综述

糖尿病前期和糖尿病视网膜病变临床前期的视网膜改变

Retinal changes in pre-diabetes and pre-clinic diabetes retinopathy

:454-460
 
糖尿病视网膜病变(diabetic retinopathy,DR)是世界范围内劳动年龄人口视力损伤的主要原因。糖尿病前期和DR临床前期患者作为罹患DR的高危人群,在该阶段可发现视网膜神经元形态功能及视网膜微小血管的改变。视网膜及神经纤维层厚度的变化可部分反映视网膜神经元结构改变;色觉、对比敏感度、视野及视觉电生理等变化可反映视网膜神经元功能改变。随着光学相关断层扫描血管成像技术的发展,临床可以检测出DR之前视网膜微血管的改变。此外,许多生物标志物也可以预测和评估DR。由于目前还没有方法可以阻止DR的发生与进展,临床可以通过观察以上视网膜的改变更为及时地发现DR,以降低其患病率,最大限度地减少DR带来的视力损伤。
Diabetes retinopathy (DR) is the main cause of visual impairment in the working population worldwide. Patients with pre-diabetes and pre-clinic diabetic retinopathy are regarded as in high risk group of DR. The changes in morphology and function of renal neurons and retinal micro-vessels can be found in these patients at this stage. The changes of retinal nerve structure can be partly reflected by changes in the thickness of retina and nerve fiber layer. The changes in function of retinal neurons can be reflected by changes in color vision, contrast sensitivity, visual field and visual electrophysiology.With the development of optical coherence tomography angiography, changes in retinal micro-vessels can be observed prior to clinical detection of DR. In addition, many biomarker can also predict and evaluate DR. Since there is no way to prevent the occurrence and progress of DR at present, more attention should be paid in DR by observing the changes inthe retina mentioned above timely, to reduce its incidence and minimize the visual damage caused by DR.
百年校庆

Müller 细胞介导的 IL-17 信号通路与糖尿病视网膜病变之间关系的研究进展

Research progress on the relationship between Müller cell-mediated IL-17 signaling pathway and diabetic retinopathy

:512-519
 
糖尿病视网膜病变(diabetes retinopathy, DR)是糖尿病常见的眼部并发症,其病理过程复杂,涉及多种细胞及炎症因子。Müller细胞作为视网膜主要支持细胞,在DR中不仅产生白介素-17(interleukin-17, IL-17),还作为其主要靶点发挥作用,通过谷氨酸代谢异常、血管内皮生长因子(vascular endothelial growth factor, VEGF)分泌增加及调控参与DR的病理过程,加重炎症反应。IL-17主要由辅助性T细胞17(T helper cell 17, Th17)分泌,通过促进多种炎症介质(如细胞因子、趋化因子和金属蛋白酶)的分泌,增强炎症反应,导致视网膜微血管损害和神经元凋亡,促进DR的发展。高糖环境下,Müller细胞功能受损,IL-17进一步加剧其功能障碍形成恶性循环。研究表明,阻断IL-17及核因子-κB激活剂1(Nuclear factor-kappa B activator 1, Act1)/肿瘤坏死因子受体关联因子6(tumor necrosis factor receptor associated factor 6, TRAF6)/核因子-κB(Nuclear factor-kappa B, NF-κB)信号通路可减轻DR的病理改变,为DR的治疗提供了新的思路。因此,深入研究IL-17与Müller细胞在DR中的相互作用机制,对于研究该疾病的发病机制及开发精准有效的治疗策略具有重要意义。
Diabetes retinopathy (DR) is a common ocular complication of diabetes, characterized by a complex pathological process involving multiple cells and inflammatory factors. Müller cells, as the primary supporting cells of the retina, not only produce interleukin-17 (IL-17) but also serve as a primary target in DR. They participate in the pathological process of DR by contributing to abnormal glutamate metabolism, increased secretion of vascular endothelial growth factor (VEGF), and regulatory functions, thereby exacerbating the inflammatory response. IL-17 is primarily secreted by T helper cell 17 (Th17) cells and enhances the inflammatory response by promoting the secretion of various inflammatory mediators (such as cytokines, chemokines, and metalloproteinases), leading to retinal microvascular damage and neuronal apoptosis, which accelerates the progression of DR. In a high-glucose environment, Müller cell function is impaired, and IL-17 further exacerbates this dysfunction, creating a vicious cycle. Studies have shown that blocking the IL-17 and Act1/TRAF6/NF-κB signaling pathways can mitigate the pathological changes associated with DR, providing new insights for the treatment of this disease. Therefore, conducting in-depth research on the interaction mechanism between IL-17 and Müller cells in DR is of great significance for exploring the pathogenesis of this disease and developing precise and effective treatment strategies.
综述

