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[糖尿病患者糖尿病视网膜病变发生中的眼部生物结构及相关危险因素]

[Ocular biological structures and relevant risk factors in the occurrence of diabetic retinopathy in diabetes mellitus patients].

作者信息

Jiang Jing-jing, Li Xiao-xin, Yuan Li, Ji Li-nong, Wu Xi

机构信息

Department of Ophthalmology, Peking University People's Hospital, Beijing, China.

出版信息

Zhonghua Yan Ke Za Zhi. 2012 Oct;48(10):898-902.

Abstract

OBJECTIVE

To investigate the characteristics and risk factors of biological ocular structures in the development of diabetic retinopathy in diabetes mellitus (DM) patients.

METHODS

Retrospective case series study. Systemic condition, results of laboratory examination, fundus examination, refractive status and ocular biometry measured by IOL Master, were collected from the DM group (118 type-II diabetic patients with diabetes more than 10 years) and the control group (50 cataract subjects without diabetes). The DM group was classified to three subgroups: none diabetic retinopathy, minimal and moderate nonproliferative diabetic retinopathy (NPDR) and vision-threatening diabetic retinopathy. Chi-square and Kruskal-Wallis rank sum tests were used to compare the difference between the DM and control groups. Ocular biometry, including axial length (AL), anterior chamber depth (ACD), corneal diameter, corneal curvature and spherical equivalent refraction (SE) were analyzed with multivariate logistic regression.

RESULTS

  1. There was no significant difference in systemic factors. 2. Ocular factors: There were significant differences of AL and ACD between the DM and control groups. The risk for the development of DR and the severity of DR were increasing with shorter AL and ACD between the three DR subgroups, especially the risk of and the occurrence of macular edema (ME) (OR = 16.869, 7.248, 6.577; P < 0.05, respectively). 3. The risk of advanced DR increased significantly in hyperopia (OR = 1.301, 95%CI = 1.044 to 1.621; P < 0.05).

CONCLUSIONS

The ocular risk factors of type-II DM patients with diabetes more than 10 years are the AL and ACD, which have significant relationship with the development and the progress of DR.

摘要

目的

探讨糖尿病(DM)患者糖尿病视网膜病变发展过程中眼部生物结构的特征及危险因素。

方法

回顾性病例系列研究。收集DM组(118例病程超过10年的II型糖尿病患者)和对照组(50例无糖尿病的白内障患者)的全身状况、实验室检查结果、眼底检查、屈光状态及IOL Master测量的眼部生物测量数据。DM组分为三个亚组:无糖尿病视网膜病变、轻度和中度非增殖性糖尿病视网膜病变(NPDR)以及威胁视力的糖尿病视网膜病变。采用卡方检验和Kruskal-Wallis秩和检验比较DM组和对照组之间的差异。对眼部生物测量数据,包括眼轴长度(AL)、前房深度(ACD)、角膜直径、角膜曲率和等效球镜度(SE)进行多因素逻辑回归分析。

结果

  1. 全身因素无显著差异。2. 眼部因素:DM组和对照组之间的AL和ACD存在显著差异。在三个糖尿病视网膜病变亚组中,随着AL和ACD缩短,糖尿病视网膜病变发生风险及病变严重程度增加,尤其是黄斑水肿(ME)的发生风险(OR分别为16.869、7.248、6.577;P均<0.05)。3. 远视患者发生晚期糖尿病视网膜病变的风险显著增加(OR = 1.301,95%CI = 1.044至1.621;P < 0.05)。

结论

病程超过10年的II型糖尿病患者的眼部危险因素为AL和ACD,它们与糖尿病视网膜病变的发生和进展密切相关。

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