿病患者中，实际受检者519例，受检率72.1%。双眼生活视力均小于0.3者 34例（占6.6%），经过矫正，20例至少一眼视力达到0.3及以上，其余14例双眼矫正视力均小于0.3。导致他们视功能损伤的主要原因为糖尿病视网膜病变，占42.9%。519例糖尿病患者中，73例照片不可读，占14.1%，经阅片明确患糖尿病视网膜病变的患者有141例，占总人数的27.2%。存在威胁视力的糖尿病视网膜病变和照片不可读的患者均需转诊眼科进一步检查，共计150例，占28.9%。经Logistic多因素分析，糖尿病病程、体重指数（BMI）、糖尿病视网膜病变罹患情况是糖尿病患者视力损伤的危险因素。结论糖尿病患者视功能损伤的重要原因是糖尿病视网膜病变；加强社区糖尿病防治的眼病筛查，及时发现威胁视力的糖尿病视网膜病变，可能是减少糖尿病致盲的重要措施。

Epidemiological investigation of visual impairment in diabetes patients from the Beijing Desheng community

ObjectiveTo investigate the prevalence and related factors of visual impairment in patients with diabetes mellitus. MethodsBased on health records， type 2 diabetes patients from Beijing Desheng Community Health Center were enrolled into a cross-sectional investigative study. Visual acuity and the anterior segment of the eyes were checked. Two-field 45-degree color fundus images were taken through an undilated pupil. The retinal changes were graded using the Scottish Diabetic Retinopathy Grading System （2003）. Data collection was secured with Epidata. Data were analyzed using a t test， rank sum test， chi-square test and logistic regression analysis. ResultsA total of 720 patients were enrolled and 519（72.1%） participated in the survey. Thirty-four patients presented with a visual acuity of less than 0.3 in both eyes. Among them， at least one eye in 20 patients improved to no less than 0.3 with correction. The best visual acuity of the other 14 patients remained less than 0.3. The main reason for their visual impairment was diabetic retinopathy （42.9%）. Among all the participants， there were 73（14.1%） with ungraded images and 141（27.2%） with some diabetic retinopathy. In all， 150 patients （28.9%） needed to be referred to ophthalmologists due to vision threatened by diabetic retinopathy or ungraded images. The risk factors of visual impairment in diabetes patients through logistic regression analysis include diabetic duration， body mass index and diabetic retinopathy. ConclusionThe main reason for visual impairment among diabetes patients was diabetic retinopathy. Screening for visual problems in the community might be one of the important strategies for the prevention of blindness among diabetes patients.