胆固醇代谢异常与糖尿病视网膜病变的关系探究

Study on the relationship between abnormal cholesterol metabolism and diabetic retinopathy

:617-623
 
糖尿病视网膜病变是最为常见的糖尿病微血管并发症,主要由糖尿病引起的机体代谢紊乱导致。而然在临床工作中发现,部分患者通过单纯控制血糖以延缓糖尿病视网膜病变进展,所取得效果不甚理想,一些其他因素对于糖尿病视网膜病变的发生、发展,也起到不可忽视的作用。研究表明,在并发高脂血症的糖尿病视网膜病变患者中,胆固醇代谢异常是诱发视网膜病变的主要原因之一。胆固醇代谢异常通过减弱肝脏X受体,导致胆固醇在视网膜上不断积累,降低视网膜血管内皮功能,从而造成视网膜缺血、缺氧环境的形成,又可通过增加炎症因子和细胞黏附分子-1的表达,使原本病态的糖尿病视网膜血管变得更加脆弱,该文总结了糖尿病视网膜病变的病理因素,对比分析当前糖尿病视网膜病变的主要治疗手段,通过分析胆固醇逆向转运(cholesterol reverse transport,RCT)途径转运对糖尿病视网膜病变发生、发展的影响,发现降低高血脂可提高糖尿病视网膜病变的治愈率,这将为糖尿病视网膜病变的临床防治工作提供新思路。
Diabetic retinopathy is the most common diabetic microvascular complication, which is mainly caused by metabolic disorders caused by diabetes. However, in clinical work, it is found that some patients do not achieve satisfactory results in delaying the progress of diabetic retinopathy by simply controlling blood sugar, and some other factors contribute to the occurrence and development of diabetic retinopathy. Also played a role that can not be ignored. Studies have shown that abnormal cholesterol metabolism is one of the main causes of retinopathy in diabetic retinopathy patients with hyperlipidemia. Abnormal cholesterol metabolism leads to the accumulation of cholesterol in the retina and the decrease of retinal vascular endothelial function by weakening the X receptor in the liver, resulting in the formation of retinal ischemia and hypoxia environment. it can also increase the expression of inflammatory cytokines and cell adhesion molecule-1 to make the originally morbid retinal vessels more fragile. This paper summarizes the pathological factors of diabetic retinopathy. By comparing and analyzing the main treatment methods of diabetic retinopathy at present, and by analyzing the influence of cholesterol reverse transport (cholesterolreversetransport,RCT) pathway on the occurrence and development of diabetic retinopathy, it is found that reducing hyperlipidemia can improve the cure rate of diabetic retinopathy, which will provide new ideas for the clinical prevention and treatment of diabetic retinopathy.
综述

