Teng Yan, Cui Hao, Zhang Qing-Sheng, Teng Yu-Fei, Su Ying, Yang Ming-Ming, Yu Xu-Hui
Department of Ophthalmology, 1st Affiliated Hospital, Harbin Medical University, Harbin 150001, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2010 Aug;31(8):856-9.
The purpose of this study was to understand the awareness, prevalence of diabetic retinopathy and treatment status of people aged over 50 and living in the rural areas of Shuangcheng city, Heilongjiang province, China.
Cluster sampling was used in randomly selected 5504 survey for ophthalmic clinical examination, in patients with diabetic retinopathy. A questionnaire in the state of knowledge about prevention and treatment was developed.
Among the 5504 persons entering in the project, 5053 were examined on their eyes (91.8%). In this selected population, 56 persons (112 eyes) were diagnosed as diabetic retinopathy (1.108%), with 95% confidence interval (CI) as: 0.819% to 1.397%. Of 56 patients, 49 cases were non-proliferative diabetic retinopathy, accounting for 87.50% of the total number of patients with diabetic retinopathy; proliferative diabetic retinopathy 7 cases, accounting for 12.50% of the 112 eyes, 6.25% (7/112) having vitreous hemorrhage, 8.04% (9/112) having macular edema. For diabetic retinopathy prevalence rates, there was no significant difference in males and females. Between the per differential 10-year-old division, the difference was significant. Among the 60 to 69 group, a significantly higher prevalence rate was seen. Of the 112 eyes with diabetic retinopathy, 34 eyes (30.4%) were low vision [visual acuity < 20/60 (0.3) to ≥ 20/400 (0.05)]; 6 eyes (5.4%) were blind [visual acuity < 20/400 (0.05) to NLP]. The rate in the patients with PDR and fasting blood glucose was above 11.1 mmol/L was higher than having NPDR and fasting blood glucose below 11.1 mmol/L. Having fasting blood glucose 11.1 mmol/L and above with the course over five years among patients with PDR, the proportion of fasting blood glucose was higher than those with less than 11.1 mmol/L and diabetic retinopathy duration of less than five years. Of 56 patients with diabetic retinopathy, 38 cases (67.9%) did not receive any treatment. Among 18 cases (32.1%) with insulin or oral drug therapy, regularly using insulin or other medication (14.3%), only 1 (1.8%) case was given the treatment for diabetic retinopathy. Results from our survey showed that patients with diabetic retinopathy had a poor understanding about prevention and treatment of the disease.
Long duration and high blood glucose in patients with diabetic retinopathy seemed to be the important risk factor. Early systematic drug use for prevention and blood glucose control was the key to prevent diabetic retinopathy. Patients with diabetic retinopathy in China had poor understanding about the prevention measures of the disease and lack of knowledge.
本研究旨在了解中国黑龙江省双城市农村地区50岁以上人群糖尿病视网膜病变的知晓率、患病率及治疗状况。
采用整群抽样法，随机选取5504人进行眼科临床检查，针对糖尿病视网膜病变患者制定了关于防治知识状况的调查问卷。
纳入本项目的5504人中，5053人接受了眼部检查（91.8%）。在该抽样人群中，56人（112只眼）被诊断为糖尿病视网膜病变（1.108%），95%置信区间（CI）为：0.819%至1.397%。56例患者中，49例为非增殖性糖尿病视网膜病变，占糖尿病视网膜病变患者总数的87.50%；增殖性糖尿病视网膜病变7例，占112只眼中的12.50%，6.25%（7/112）发生玻璃体积血，8.04%（9/112）发生黄斑水肿。糖尿病视网膜病变患病率在男性和女性之间无显著差异。每相差10岁分组之间，差异有统计学意义。在60至69岁组中，患病率显著更高。在112只患有糖尿病视网膜病变的眼中，34只眼（30.4%）为低视力[视力<20/60（0.3）至≥20/400（0.05）]；6只眼（5.4%）为盲[视力<20/400（0.05）至无光感]。增殖性糖尿病视网膜病变且空腹血糖高于11.1 mmol/L患者的比例高于非增殖性糖尿病视网膜病变且空腹血糖低于11.1 mmol/L的患者。增殖性糖尿病视网膜病变患者中，空腹血糖11.1 mmol/L及以上且病程超过5年者，空腹血糖高于病程小于5年且空腹血糖低于11.1 mmol/L者。56例糖尿病视网膜病变患者中，38例（67.9%）未接受任何治疗。在18例（32.1%）接受胰岛素或口服药物治疗的患者中，规律使用胰岛素或其他药物的占14.3%，仅1例（1.8%）接受了糖尿病视网膜病变治疗。调查结果显示，糖尿病视网膜病变患者对该病的防治了解较差。
糖尿病视网膜病变患者病程长和血糖高似乎是重要危险因素。早期系统用药预防及控制血糖是预防糖尿病视网膜病变的关键。中国糖尿病视网膜病变患者对该病的预防措施了解较差且知识匮乏。
