糖尿病视网膜病变的流行病学调查及安多明在糖尿病视网膜病变治疗中的应用研究
发布时间：2018-08-17 13:11
【摘要】：第一部分糖尿病视网膜病变的流行病学调查 【目的】 调查广州市番禺地区糖尿病视网膜病变(DR)的患病情况,了解其与病程,高血压及高血脂等合并症的关系。 【方法】 对番禺中心医院2010年内分泌门诊,以及住院部确诊为糖尿病的524例患者进行筛查,参照糖尿病视网膜病变的诊断标准及分期标准,对不同糖尿病分型、是否合并高血脂及高血压、不同病程的患者的患病情况进行统计并分析。 【结果】 番禺地区糖尿病患者中,DR的发病率为45%;1型糖尿病患者中DR的发病率明显高于2型糖尿病患者;单纯糖尿病患者的DR的发病率明显低于合并高血压及高血脂者,其中同时合并高血脂高血压患者的DR的发病率最高,合并高血压及合并高血脂者DR的发病率接近;随病程的延长DR的发病率明显升高,而且其严重程度逐渐加重 【结论】 由于DR是目前临床上很重要的一个致盲性因素,而且在糖尿病患者中具有较高的发病率,因此要呼吁糖尿病患者对该疾病引起足够的重视;临床工作中要加大对糖尿病病人的筛查力度,提倡早期发现,早期诊断,早期治疗;治疗中除了严格的控制血糖血压外,还必须强调同期控制血脂的重要性。 第二部分安多明在糖尿病视网膜病变治疗中的应用研究 【目的】 通过对糖尿病视网膜病变(DR)患者进行激光联合安多明治疗的对比研究,了解安多明在不同分期的治疗效果,为临床治疗提供参考。 【方法】 确诊为糖尿病视网膜病变3-5期的2型糖尿病患者108人,采用相同标准严格控制血糖及血压。随机分为两组,一组54例105眼,为治疗组,采用激光治疗同时联合安多明胶囊口服;另外一组54例102眼为对照组,采用单纯激光治疗。治疗前后行视力、眼底以及行荧光造影检查,根据视力检查标准以及荧光造影标准判定治疗效果,得出相关数据使用SPSS10.0软件,行x2检验,作统计学分析。 【结果】 DR3、4期治疗组(视力、眼底检查及造影)的有效率明显大于对照组,其差异具有统计学意义(P㩳0.05)。DR5期治疗组及对照组的有效率接近,其差异无统计学意义(P㧐0.05)。 【结论】 早期DR(1、2期)的患者可以采用安多明等药物治疗;3、期患者需尽早激光治疗,可以同时辅以安多明提高治疗效果;但对于DR5期患者,安多明的治疗效果并不明显,激光及手术治疗尤为重要。
[Abstract]:Part I Epidemiological investigation of Diabetic Retinopathy [objective] to investigate the prevalence of diabetic retinopathy (DR) in Panyu area of Guangzhou, and to understand its relationship with the course of disease. The relationship between hypertension and hyperlipidemia and other complications. [methods] 524 patients diagnosed as diabetes mellitus in Panyu Central Hospital in 2010 were screened. According to the diagnostic criteria and staging criteria of diabetic retinopathy, whether or not hyperlipidemia and hypertension are associated with different types of diabetes, [results] the incidence of Dr in patients with diabetes in Panyu was significantly higher than that in patients with type 2 diabetes. The incidence of Dr in patients with simple diabetes mellitus was significantly lower than that in patients with hypertension and hyperlipidemia. The incidence of Dr in patients with hyperlipidemia and hyperlipidemia was the highest, and the incidence of Dr in patients with hypertension and hyperlipidemia was similar. With the prolongation of the course of disease, the incidence of Dr increased obviously, and the severity of Dr increased gradually [conclusion] Dr is an important clinical cause of blindness at present. Moreover, there is a high incidence of diabetes in patients with diabetes, so it is necessary to appeal to patients with diabetes to pay enough attention to the disease, to strengthen the screening of patients with diabetes in clinical work, to advocate early detection, early diagnosis and early treatment. In addition to strict control of blood glucose and blood pressure, the importance of controlling blood lipids in the same period must be emphasized. The second part: a comparative study of the application of Amtamine in the treatment of diabetic retinopathy by laser combined with ammine in patients with diabetic retinopathy. To understand the therapeutic effect of Amdolin in different stages and to provide reference for clinical treatment. [methods] 108 patients with type 2 diabetes mellitus were diagnosed as stage 3-5 diabetic retinopathy. Blood sugar and blood pressure are strictly controlled by the same standard. They were randomly divided into two groups: one group (54 cases, 105 eyes), the treatment group (54 cases, 105 eyes) and the other group, 54 cases (102 eyes) were treated with laser alone, and the other group (54 cases, 102 eyes) was treated with laser alone. The visual acuity, fundus and fundus of the eyes were examined before and after the treatment. According to the standard of visual acuity examination and the standard of fluorescence angiography, the therapeutic effect was determined. The relevant data were obtained by using SPSS10.0 software and x2 test. [results] the effective rate of DR3 stage 4 treatment group (visual acuity, fundus examination and contrast group) was significantly higher than that of the control group, and the difference was statistically significant (P0. 05) .The effective rate of DR5 stage treatment group and control group was close to that of control group. There was no significant difference (P 0.05). [conclusion] patients with early stage Dr (stage 1 ~ 2) can be treated with triamcinolone and other drugs, while patients with stage 2 need laser therapy as early as possible, and can be supplemented with ammine to improve the therapeutic effect. However, for DR5 patients, the effect of Amtamine is not obvious, laser and surgical treatment is particularly important.
