【摘要】：第一部分糖尿病視網(wǎng)膜病變的流行病學(xué)調(diào)查 【目的】 調(diào)查廣州市番禺地區(qū)糖尿病視網(wǎng)膜病變(DR)的患病情況,了解其與病程,高血壓及高血脂等合并癥的關(guān)系。 【方法】 對(duì)番禺中心醫(yī)院2010年內(nèi)分泌門診,以及住院部確診為糖尿病的524例患者進(jìn)行篩查,參照糖尿病視網(wǎng)膜病變的診斷標(biāo)準(zhǔn)及分期標(biāo)準(zhǔn),對(duì)不同糖尿病分型、是否合并高血脂及高血壓、不同病程的患者的患病情況進(jìn)行統(tǒng)計(jì)并分析。 【結(jié)果】 番禺地區(qū)糖尿病患者中,DR的發(fā)病率為45%;1型糖尿病患者中DR的發(fā)病率明顯高于2型糖尿病患者;單純糖尿病患者的DR的發(fā)病率明顯低于合并高血壓及高血脂者,其中同時(shí)合并高血脂高血壓患者的DR的發(fā)病率最高,合并高血壓及合并高血脂者DR的發(fā)病率接近;隨病程的延長DR的發(fā)病率明顯升高,而且其嚴(yán)重程度逐漸加重 【結(jié)論】 由于DR是目前臨床上很重要的一個(gè)致盲性因素,而且在糖尿病患者中具有較高的發(fā)病率,因此要呼吁糖尿病患者對(duì)該疾病引起足夠的重視;臨床工作中要加大對(duì)糖尿病病人的篩查力度,提倡早期發(fā)現(xiàn),早期診斷,早期治療;治療中除了嚴(yán)格的控制血糖血壓外,還必須強(qiáng)調(diào)同期控制血脂的重要性。 第二部分安多明在糖尿病視網(wǎng)膜病變治療中的應(yīng)用研究 【目的】 通過對(duì)糖尿病視網(wǎng)膜病變(DR)患者進(jìn)行激光聯(lián)合安多明治療的對(duì)比研究,了解安多明在不同分期的治療效果,為臨床治療提供參考。 【方法】 確診為糖尿病視網(wǎng)膜病變3-5期的2型糖尿病患者108人,采用相同標(biāo)準(zhǔn)嚴(yán)格控制血糖及血壓。隨機(jī)分為兩組,一組54例105眼,為治療組,采用激光治療同時(shí)聯(lián)合安多明膠囊口服;另外一組54例102眼為對(duì)照組,采用單純激光治療。治療前后行視力、眼底以及行熒光造影檢查,根據(jù)視力檢查標(biāo)準(zhǔn)以及熒光造影標(biāo)準(zhǔn)判定治療效果,得出相關(guān)數(shù)據(jù)使用SPSS10.0軟件,行x2檢驗(yàn),作統(tǒng)計(jì)學(xué)分析。 【結(jié)果】 DR3、4期治療組(視力、眼底檢查及造影)的有效率明顯大于對(duì)照組,其差異具有統(tǒng)計(jì)學(xué)意義(P㩳0.05)。DR5期治療組及對(duì)照組的有效率接近,其差異無統(tǒng)計(jì)學(xué)意義(P㧐0.05)。 【結(jié)論】 早期DR(1、2期)的患者可以采用安多明等藥物治療;3、期患者需盡早激光治療,可以同時(shí)輔以安多明提高治療效果;但對(duì)于DR5期患者,安多明的治療效果并不明顯,激光及手術(shù)治療尤為重要。
[Abstract]:Part I Epidemiological investigation of Diabetic Retinopathy [objective] to investigate the prevalence of diabetic retinopathy (DR) in Panyu area of Guangzhou, and to understand its relationship with the course of disease. The relationship between hypertension and hyperlipidemia and other complications. [methods] 524 patients diagnosed as diabetes mellitus in Panyu Central Hospital in 2010 were screened. According to the diagnostic criteria and staging criteria of diabetic retinopathy, whether or not hyperlipidemia and hypertension are associated with different types of diabetes, [results] the incidence of Dr in patients with diabetes in Panyu was significantly higher than that in patients with type 2 diabetes. The incidence of Dr in patients with simple diabetes mellitus was significantly lower than that in patients with hypertension and hyperlipidemia. The incidence of Dr in patients with hyperlipidemia and hyperlipidemia was the highest, and the incidence of Dr in patients with hypertension and hyperlipidemia was similar. With the prolongation of the course of disease, the incidence of Dr increased obviously, and the severity of Dr increased gradually [conclusion] Dr is an important clinical cause of blindness at present. Moreover, there is a high incidence of diabetes in patients with diabetes, so it is necessary to appeal to patients with diabetes to pay enough attention to the disease, to strengthen the screening of patients with diabetes in clinical work, to advocate early detection, early diagnosis and early treatment. In addition to strict control of blood glucose and blood pressure, the importance of controlling blood lipids in the same period must be emphasized. The second part: a comparative study of the application of Amtamine in the treatment of diabetic retinopathy by laser combined with ammine in patients with diabetic retinopathy. To understand the therapeutic effect of Amdolin in different stages and to provide reference for clinical treatment. [methods] 108 patients with type 2 diabetes mellitus were diagnosed as stage 3-5 diabetic retinopathy. Blood sugar and blood pressure are strictly controlled by the same standard. They were randomly divided into two groups: one group (54 cases, 105 eyes), the treatment group (54 cases, 105 eyes) and the other group, 54 cases (102 eyes) were treated with laser alone, and the other group (54 cases, 102 eyes) was treated with laser alone. The visual acuity, fundus and fundus of the eyes were examined before and after the treatment. According to the standard of visual acuity examination and the standard of fluorescence angiography, the therapeutic effect was determined. The relevant data were obtained by using SPSS10.0 software and x2 test. [results] the effective rate of DR3 stage 4 treatment group (visual acuity, fundus examination and contrast group) was significantly higher than that of the control group, and the difference was statistically significant (P0. 05) .The effective rate of DR5 stage treatment group and control group was close to that of control group. There was no significant difference (P 0.05). [conclusion] patients with early stage Dr (stage 1 ~ 2) can be treated with triamcinolone and other drugs, while patients with stage 2 need laser therapy as early as possible, and can be supplemented with ammine to improve the therapeutic effect. However, for DR5 patients, the effect of Amtamine is not obvious, laser and surgical treatment is particularly important.
【學(xué)位授予單位】：廣州醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2011
【分類號(hào)】：R587.2;R774.1

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