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糖尿病性视网膜病变中观察到的变化:对西班牙居民的八年随访

Romero-Aroca P, de la Riva-Fernandez S, Valls-Mateu A, et al.

期刊名称:British Journal of Ophthalmology

卷期:2016年第100卷第10期

摘要

背景/目的:以人群为基础对糖尿病(DM)患者进行研究,确定糖尿病性视网膜病变(DR)和糖尿病性黄斑水肿(DMO)发病率的变化及它们的风险因子。该研究涉及我们16个初级卫生保健区(HCAs)。方法:在八年随访过程中,对总数为15396的白人糖尿病患者进行基于人群的前瞻性研究。这些人占我们卫生保健区糖尿病患者总数的86.53%。8年中,平均每位患者要随访检查3.18±1.11次。结果:DR发病率的年平均值为8.37±2.19% (8.09%-8.99%),晚期DR发病率的年平均值为0.46±0.22% (0.03-0.78),DMO发病率的年平均值为2.19±0.18% (2%-2.49%)。后三年可观察到发病率的明显增加,DR发病率从2007年的8.09%增加到2014年的8.99%。DMO发病率从2007年的2%增加到2014年的2.49%。在一些年龄组中这些增加更为明显。对于41至50岁、51至60岁的DR患者,以及41至50岁、51至60岁和61至70岁的晚期DR患者来说,发病率的增加更为显著。这些增加与糖化血红蛋白值的增加以及病人使用胰岛素进行治疗有关。结论:我们观察到DR和DMO的发病率有所增加,尤其对于31到70岁的患者来说,这与糖尿病的不良代谢控制有关。我们的结果表明,如果目前的研究结果没有得到正确处理的话,不久的将来将会有更多的眼部并发症,比如新生血管性青光眼。

BACKGROUND/AIMS:To determine the changes in the incidence of diabetic retinopathy (DR), diabetic macular oedema (DMO) and their risk factors in a population-based study of patients with diabetes mellitus (DM) referred to our 16 Primary Health Care Areas (HCAs).METHODS:Prospective population-based study of a total of 15396 Caucasian patients with DM, who represent 86.53% of the total patients with DM in our HCAs, were studied over an 8-year follow-up period. All patients were screened with a mean follow-up of 3.18±1.11 times for each patient over the 8years.RESULTS:The yearly mean value of any DR was 8.37±2.19% (8.09%-8.99%); of advanced DR yearly mean value of 0.46±0.22% (0.03-0.78); and of DMO a yearly mean value of 2.19±0.18% (2%-2.49%). A clear increase was observed in the last 3years, any DR increased from 8.09% in 2007 to 8.99% in 2014, and DMO from 2% in 2007 to 2.49% in 2014. These increases were more evident in some age groups. For patients with any DR aged 41-50 and 51-60 and for patients with advanced DR aged 41-50, 51-60 and 61-70, the increase was more marked, related to an increase in HbA1c values or to patients treated with insulin. CONCLUSIONS:An increase in the incidence of DR and DMO was observed, especially in the younger patients aged between 31 and 70years. This is linked to bad metabolic control of DM. Our results suggest a greater number of ocular complications in the near future, such as neovascular glaucoma, if these current findings are not addressed.


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