摘要目的 分析2型糖尿病(DM)患者血糖控制相关因素与糖尿病视网膜病变(DR)发生的关系.方法 对住院的412例DM患者DR筛查分期资料与患者病史资料糖化血红蛋白(HbAlC)、空腹和餐后1、2、3 h血糖、胰岛素、C肽检测结果和血糖、胰岛素、C肽波动值进行相关分析.结果 (1)DR及增生型DR(PDR)患病率随DM病程的延长明显增加;(2)非DR组、非PDR组及PDR组3组患者间年龄、DM病程、体质指数、高血压级别、HbAlC、餐后2、3 h血糖、餐后1、2、3 h血糖波动值、空腹胰岛素、餐后1、2 h胰岛素、餐后1、2、3 h胰岛素波动值、空腹C肽、餐后1、2、3 h C肽、餐后1、2、3 h C肽波动值比较,差异均有统计学意义(P＜0.05);(3)多因素Logistic回归分析显示,餐后3 h血糖、空腹胰岛素与DR发生在统计学上相关(P＜0.05).结论 餐后血糖和空腹胰岛素为DR发生的危险因素;餐后胰岛素、空腹及餐后C肽的检测和血糖、胰岛素及C肽餐后波动值能在一定程度上可作为DR是否发生的预测指标.

abstractsObjective To explore the related risk factors for diabetic retinopathy(DR)in type 2diabetes.Methods The clinical data of 412 type 2 diabetes patients,diagnosed between 2003 and 2010,were analyzed retrospectively.The diagnosis of DR and proliferative diabetic retinopathy(PDR)was confirmed by ophthalmoloseopy and fundus fluorescein angiography.Glycated hemoglobin Alc,glucose,insulin,and C-peptide of fasting plasma,and 1,2 and 3 hours postprandial plasma were measured.According to the above-mentioned data,get the fluctuation of glucose,insulin and C-peptide of 1,2 and 3hour postprandial plasma.Results The morbidity of DR and PDR increased following the longer disease duration.Age,diabetic duration,body mass index(BMI),hypertension grade,HbAlC,fasting plasma insulin and C-peptide,2 and 3 hours postprandial plasma glucose,1 and 2 hours postprandial plasma insulin,1,2 and 3 hour postprandial plasma C-peptide,1,2 and 3 hours postprandial plasma glucose,insulin and C-peptide fluctuation are different statistically among non-DR group,non-PDR group and PDR group(P＜0.05).3 hours postprandial plasma glucose and fasting plasma insulin were risk factors of DR (P＜0.05).Conclusions Postprandial plasma glucose and fasting plasma insulin were risk factors of DR.Nevertheless,postprandial insulin,fasting and postprandial C-peptide,postprandial plasma glucose,insulin and C-peptide fluctuation were useful for DR diagnosis.