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目的了解2型糖尿病患者首次就诊眼科查眼底距离确诊糖尿病的时间及当时糖尿病视网膜病变(DR)的病情状况。设计问卷调查。研究对象北京同仁医院眼科专家门诊就诊的2型糖尿病患者956例(1905眼)。方法采用自行设计的问卷进行调查。根据患者的初次眼底检查距确诊糖尿病的时间、眼科初诊时DR病情、糖尿病病程、受教育程度、居住地域进行分组分析。主要指标初次眼底检查距离确诊糖尿病的时间、DR病情状况。结果初次眼底检查距离确诊糖尿病的时间,糖尿病病程越长者相对越晚(P均<0.05);在不同受教育程度组未见明显差异;城镇患者相对早于农村患者(P均<0.05)。糖尿病病程越长组患者发生玻璃体积血、视网膜脱离及需要眼底激光治疗的比例也相对越高(P均<0.05)。小学文化组糖尿病患者建议眼底激光治疗和发现玻璃体积血的比例均高于中学及大专文化组(P均<0.05)。初诊时糖尿病患者发生玻璃体积血及视网膜脱离的比例在北京与外地患者间无显著差异(P均<0.05)。DR病情在城镇患者比农村患者相对轻(P均<0.05)。结论初步调查结果表明大部分糖尿病患者进行眼底检查的时间较晚,低文化程度及偏远地域的患者往往就诊更晚、病情更重。
Objective To understand the time of diag- nosis and the diabetic retinopathy (DR) at the first ophthalmologic examination in type 2 diabetic patients. Design Questionnaire. The study included 956 patients (1905 eyes) with type 2 diabetes who were treated by ophthalmic experts in Beijing Tongren Hospital. Methods Self-designed questionnaires were used to investigate. According to the patient’s initial fundus examination from the time of diagnosis of diabetes, early diagnosis of eye disease DR, diabetes course, education, living area for group analysis. The main indicators of the time of the first fundus examination confirmed the time of diabetes, DR condition. Results The time from the first fundus examination to the diagnosis of diabetes mellitus was relatively later (all P <0.05). There was no significant difference among different educational levels. The urban patients were earlier than those from rural areas (all P <0.05). Patients with longer duration of diabetes had vitreous hemorrhage, retinal detachment and retinal laser treatment (P <0.05). The proportion of fundus laser treatment and vitreous hemorrhage suggested by primary school students with diabetes was higher than that of secondary and tertiary education groups (all P <0.05). There was no significant difference in the proportion of vitreous hemorrhage and retinal detachment between diabetic patients and newly diagnosed diabetic patients (all P <0.05). DR patients in rural areas than in rural patients were relatively light (P all <0.05). Conclusions The preliminary findings indicate that most diabetic patients have a late fundus examination. Patients with low educational level and remote areas often visit later and have more serious illness.