【摘要】：目的評(píng)價(jià)糖尿病患者中糖尿病視網(wǎng)膜病變(diabetic retinopathy,DR)的患病率及其與腎小球?yàn)V過(guò)率(glomerular filtration rate,GFR)的相互關(guān)系,探討eGFR(estimated GFR)作為DR預(yù)警因子的可行性。方法 1613例2型糖尿病(type 2 diabetes mellitus,T2DM)患者參與本研究。所有研究對(duì)象均自愿接受生物化學(xué)和眼部檢查。DR由眼科醫(yī)師通過(guò)眼底鏡檢查和眼底照相確診。通過(guò)易爾統(tǒng)計(jì)分析軟件評(píng)估DR與eGFR之間的關(guān)系。結(jié)果 1613例糖尿病患者中,DR患病率為34.10%(550例)。將有無(wú)DR的患者分組比較,DR組與NDR組差異有統(tǒng)計(jì)學(xué)意義的變量有:年齡、DM病程、DM家族史、空腹及餐后2 h血糖、糖化血紅蛋白、總膽固醇、收縮壓、eGFR、血清肌酐及高、低密度脂蛋白膽固醇。Logistic回歸分析結(jié)果顯示,年齡、DM病程、血漿糖化血紅蛋白、收縮壓、舒張壓、eGFR以及高密度脂蛋白膽固醇為DR的獨(dú)立危險(xiǎn)因素,其中eGFR與DR呈負(fù)相關(guān)。經(jīng)調(diào)整后的飽和效應(yīng)分析結(jié)果表明當(dāng)eGFR99.4 mL·min-1時(shí),糖尿病患者患DR的風(fēng)險(xiǎn)明顯增加。結(jié)論 eGFR與DR負(fù)相關(guān),eGFR為99.4 mL·min-1是預(yù)測(cè)DR發(fā)生的關(guān)鍵點(diǎn)。檢測(cè)和評(píng)價(jià)這一因素對(duì)于DR的早期發(fā)現(xiàn)具有極其重要的臨床意義。
[Abstract]:Objective to evaluate the prevalence of diabetic retinopathy (diabetic retinopathy,DR) and its relationship with glomerular filtration rate (glomerular filtration rate,GFR) in diabetic patients and to explore the feasibility of eGFR (estimated GFR) as an early warning factor for DR. Methods 1613 patients with type 2 diabetes mellitus (type 2 diabetes mellitus,T2DM) were involved in this study. All subjects volunteered for biochemical and ocular examinations. DR was confirmed by ophthalmologists through fundus examinations and fundus photography. The relationship between DR and eGFR was evaluated by means of the Eill statistical analysis software. Results the prevalence of DR was 34.10% (550 cases) in 1613 diabetic patients. Patients with or without DR were divided into two groups: age, course of DM, family history of DM, fasting and 2 h postprandial blood glucose, glycosylated hemoglobin, total cholesterol, systolic blood pressure, serum creatinine and high eGFR,. Logistic regression analysis showed that age, course of DM, plasma glycosylated hemoglobin, systolic blood pressure, diastolic blood pressure, eGFR and high density lipoprotein cholesterol were independent risk factors for DR. EGFR was negatively correlated with DR. The adjusted saturation effect analysis showed that the risk of DR was significantly increased in diabetic patients with eGFR99.4 mL min-1. Conclusion there is a negative correlation between eGFR and DR, and a eGFR of 99.4 mL min-1 is the key point to predict the occurrence of DR. Detection and evaluation of this factor is of great clinical significance for early detection of DR.
【作者單位】： 中國(guó)醫(yī)科大學(xué)附屬第一醫(yī)院眼科;
【分類號(hào)】：R587.2;R774.1

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