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目的探讨非胰岛素依赖型糖尿病性白内障发病的有关因素。方法对729例非胰岛素依赖型糖尿病患者检查视力、外眼、眼前段、眼底,血液检查项目包括血糖、糖化血红蛋白A1c(AHbA1c)、尿素氮(BUN)、肌酐(Cr)、尿酸(UA)、N乙酰βD氨基葡萄糖苷酶(NAG)、β2微球蛋白(β2MG)和白蛋白,尿液检查项目包括尿糖、pH、蛋白质、细胞、管型和酮体,白内障的诊断按Chylack等的晶状体混浊分类系统Ⅱ进行。结果白内障在本组糖尿病患者中的发生率为62.37%(494/729),白内障的发生与性别无关,但与糖尿病的病程有关。糖尿病病程少于5年(A组)、5～10年(B组)和10年以上(C组)者的发生率分别为49.67%(228/459)、71.84%(125/174)和88.68%(141/159)。A组和B组及C组间的白内障发生率差异有非常显著意义,B组及C组间的白内障发生率差异则无显著意义。在血液BUN和(或)Cr含量升高的糖尿病患者白内障的发生率明显高于BUN和(或)Cr含量正常的糖尿病患者。结论非胰岛素依赖型糖尿病患者病程的延长、肾功能不良及血糖控制不良可加速白内障的发展。
Objective To investigate the related factors of non-insulin-dependent diabetic cataract. Methods Blood glucose, hemoglobin A1c (AHbA1c), blood urea nitrogen (BUN), creatinine (Cr) and uric acid (UA) were measured in 729 patients with non-insulin dependent diabetes mellitus N acetyl βD glucosaminidase (NAG), β2 microglobulin (β2MG) and albumin, urine test items include urine sugar, pH, protein, cells, tubular and ketone body, the diagnosis of cataract according to Chylack lens Turbid Classification System II. Results The incidence of cataract in this group was 62.37% (494/729). The incidence of cataract was not related to sex but was related to the course of diabetes. The incidence of diabetes was less than 5 years (group A), 5 to 10 years (group B) and 10 years (group C) were 49.67% (228/459), 71.84% (125/174) and 88.68 % (141/159). There was a significant difference in the incidence of cataracts between groups A and B and C, but there was no significant difference between groups B and C in the incidence of cataracts. The incidence of cataracts in diabetic patients with elevated levels of BUN and / or Cr in the blood is significantly higher than in patients with normal BUN and / or Cr levels. Conclusion The duration of non-insulin-dependent diabetes mellitus is prolonged, renal dysfunction and poor glycemic control may accelerate the development of cataract.