【学位授予单位】：广州医学院
【学位级别】：硕士
【学位授予年份】：2011
【分类号】：R587.2;R774.1
本文编号：2187738
[Abstract]:Part I Epidemiological investigation of Diabetic Retinopathy [objective] to investigate the prevalence of diabetic retinopathy (DR) in Panyu area of Guangzhou, and to understand its relationship with the course of disease. The relationship between hypertension and hyperlipidemia and other complications. [methods] 524 patients diagnosed as diabetes mellitus in Panyu Central Hospital in 2010 were screened. According to the diagnostic criteria and staging criteria of diabetic retinopathy, whether or not hyperlipidemia and hypertension are associated with different types of diabetes, [results] the incidence of Dr in patients with diabetes in Panyu was significantly higher than that in patients with type 2 diabetes. The incidence of Dr in patients with simple diabetes mellitus was significantly lower than that in patients with hypertension and hyperlipidemia. The incidence of Dr in patients with hyperlipidemia and hyperlipidemia was the highest, and the incidence of Dr in patients with hypertension and hyperlipidemia was similar. With the prolongation of the course of disease, the incidence of Dr increased obviously, and the severity of Dr increased gradually [conclusion] Dr is an important clinical cause of blindness at present. Moreover, there is a high incidence of diabetes in patients with diabetes, so it is necessary to appeal to patients with diabetes to pay enough attention to the disease, to strengthen the screening of patients with diabetes in clinical work, to advocate early detection, early diagnosis and early treatment. In addition to strict control of blood glucose and blood pressure, the importance of controlling blood lipids in the same period must be emphasized. The second part: a comparative study of the application of Amtamine in the treatment of diabetic retinopathy by laser combined with ammine in patients with diabetic retinopathy. To understand the therapeutic effect of Amdolin in different stages and to provide reference for clinical treatment. [methods] 108 patients with type 2 diabetes mellitus were diagnosed as stage 3-5 diabetic retinopathy. Blood sugar and blood pressure are strictly controlled by the same standard. They were randomly divided into two groups: one group (54 cases, 105 eyes), the treatment group (54 cases, 105 eyes) and the other group, 54 cases (102 eyes) were treated with laser alone, and the other group (54 cases, 102 eyes) was treated with laser alone. The visual acuity, fundus and fundus of the eyes were examined before and after the treatment. According to the standard of visual acuity examination and the standard of fluorescence angiography, the therapeutic effect was determined. The relevant data were obtained by using SPSS10.0 software and x2 test. [results] the effective rate of DR3 stage 4 treatment group (visual acuity, fundus examination and contrast group) was significantly higher than that of the control group, and the difference was statistically significant (P0. 05) .The effective rate of DR5 stage treatment group and control group was close to that of control group. There was no significant difference (P 0.05). [conclusion] patients with early stage Dr (stage 1 ~ 2) can be treated with triamcinolone and other drugs, while patients with stage 2 need laser therapy as early as possible, and can be supplemented with ammine to improve the therapeutic effect. However, for DR5 patients, the effect of Amtamine is not obvious, laser and surgical treatment is particularly important.
【学位授予单位】：广州医学院
【学位级别】：硕士
【学位授予年份】：2011
【分类号】：R587.2;R774.1
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