糖尿病视网膜病变的全科医学管理

General practice management of diabetic retinopathy

:350-359
 
糖尿病视网膜病变是糖尿病引起的微血管病变之一,是不可逆性致盲的眼病。根据其病程可分为根据其病程可分为非增殖期和增殖期,其中还包括糖尿病性黄斑水肿。全科医师需要检测量裸眼视力、矫正视力和眼压,通过裂隙灯显微镜评估眼前节以及眼底检查来评估眼部整体情况。控制血糖、血压、血脂对改善预后很重要。需要重视餐前、餐后血糖,糖化血红蛋白和代谢记忆,一线降血压药物包括血管紧张素转化酶抑制剂和血管紧张素Ⅱ受体阻断剂,调脂药物首选他汀类,而非诺贝特有额外的视网膜保护作用。干预生活方式,宣教,早期发现也同样重要。全科医师需要进行眼底筛查和评分,及时转诊至眼科治疗。眼科治疗包括全视网膜激光光凝术、经平坦部玻璃体切除术、玻璃体抗血管内皮生长因子药物注射术。
Diabetic retinopathy is one of the microvascular diseases caused by diabetes, it is an irreversible blindness eye disease. According to its course, it can be divided into non-proliferative diabetic retinopathy and proliferative diabetic retinopathy, including diabetic macular edema. Te general practitioner needs to measure the uncorrected visual acuity, corrected visual acuity intraocular pressure, use the slit lamp microscope to exam the anterior segment and fundus to evaluate the overall condition of the eye. Controlling blood glucose, blood pressure and blood lipid is very important to improve the prognosis. Attach importance to pre- and postprandial blood glucose, glycosylated hemoglobin and metabolic memory should be carried out. The first-line antihypertensive drugs are angiotensin converting enzyme inhibitors and angiotensin II receptor blockers. Statins are the first choice for lipid-lowering drugs, fenofibrate has additional protective efect of retinal. Intervention in lifestyle, education and early detection are is important. Te general practitioner needs to perform fundus screening and scoring, timely refer to ophthalmology department for treatment. Ophthalmic treatment includes panretinal laser photocoagulation, pars plana vitrectomy, and intravitreal injection of anti-vascular endothelial growth factor drugs.
综述

血糖变异性对糖尿病视网膜病变的影响及研究进展

The impact of blood glucose variability on diabetic retinopathy

:189-195
 
糖尿病视网膜病变(diabetic retinopathy, DR)作为糖尿病的一种常见并发症是导致工作年龄人群失明的主要原因。血糖变异性(glycemic variability, GV)指血糖波动的程度。最新研究表明,GV与糖尿病患者的代谢状况和微血管病变密切相关。该文综述了GV对DR的影响及其研究进展。GV是指血糖水平在高点和低点之间波动的不稳定状态,分为长期GV和短期GV。长期GV主要通过空腹血糖(fasting plasma glucose, FPG)、餐后血糖(postprandial plasma glucose, PPG)和糖化血红蛋白(glycated hemoglobin, HbA1c)评估,短期GV则通过血糖标准差(standard deviation, SD)、变异系数(coefficient of variation, CV)、低血糖指数(low blood glucose index, LBGI)等指标量化。研究表明,GV是糖尿病大管和微血管并发症的重要风险预测因子,与冠状动脉综合征、心肌梗死、脑卒中、糖尿病肾病、周围神经病变等密切相关。在DR方面,GV可能是其进展的风险因素,高GV会加剧氧化应激、炎症反应、内皮功能障碍和新生血管生成,从而促进DR的发展。治疗策略包括动态血糖监测系统、药物干预(如基础胰岛素、阿格列汀等)、合理饮食和运动等,这些方法可改善GV,降低并发症风险,提高患者预后和生活质量。

Diabetic retinopathy (DR) is a common complication of diabetes and is a leading cause of blindness in the working-age population. Glycemic variability (GV) refers to the degree of fluctuation in blood glucose levels. Recent studies have shown that GV is closely related to the metabolic status and microvascular complications in patients with diabetes. This article reviews the impact of glycemic variability (GV) on diabetic retinopathy (DR) and the latest research progress.GV is defined as the unstable state of blood glucose levels fluctuating between highs and lows, which is categorized into long-term GV and short-term GV. Long-term GV is mainly assessed through fasting plasma glucose (FPG), postprandial plasma glucose (PPG), and glycated hemoglobin (HbA1c). Short-term GV is quantified by indicators such as the standard deviation of blood glucose (SD), coefficient of variation (CV), and low blood glucose index (LBGI).Studies have shown that GV is an important risk predictor for both macrovascular and microvascular complications in diabetic patients, being closely associated with conditions such as coronary artery syndrome, myocardial infarction, stroke, diabetic nephropathy, and peripheral neuropathy. Regarding DR, GV is likely a risk factor for its progression. High GV can exacerbate oxidative stress, inflammatory responses, endothelial dysfunction, and neovascularization, thereby promoting the development of DR.Treatment strategies include continuous glucose monitoring systems, pharmacological interventions (such as basal insulin, alogliptin, etc.), as well as proper diet and exercise. These approaches can improve GV, reduce the risk of complications, and enhance patients' prognosis and quality of life.

