早期糖尿病视网膜病变进展的多因素分析

发布时间：2018-06-03 17:34

本文选题：糖尿病视网膜病变 + 危险因素　；参考：《河南科技大学》2010年硕士论文

【摘要】：目的1.探讨早期糖尿病视网膜病变(DR)发生发展的相关危险因素。2.分析视觉诱发电位(VEP)与早期DR发生发展之间的相关性。方法收集DR-0期,轻、中、重度非增生性糖尿病视网膜病变(NPDR)各30例,正常体检人群作为对照组40例,记录年龄、病程、血糖、血压、血脂、血小板参数、凝血功能以及VEP检查在不同分组中的值,计量数据均以x±s表示,各因素在对照组与DR组比较采用t检验,了解DR发生的危险因素,各因素与DR组之间的相关性采用直线相关分析,了解促使DR发展的危险因素;VEP在对照组与DR组检查结果比较采用t检验,了解VEP对早期DR的诊断作用,VEP与DR组之间的相关性分析采用直线相关,了解VEP与DR发展之间的关系。结果1. DR组的糖化血红蛋白(HbA1c)、空腹血糖(FBG)、收缩压(SBP)、胆固醇(CHO)、甘油三酯(TG)、低密度脂蛋白(LDL)、纤维蛋白原(FG)明显高于对照组,对两组数据进行t检验,差异有统计学意义(SBP、CHO、TG、LDL、FG P0.05, HbA1c、FBG P0.01);而高密度脂蛋白(HDL)则低于对照组,差异有统计学意义(P0.05)。病程在DR-0期, NPDR轻、中、重期值分别为5.36±1.98y、7.88±2.25y、10.51±3.26y、13.23±4.54y,与DR的病变程度呈显著正相关(r=0.681); HbA1c在DR-0期, NPDR轻、中、重期值分别为7.46±1.85%、9.23±2.80%、9.87±2.95%、10.51±3.69%,与DR的病变程度呈显著正相关(r=0.345) ; TG在DR-0期, NPDR轻、中、重期值分别为2.18±0.39mmol/L、2.34±0.68mmol/L、2.40±0.73mmol/L、2.65±0.76mmol/L,与DR的病变程度呈显著正相关(r=0.358)。 2. VEP的P100潜伏期(LP100)及P100幅值(AP100)明显高于对照组,对两组数据进行独立样本的t检验,差异有统计学意义(LP100及AP100 P0.05),LP100及AP100与早期DR进展之间相关性分析无统计学意义(r=0.147; r=0.214)。结论SBP、HbA1c、FBG、CHO、TG、LDL、HDL及FG可能是早期DR发生的危险因素,将这些因素控制在正常范围可以延缓DR发生;病程、HbA1c、TG可能与早期DR的发展有一定相关性,这些因素高于正常范围可能会促进早期DR的发展;LP100、AP100对DR的早期诊断有一定指导意义,未发现对早期DR的进展的指导意义。
[Abstract]:Objective 1. To investigate the risk factors related to the development of early diabetic retinopathy. 2. 2. To analyze the correlation between visual evoked potential (VEP) and the development of early Dr. Methods the age, course, blood glucose, blood pressure, blood lipid and platelet parameters were recorded in 30 cases of DR-0, 30 cases of mild, moderate and severe nonproliferative diabetic retinopathy and 40 cases of normal controls. The blood coagulation function and the value of VEP in different groups were expressed as x 卤s. T test was used to understand the risk factors of Dr in the control group and Dr group. The correlation between each factor and Dr group was analyzed by linear correlation analysis to understand that the risk factor of Dr development was compared with that of Dr group by t test. To understand the diagnostic effect of VEP on early Dr the correlation between VEP and Dr was analyzed by linear correlation and the relationship between VEP and Dr development was studied. Result 1. The glycosylated hemoglobin (HbA1cN), fasting blood glucose (FBGN), systolic blood pressure (SBP), cholesterol triglyceride (TGN), low density lipoprotein (LDLN), fibrinogen (FG) in Dr group were significantly higher than those in control group. The difference was statistically significant (P 0.05, HbA1cFBG P 0.01, HDL) was significantly lower than that in the control group (P 0.05), and the difference was statistically significant (P 0.05) between the control group and the control group (P < 0.05), but the difference was statistically significant (P < 0.05), but the high density lipoprotein (HDL) was significantly lower than that in the control group (P < 0.05). In the DR-0 stage, NPDR was mild, and the severe stage was 5.36 卤1.98yr 7.88 卤2.25yr 10.51 卤3.26yg 13.23 卤4.54yr, which was positively correlated with the degree of Dr lesion, HbA1c was 7.46 卤1.8599.23 卤2.95yr 9.87 卤2.95yr 10.51 卤3.69yr in the DR-0 stage, and was significantly correlated with the pathological degree of Dr in DR-0 stage, NPDR light, moderate and moderate, TG was significant positive correlation with Dr in DR-0 stage, NPDR was light, moderate, and severe stage was 7.46 卤1.85 卤2.85yr 9.87 卤2.95yr 10.51 卤3.69yr, TG was significant positive correlation with the degree of Dr. The duration was 2.18 卤0.39 mmol / L, 2.34 卤0.68 mmol / L, 2.40 卤0.73 mmol / L, 2.65 卤0.76 mmol / L, respectively. There was a significant positive correlation between the severity of Dr and the severity of Dr. 2. The P100 latency (LP100) and P100 amplitude (AP100) of VEP were significantly higher than those of the control group. The t test of independent samples of the two groups showed that there was no significant correlation between LP100 and AP100 P0.05LP100 and AP100 and the progression of early Dr. There was no significant correlation between LP100 and AP100 P0.05LP100, r0.2147r0.2147. Conclusion HDL and FG may be the risk factors of early Dr, which can be delayed by controlling these factors in normal range, and may be related to the development of early Dr. These factors above the normal range may promote the development of early Dr. LP100 AP100 may be helpful to the early diagnosis of Dr, but not to the progression of early Dr.
【学位授予单位】：河南科技大学
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R587.1;R774.1

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