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目的研究分析2型糖尿病患者视网膜病变(DR)与冠状动脉粥样硬化(CAS)的关系及DR的危险因素。方法将2012年3月—2014年12月郑州第三人民医院诊治的100例T2DM中45例T2DM合并DR患者设为研究Ⅰ组,其余55例非DR的T2DM患者设为研究Ⅱ组,另选择同期于本院体检的85例健康者作为对照组,3组研究对象均接受冠状动脉64层螺旋CT成像(MDCTA)检查,另外检测血压、血糖、体重指数(BMI)、尿白蛋白排泄率(UAER)、清蛋白(Alb)等实验室指标。结果研究Ⅰ、Ⅱ组CAS与Alb发生率分别为80.00%与55.56%、34.55%与25.45%均高于对照组3.53%与0.00%(P<0.01),其中Ⅰ组CAS与Alb发生率最高(P<0.01);研究Ⅰ、Ⅱ组SBP、FPG、Hb Alc、BMI与UAER水平明显高于对照组(P<0.01),e GFR明显低于对照组(P<0.01),且Ⅰ组SBP、BMI与UAER水平明显高于Ⅱ组(P<0.05)。结论 T2DM患者DR是引发CAS的独立性重要因素,SBP、BMI与UAER是DR的主要危险因素,临床应加强重视。
Objective To study the relationship between retinopathy (DR) and coronary atherosclerosis (CAS) and the risk factors of DR in type 2 diabetic patients. Methods Forty-five patients with T2DM complicated with DR in 100 T2DM patients diagnosed and treated in Zhengzhou Third People’s Hospital from March 2012 to December 2014 were enrolled in study Ⅰ, and the remaining 55 non-DR T2DM patients were enrolled into study Ⅱ group. In the same period, 85 healthy people in our hospital were taken as the control group. All the three groups were examined by 64-slice CT coronary angiography (MDCTA), and blood pressure, blood glucose, body mass index (BMI) and urinary albumin excretion rate UAER), albumin (Alb) and other laboratory indicators. Results The incidences of CAS and Alb in group Ⅰ and group Ⅱ were 80.00% and 55.56%, 34.55% and 25.45%, respectively, which were significantly higher than those in control group (3.53% vs 0.00%, P <0.01) P <0.01). The levels of SBP, FPG, Hb Alc, BMI and UAER in group Ⅰ and group Ⅱ were significantly higher than those in control group (P <0.01) BMI and UAER levels were significantly higher than those in group Ⅱ (P <0.05). Conclusions DR in T2DM patients is an important factor to trigger the independence of CAS. SBP, BMI and UAER are the main risk factors of DR, so clinical should pay more attention to it.