VEGF、IL-6 的水平与糖尿病视网膜病变关系的研究

:26-30
 

目的:检测 2 型糖尿病患者眼房水中血管内皮生长因子(Vascular endothelial growth factor, VEGF)和白细胞介素-6(Interleukin-6, IL-6)的含量,并探讨其临床意义

方法:在白内障手术过程中获取 66 例 2 型糖尿病患者的房水,采用双抗体夹心酶联免疫吸附(ELISA)法测定 VEGF 和 IL-6 的含量。根据手术后散瞳眼底检查和眼底荧光素血管造影检查确定糖尿病视网膜病变的分期。实验组分为:无糖尿病视网膜病变组(NDR)21 例、单纯型糖尿病性视网膜病变组(BDR)26 例、增生型糖尿病性视网膜病变组(PDR)19 例,正常对照组为健康的老年性白内障患者 20 例。

结果NDR 组、BDR 组、PDR 组的房水 VEGF 含量分别为(240.30 ± 26.15)pg/ml、(292.27 ± 58.91)pg/ml、(477.41 ± 91.01)pg/ml,IL-6 含量分别为(160.83 ± 33.41)pg/ml、(238.60 ± 62.23)pg/ml、(389.13 ± 90.35)pg/ml,对照组房水 VEGF 含量为(140.58 ± 26.27)pg/ml、IL-6 含量为(82.72 ± 21.53)pg/ml,对照组与实验组比较差异均有统计学意义(F = 113.67,P < 0.01;F = 106.53,P < 0.01)。实验组房水中的 VEGF 与 IL-6 含量有相关性(r = 0.995,P < 0.01);糖尿病患者的病程与房水中 VEGF(r = 0.792,0.826,0.841 均 P < 0.01)、IL-6(r = 0.829,0.817,0.896 均 P < 0.01)含量有相关性。

结论:VEGF、IL-6 在糖尿病视网膜病变的形成过程中有重要作用,且两者之间有相关性。

Purpose: To explore the role of vascular endothelial growth factor (VEGF) and interleukin-6 (IL-6) in the aqueous humor in the pathogenesis of diabetic retinopathy (DR).

Methods: Aqueous humor samples were collected in type 2 diabetic patients during cataract surgery. The classification of DR was assigned based on the fundus examination and fluorescein angiography after cataract surgery. The experiment group included non-diabetic retinopathy (NDR, 21 cases), background diabetic retinopathy (BDR, 26 cases), and proliferative diabetic retinopathy (PDR, 19 cases). The control group was the healthy cataract patients (20 cases). The levels of VEGF and IL-6 in the aqueous humor were assessed using the ELISA technique.

Results: The level of VEGF in NDR, BDR, and PDR cases were (240.30 ± 26.15) pg/ml, (292.27 ± 58.91) pg/ml, and (477.41 ± 91.01) pg/ml, respectively. The level of IL-6 in NDR, BDR, and PDR cases were (160.83 ± 33.41) pg/ml, (238.60 ± 62.23) pg/ml, and (389.13 ± 90.35) pg/ml, respectively. The levels of VEGF and IL-6 in the aqueous humor from the control group were (140.58 ± 26.27) pg/ml, (82.72 ± 21.53) pg/ml. The levels of VEGF and IL-6 were significantly different in experiment and control groups (F = 113.67, P < 0.01; F = 106.53, P < 0.01). In the aqueous humor of diabetic patients increased significantly (P < 0.1). The levels of VEGF and IL-6 were significantly correlated with each other in the experiment group (r = 0.995, P < 0.01). The levels of VEGF (r = 0.792, 0.826, 0.841, P < 0.01) and IL-6 ((r = 0.829, 0.817, 0.896, P < 0.01) were also significantly correlated with the duration of DR.

Conclusion: VEGF and IL-6 play important roles in the development of DR. The levels of these two factors are correlated with each other in DR patients. 

