【摘要】：目的：探討脂代謝異常與糖尿病視網(wǎng)膜病變的相關(guān)性。 方法：選取2011年8月16號至2011年12月10日期間，在大連市中心醫(yī)院接受社區(qū)糖尿病普查的年齡大于等于40周歲的10300例社區(qū)居民，去掉缺項少項共收集到10144例，依據(jù)有無糖尿病，有無糖尿病視網(wǎng)膜病變劃分成三組，非糖尿病人群（A組），糖尿病無視網(wǎng)膜病變?nèi)巳海˙組），糖尿病視網(wǎng)膜病變?nèi)巳海–組）。比較三組資料免散瞳眼底照相、年齡、性別、體重、腰圍、臀圍、空腹血糖、兩小時血糖以、糖化血紅蛋白、TG、TC、HDL-C、LDL-C等指標(biāo)，對比分析與糖尿病視網(wǎng)膜病變的相關(guān)危險因素。 結(jié)果： 1、血脂情況:接受社區(qū)普查的居民中血脂正常者共4199人，血脂異常者共5945人，血脂異常者占總體人數(shù)的58.60%，低HDL-C血癥，高LDL-C血癥，高TC血癥、高TG血癥的患病率分別為4.02%、33.42%、38.77%、29.62%。 2、糖尿病脂代謝異常人群視網(wǎng)膜病變的發(fā)病率與糖尿病脂代謝正常的人群視網(wǎng)膜病變發(fā)病率比較發(fā)病率分別為（10.14%vs9.3%, χ2=0.39, P＞0.05）。 3、糖尿病人群中高TG和正常TG水平下糖尿病視網(wǎng)膜病變的發(fā)病率比較發(fā)病率分別為（9.1%vs10.4%, χ2=1.087, P＞0.05）。 4、糖尿病人群中高TC和正常TC水平下糖尿病視網(wǎng)膜病變的發(fā)病率比較發(fā)病率分別為（9.9%vs9.8%, χ2=0.007, P＞0.05）。 5、糖尿病人群中高HDL-C和正常HDL-C水平下糖尿病視網(wǎng)膜病變的發(fā)病率比較發(fā)病率分別為（10.1%vs9.7%, χ2=0.006P＞0.05）。 6、糖尿病人群中高LDL-C和正常LDL-C水平下糖尿病視網(wǎng)膜病變的發(fā)病率比較發(fā)病率分別為（13.6%vs9.6%, χ2=0.582, P＞0.05）。 7、經(jīng)非條件多因素logistic回歸分析糖化血紅蛋白OR=9.1,(95%CI1.175-2.207), P＜0.05，收縮壓OR=32.09,(95%CI2.308-5.568), P＜0.05及病程OR=145.49,(95%CI4.373-7.742), P＜0.05。 結(jié)論： 1.脂質(zhì)代謝異常與糖尿病DR的發(fā)生無相關(guān)性。 2.糖化血紅蛋白，收縮壓及病程參與了糖尿病視網(wǎng)膜病變的發(fā)生發(fā)展。
[Abstract]:Objective: to investigate the relationship between abnormal lipid metabolism and diabetic retinopathy. Methods: from August 16, 2011 to December 10, 2011, 10300 community residents aged over 40 years were selected for community diabetes census in Dalian central hospital, and 10144 cases were collected according to diabetes. Patients with diabetic retinopathy were divided into three groups: non-diabetic group (group A), diabetic group without retinopathy (group B) and diabetic retinopathy group (group C). The data of the three groups were compared without radiography, age, sex, body weight, waist circumference, hip circumference, fasting blood glucose, two hours blood glucose, glycosylated hemoglobin, TG,TC,HDL-C,LDL-C and so on. The risk factors associated with diabetic retinopathy were compared and analyzed. Results: 1. Blood lipid status: there were 4199 patients with normal blood lipid and 5945 patients with dyslipidemia among the residents who received community census. The patients with dyslipidemia accounted for 58.60% of the total population. The patients with dyslipidemia had low HDL-C, high LDL-C and high TC. The prevalence of hyperlipidemia was 4.02 and 33.42 respectively. The incidence of retinopathy in patients with abnormal lipid metabolism was 29.62. The incidence of retinopathy in patients with abnormal lipid metabolism was higher than that in those with normal lipid metabolism (10.14 vs 9.3, 蠂 2 = 0.39, P > 0. 05). 3. The incidence of diabetic retinopathy in diabetic patients with high TG level and normal TG level were respectively (9.1 vs 10.4, 蠂 ~ 21.087, P > 0.05). 4. In diabetic patients with high TC and normal TC levels, the incidence of diabetic retinopathy was higher than that of normal TC. The incidence of diabetic retinopathy in diabetic patients with high HDL-C level and normal HDL-C level was (10.1 vs 9.7, 蠂 2 + 0.006 P > 0.05). The incidence of diabetic retinopathy in the patients with high LDL-C and normal LDL-C levels was 13.6v 9.6and 蠂 2 0.582, P > 0.05.7.The glycosylated hemoglobin OR=9.1, (95%CI1.175-2.207), P < 0.05) and systolic pressure OR=32.09, (95%CI2.308-5.568), P) were analyzed by non-conditional multivariate logistic regression analysis. < 0. 05 and OR=145.49, (95%CI4.373-7.742), P < 0. 05). Conclusion: 1. There was no correlation between abnormal lipid metabolism and diabetes mellitus DR. 2. Glycosylated hemoglobin, systolic blood pressure and course of disease are involved in the development of diabetic retinopathy.
【學(xué)位授予單位】：大連醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2012
【分類號】：R587.2;R774.1

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