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目的研究分析糖尿病视网膜病变进展危险因素。方法回顾性分析2012年7月-2015年7月收治的137例糖尿病患者的临床资料,按照糖尿病患者的视网膜病变情况分为3组,将43例未发生视网膜病变的患者作为对照组,46例非增生型视网膜病变作为观察组,48例增生型视网膜病变作为试验组。统计糖尿病血压、血糖、糖化血红蛋白、血脂、白蛋白肌酐比值等指标情况,并利用多因素非条件logistic回归分析,观察糖尿病视网膜病变进展高危因素。结果 3组患者的糖化血红蛋白、总胆固醇、三酰甘油、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、体质量指数、餐后2 h血糖及空腹血糖指标差异均无统计学意义(P>0.05);病程时间、血管生成素2、血管内皮生长因子及尿白蛋白肌酐比值组间对比,差异均有统计学意义(P<0.05);多因素logistic回归分析结果显示,糖尿病病程、糖化血红蛋白、收缩压、尿白蛋白肌酐比值及血管内皮生长因子均与糖尿病视网膜病变因素独立相关(P<0.05)。结论糖尿病患者病程的增长,血糖、血压状态不稳以及血管生成素2、血管内皮生长因子的升高均可造成糖尿病视网膜病变的进展。
Objective To study the risk factors of progression of diabetic retinopathy. Methods The clinical data of 137 patients with diabetes mellitus admitted from July 2012 to July 2015 were retrospectively analyzed. According to the diabetic retinopathy, the patients were divided into 3 groups. 43 patients without retinopathy were included as control group, and 46 patients Non-proliferative retinopathy as observation group and 48 cases of proliferative retinopathy as experimental group. Blood pressure, blood glucose, glycosylated hemoglobin, serum lipids, albumin creatinine and other indicators of the situation, and the use of multivariate non-conditional logistic regression analysis to observe the risk factors for the progression of diabetic retinopathy. Results There was no significant difference in HbAlc, total cholesterol, triglyceride, LDL cholesterol, HDL cholesterol, body mass index, 2 h postprandial blood glucose and fasting plasma glucose among the three groups (P> 0.05 ); Duration of disease, angiopoietin 2, vascular endothelial growth factor and urinary albumin creatinine ratio between the two groups were statistically significant (P <0.05); multivariate logistic regression analysis showed that duration of diabetes, glycosylated hemoglobin, Systolic blood pressure, urinary albumin creatinine ratio and vascular endothelial growth factor were independently associated with diabetic retinopathy (P <0.05). Conclusion The course of diabetic patients with diabetes mellitus, blood glucose, unstable blood pressure status, angiopoietin 2, and vascular endothelial growth factor may all contribute to the progression of diabetic retinopathy.