论著

全视网膜光凝及术后应用羟苯磺酸钙治疗糖尿病视网膜病变的疗效观察

Curative effect observation of full retinal laser photocoagulation and postoperative application of calcium dobesilate in the treatment of diabetic retinopathy

:246-250
 
目的:探讨全视网膜光凝及术后应用羟苯磺酸钙治疗糖尿病视网膜病变的疗效。方法:选取96例患者,共175只眼,随机分为对照组(48例,86只眼)和研究组(48例,89只眼)。两组均予全视网膜激光光凝治疗,其中研究组术后再予羟苯磺酸钙继续12周治疗。12周后,观察两组患者治疗前后视力、血液流变学的变化。结果:治疗后研究组在视力>1.0范围的患者明显多于对照组(χ2=6.779,P=0.009), 而2组在视力≤0.4,0.4~0.6,0.7~1.0范围患者视力差异比较分别为( χ2=0.003,P=0.955),(χ2=1.640,P=0.200),(χ2=2.148,P=0.143)。治疗后研究组患者的血浆粘度、红细胞压积、红细胞变形指数、纤维蛋白原改善均优于对照组(P<0.05)。研究组总有效率89.9%,对照组75.6%,两组差异比较(χ2 =6.302,P=0.012)。结论:全视网膜激光光凝及术后应用羟苯磺酸钙治疗糖尿病性视网膜病,能有效提高视力及临床疗效,可能与改善患者血液流变相关。
Objective: To investigate the curative effect of the postoperative retinal laser photocoagulation and calcium dobesilate in the treatment of diabetic retinopathy. Methods: Selected 96 patients, 175 eyes, randomly divided into control group (48 cases, 86 eyes) and study group (48 cases, 89 eyes). Two groups were all given retinal laser photocoagulation treatment, while the study group continued to receive calcium dobesilate for 12 weeks after treatment. After 12 weeks, observed the eyesight, change of blood rheology of the two groups. Results: After the treatment, the patients with vision >1.0 in the study group were significantly more than the control group (χ2 =6.779, P=0.009), in the vision range of ≤0.4, 0.4~0.6, 0.7~1.0, the difference between the two groups was (χ2 =0.003, P=0.955), (χ2 =1.640, P=0.200), (χ2=2.148, P=0.143), respectively. After treatment, plasma viscosity, erythrocyte deposited, erythrocyte deformation index, fibrinogen in the study group were better than those in the control group (P<0.05). The total effectiveness in the study group was 89.9%, in the control group was 75.6%, the difference was statistically significant (χ2=6.302, P=0.012). Conclusion: The whole retinal laser photocoagulation and postoperative application of calcium dobesilate in treating the diabetic retinopathy can effectively improve eyesight and clinical curative effect, which may be associated with improving blood rheology.

2型糖尿病视网膜病变与基质金属蛋白酶-3基因多态性关系的研究

Correlation of polymorphism of MMP-3 gene with the risk of type 2 diabetic retinopathy

:153-156
 
目的:探讨基质金属蛋白酶-3(matrix metalloproteinases-3,MMP-3)基因多态位点与承德地区人群2型糖尿病视网膜病变的遗传易感性的关系。方法:应用病例对照研究方法,选取195例糖尿病视网膜病变患者(DR组),其中非增殖性糖尿病视网膜病变(non-proliferative diabetic retinopathy,NPDR)组(n=152)和增殖性糖尿病视网膜病变(proliferative diabetic retinopathy,PDR)组(n=43),205例单纯糖尿病患者(DM组)和261例正常对照组(Control组),采用限制性片段长度多态性(restrictive fragment length polymorphism,RFLP)-聚合酶链反应(polymerase chain reaction,PCR)方法检测MMP-3的基因多态性。结果:MMP-3-1171 5A/6A的等位基因及基因型频率分布在Control组,DM组和DR组之间差异无显著性(P=0.474和P=0.407)。MMP-3-1171 5A/6A的等位基因及基因型频率分布在NPDR和PDR组之间差异无显著性(P=0.724和P=0.820)。结论:MMP-3-1171 5A/6A基因多态性与2型糖尿病视网膜病变的遗传易感性无关。
目的:探讨基质金属蛋白酶-3(matrix metalloproteinases-3,MMP-3)基因多态位点与承德地区人群2型糖尿病视网膜病变的遗传易感性的关系。方法:应用病例对照研究方法,选取195例糖尿病视网膜病变患者(DR组),其中非增殖性糖尿病视网膜病变(non-proliferative diabetic retinopathy,NPDR)组(n=152)和增殖性糖尿病视网膜病变(proliferative diabetic retinopathy,PDR)组(n=43),205例单纯糖尿病患者(DM组)和261例正常对照组(Control组),采用限制性片段长度多态性(restrictive fragment length polymorphism,RFLP)-聚合酶链反应(polymerase chain reaction,PCR)方法检测MMP-3的基因多态性。结果:MMP-3-1171 5A/6A的等位基因及基因型频率分布在Control组,DM组和DR组之间差异无显著性(P=0.474和P=0.407)。MMP-3-1171 5A/6A的等位基因及基因型频率分布在NPDR和PDR组之间差异无显著性(P=0.724和P=0.820)。结论:MMP-3-1171 5A/6A基因多态性与2型糖尿病视网膜病变的遗传易感性无关。

