Kullberg C E, Finnström K, Arnqvist H J
Department of Internal Medicine, Faculty of Health Sciences, Linköping University, Sweden.
Acta Ophthalmol (Copenh). 1994 Apr;72(2):181-8. doi: 10.1111/j.1755-3768.1994.tb05014.x.
The relationship between severity of background retinopathy, and prior long-term glycaemic control was studied. Ninety patients with background retinopathy and Type 1 diabetes mellitus, diabetes duration < or = 25 years, and HbA1c monitored > 5 years (on average 9.2 years with 32 HbA1c measurements) were included. All patients had microaenurysms/haemorrhages, 33 had hard exudates, 27 soft exudates, 8 IRMA (intraretinal microangiopathy), three venous beading, and no patient had macula oedema. Patients with mean HbA1c > 8% had higher relative risks for all kinds of background retinopathy, compared to patients with HbA1c < or = 7%. In multiple regression analysis, long-term glycated haemoglobin had significant impact on all types of background retinopathy. Women had lower scores for all types of background retinopathy. No sex differences in HbA1c, age, or duration were found. We conclude that poor long-term glycaemic control is a major risk factor for all types of background retinopathy.
研究了背景性视网膜病变的严重程度与既往长期血糖控制之间的关系。纳入了90例患有背景性视网膜病变和1型糖尿病的患者，糖尿病病程≤25年，且糖化血红蛋白（HbA1c）监测时间>5年（平均9.2年，共进行32次HbA1c测量）。所有患者均有微动脉瘤/出血，33例有硬性渗出，27例有软性渗出，8例有视网膜内微血管异常（IRMA），3例有静脉串珠样改变，且无患者有黄斑水肿。与HbA1c≤7%的患者相比，平均HbA1c>8%的患者发生各种背景性视网膜病变的相对风险更高。在多元回归分析中，长期糖化血红蛋白对所有类型的背景性视网膜病变均有显著影响。女性所有类型背景性视网膜病变的评分较低。在HbA1c、年龄或病程方面未发现性别差异。我们得出结论，长期血糖控制不佳是所有类型背景性视网膜病变的主要危险因素。
