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加德满都一家三级医院住院糖尿病患者糖尿病视网膜病变的患病率、危险因素及知晓情况

Prevalence, risk factors and awareness of diabetic retinopathy among admitted diabetic patients at a tertiary level hospital in Kathmandu.

作者信息

Thapa R, Joshi D M, Rizyal A, Maharjan N, Joshi R D

机构信息

Tilganga Institute of Ophthalmology.

出版信息

Nepal J Ophthalmol. 2014 Jan;6(11). doi: 10.3126/nepjoph.v6i1.10760.

Abstract

INTRODUCTION

Diabetic retinopathy (DR) is one of the commonest causes of visual impairment and blindness in Nepal.

OBJECTIVES

The study aims to explore the prevalence, risk factors and awareness of DR among admitted diabetic patients.

MATERIALS AND METHODS

A non-interventional case series study was conducted among the inpatient diabetic cases referred for ophthalmic consultation. The patients' detailed demographics, awareness on DR, concurrent systemic problems, and glycemic control status were recorded. DR was graded using the Early Treatment Diabetic Retinopathy Study Criteria.

MAIN OUTCOME MEASURES

The prevalence, risk factors and awareness of diabetic retinopathy among the study participants was analyzed.

RESULTS

A total of 277 diabetic patients were enrolled in the study. The mean age was 62.25 ± 13.26 years. Only one-third (34.6 %) of the cases were admitted for sugar control and newly diagnosed cases comprised of 19.49 %. Nearly half of the cases (46.6 %) were not aware of diabetic retinopathy and dilated fundus evaluation was done for the first time in 44.4 %. DR was found in 38.26 % of the cases and was diagnosed in 13 % of the new cases. Almost four-fifths (78 %) of the diabetics had had the disease for a duration of 16 to 20 years. Clinically significant macular edema was found in 5.78 % and proliferative DR in 2.52 %. DR was significantly associated with the duration of diabetes (P value = 0.001) and concurrent hypertension (P value = 0.004).

CONCLUSION

The prevalence of DR was 38 % among the admitted diabetic cases and the DR was significantly associated with the duration of diabetes and systemic hypertension. Almost half of the cases had been unaware of DR before referral. This emphasizes the importance of the collaboration of the physician and the ophthalmologist for an early DR detection.

摘要

引言

糖尿病视网膜病变(DR)是尼泊尔视力损害和失明的最常见原因之一。

目的

本研究旨在探讨住院糖尿病患者中DR的患病率、危险因素及知晓情况。

材料与方法

对转诊至眼科会诊的住院糖尿病患者进行非干预性病例系列研究。记录患者详细的人口统计学信息、对DR的知晓情况、并发的全身性问题以及血糖控制状况。采用早期糖尿病视网膜病变治疗研究标准对DR进行分级。

主要观察指标

分析研究参与者中糖尿病视网膜病变的患病率、危险因素及知晓情况。

结果

本研究共纳入277例糖尿病患者。平均年龄为62.25±13.26岁。仅三分之一(34.6%)的病例因血糖控制入院,新诊断病例占19.49%。近一半(46.6%)的病例不知道糖尿病视网膜病变,44.4%的病例首次进行散瞳眼底检查。38.26%的病例发现有DR,13%的新病例被诊断为DR。近五分之四(78%)的糖尿病患者患病时间为16至20年。临床显著性黄斑水肿的发生率为5.78%,增殖性DR的发生率为2.52%。DR与糖尿病病程(P值=0.001)和并发高血压(P值=0.004)显著相关。

结论

住院糖尿病患者中DR的患病率为38%,DR与糖尿病病程和全身性高血压显著相关。几乎一半的病例在转诊前不知道自己患有DR。这强调了内科医生和眼科医生合作进行DR早期检测的重要性。

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