增殖性糖尿病视网膜病变玻璃体 SDF-1 和 VEGE 的含量分析

Vitreous Levels of Stromal Cell-Derived Factor-1and Vascular Endothelial Growth Factor inDiabetic Retinopathy

:6-9
 
目的:研究增殖性糖尿病视网膜病变患者玻璃体基质细胞衍生因子(Strmalcell-derivedfactor-1, SDF-1)和血管内皮生长因子(Vascular endothelial growth factor, VECF)的浓度,及其相互作用关系。
方法:酶联免疫吸附法(Enzyme-linked immunosorbent assay, ELISA)检测玻璃体内 SDF-1 和 VEGF 的含量,每个标本重复3次。实验组为增性糖尿病视网膜病变(Proliferalive diabeticretinopathy, PDR)的住院患者30例,对照组为同期行玻璃体切除术的特发性黄斑裂孔患者12例。
结果: PDR 患者玻璃体 VECF 的平均浓度为(2865.87+387.85) pg/ml,明显高于特发性黄斑裂孔组[(142.42+21.03) pg/ml,< 0.0001]。增殖性糖尿病视网膜病变患者玻璃体 SDF-1的含量平均为(298.40+24.57) pg/ml,对照组为(86.91+15.89) pg/ml,两组的差异具有统计学意义(< 0.0001)。在30例PDR患者玻璃体内 VEGF 和 SDF-1 的含量表现为正相关(Peanson相关系数 r=0.62,< 0.001)。
结论:增殖性糖尿病患者玻璃体 SDF-1 和 VECF 的含量均高于非糖尿病患者,提示 SDF-1 和 VEGF 共同参与了增殖性糖尿病视网膜病变患者病理性新生血管的形成过程。
Purpose: To investigate the levels of stromal cell-derived factor-1(SDF-1) andvascular endothelial growth factor (VEGF) in the vitreous of patients with proliferativediabetic retinopathy.
Methods: The levels of $DF-1 and VEGF in the vitreous of 30 eyes of 30 patients withproliferative diabetic retinopathy(PDR)and 12 eyes of 12 patients with idiopathicmacular hole (MH) were measured by enzyme-linked immunosorbent assay. Vitreousfluid samples were obtained by vitrectomy.
Resuls: The vitreous concentration of VEGF was signifcantly higher in eyes with PDR(2 865.87+387.85 pg/ml) than in eyes with idiopathic macular hole (142.42+21.03 Pgml, P< 0.000 1). The vitreous level of SDF-1 was also significantly higher in eyes withPDR (298.40+24.57 pg/ml ) than in eyes with idiopathic macular hole (86.91+15.89Pg/ml, P<0.000 1 ). The vitreous concentration of SDF-1 correlated significantly with that of VEGF in eyes with PDR( [correlation coefficient]r=0.62,P<0 .001)
Conclution: Vitreous levels of both SDF-1 and VEGF in patients with PDR aresignificantly higher than those of nondiabetic patients. SDF-1 may be correlated withVEGF in angiogenesis in PDR.
论著

湖南地区汉族人群糖尿病视网膜病变危险因素的相关性

Correlation of risk factors of diabetic retinopathy in Han population in Hunan

:509-516
 
目的:分析湖南地区汉族人群中2型糖尿病患者的人口学特征及生化指标,寻找糖尿病视网膜病变的高危因素。方法:釆用病例对照研究,统计湖南地区正常人群、2型糖尿病但无视网膜病变患者、2型糖尿病视网膜病变患者的人口学特征及生化指标的相关数据,进行成组t检验及logistic回归分析,探讨分析糖尿病视网膜病发生的易感因素。所有研究对象均为汉族。结果:对照组[非糖尿病(non-diabetes mellitus,NDM)组]和2型糖尿病未合并视网膜病变[(non-diabetic retinopathy,NDR)]组之间性别分布、年龄分布、BMI、舒张压、HbA1c、总胆固醇、高密度脂蛋白(high-density lipoprotein,HDL)、尿酸及总胆红素差异无统计学意义(均P>0.05)。NDM组中腹围、收缩压、空腹血糖、三酰甘油、肌酐和低密度脂蛋白(low-density lipoprotein,LDL)值均低于NDR组,差异有统计学意义(均P<0.05)。NDM组中BMI、腹围、收缩压、舒张压、空腹血糖、HbA1c、总胆固醇、三酰甘油、肌酐和LDL值均低于2型糖尿病合并视网膜病变组(diabetic retinopathy,DR)组,差异有统计学意义(均P<0.05)。NDR组收缩压、舒张压、HbA1c、总胆固醇、三酰甘油和肌酐值均低于DR组,差异有统计学意义(均P<0.05)。结论:收缩压超过150 mmHg,舒张压超过90mmHg,糖化血红蛋白超过9%,血清肌酐超过100 μmol/L,三酰甘油超过3 mmol/L均为糖尿病患者发生视网膜病变的高危易感因素。
Objective: To analyze the demographic characteristics and biochemical indexes of type 2 diabetic patients in Han population in Hunan, and to find the high-risk factors of diabetic retinopathy. Methods: The data of demographic characteristics and biochemical indexes of normal population, type 2 diabetic patients but without retinopathy and type 2 diabetic retinopathy in Hunan were analyzed. Group t test and logistic regression analysis were used to analyze the susceptibility factors of diabetic retinopathy. All the subjects were Han population. Results: There were no significant differences in gender distribution, age distribution, BMI, diastolic blood pressure, HbA1c,total cholesterol, high-density lipoprotein, uric acid and total bilirubin between the control group [non-diabetes mellitus (NDM) group] and the type 2 diabetic without retinopathy group [non-diabetic retinopathy (NDR)group] (all P>0.05). The abdominal circumference, systolic blood pressure, fasting blood glucose, triglyceride,creatinine and low-density lipoprotein in NDM group were all lower than those in NDR group, and the differences were statistically significant (all P<0.05). BMI, abdominal circumference, systolic blood pressure, diastolic blood pressure, fasting blood glucose, HbA1c, total cholesterol, triglyceride, creatinine and LDL in NDM group were all lower than those in type 2 diabetic retinopathy (DR) group, and the differences were statistically significant (all P<0.05). The comparison between the NDR group and the DR group showed that the values of systolic blood pressure,diastolic blood pressure, HbA1c, total cholesterol, triglyceride and creatinine in the NDR group were all lower than those in the DR group, and the differences were statistically significant (all P<0.05). Conclusion: SBP ≥150 mmHg,DBP ≥90 mmHg, HbA1c ≥9%, serum creatinine ≥100 μmol/L, triglyceride ≥3 mmol/L are the high-risk factors of diabetic retinopathy.
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  • 眼科学报

    主管:中华人民共和国教育部
    主办:中山大学
    承办:中山大学中山眼科中心
    主编:林浩添
    主管:中华人民共和国教育部
    主办:中山大学
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  • Eye Science

    主管:中华人民共和国教育部
    主办:中山大学
    承办:中山大学中山眼科中心
    主编:林浩添
    主管:中华人民共和国教育部
    主办:中山大学
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