摘要
目的了解上海市嘉定区社区糖尿病患者糖尿病视网膜病变(diabetic retinopathy,DR)的发病水平。方法2017年对辖区13家社区在管2型糖尿病患者开展DR检查,并在2018—2021年每年定期组织开展DR随访检查。2018—2021年每年均有新的患者进入随访队列,最终计算患者视网膜病变的4年累积发病率和发病密度等指标。DR检查内容包括视力检查、电脑验光、眼底拍片等。结果2017年共有13184名糖尿病患者参与DR筛查,2018—2021年每年定期随访检查,最终符合累积发病率统计要求的病例数为8758例,4年随访期间发生DR病变者共937例,累积发病率10.70%,年平均发病率2.68%。其中,男性与女性的累积发病率(10.85%vs.10.56%)无显著差异,累积发病率随年龄段增加有所降低,但差异无统计学意义。2017年入组参与DR筛查且未检出DR病变者,经2018—2021年每年定期随访,加上2018—2021年新增的随访对象,最终符合发病密度统计要求的糖尿病患者数为10253例,DR发病密度为34.20/千人年,其中男性为35.54/千人年,女性为33.03/千人年。Cox回归分析结果显示,男性(HR=1.278,95%CI:1.120~1.458)糖尿病患者更容易发生DR,裸眼视力较好(HR=0.373,95%CI:0.172~0.809)是糖尿病患者发生DR的保护因素。结论上海市嘉定区糖尿病患者DR发病率较高,定期随访应答率较低。建议加强宣传,定期开展糖尿病患者DR筛查,并重点关注男性、裸眼视力差的糖尿病患者。
Objective To investigate the occurrence and distribution of diabetic retinopathy(DR)in patients with diabetes in Jiading District,Shanghai.Methods DR examination was conducted in 13 communities of the jurisdiction for the patients with type 2 diabetes in 2017,and DR follow-up examination was regularly organized from 2018 to 2021,and new patients entered the follow-up cohort every year from 2018 to 2021.Finally,the 4-year cumulative incidence and incidence density of patients with retinopathy were calculated.DR examination included vision examination,computer optometry,fundus film,etc.Results A total of 13184 diabetic patients participated in DR screening in 2017,and annual follow-up examinations were conducted from 2018 to 2021.A total of 8758 patients were included in the cumulative incidence statistics.During the 4-year follow-up period,937 patients developed DR lesions,with a cumulative incidence of 10.70%and an annual average incidence of 2.68%.The cumulative incidence of male(10.85%)was slightly higher than that of female(10.56%).The cumulative incidence decreased with the increase of age group without statistic difference.The patients enrolled in 2017 who participated in DR screening and did not detect DR lesions were followed up annually from 2018 to 2021,and the newly added patients were followed up from 2018 to 2021.The number of cases finally included in the incidence density statistics was 10253.After 4 years of follow-up,the incidence density of DR in diabetic patients was 34.20/1000 person-years.The incidence density was 35.54/1000 person-years for males and 33.03/1000 person-years for females.Cox regression analysis showed that male(HR=1.278,95%CI:1.120-1.458)diabetic patients were more likely to develop DR,and better naked eye vision(HR=0.373,95%CI:0.172-0.809)was a protective factor for the development of DR in diabetic patients.Conclusion The incidence of DR in diabetic patients is relatively high in Jiading District,Shanghai.While the response rate of regular follow-up is relatively low.It is necessary to strengthen the publicity,carry out regular DR screening in diabetic patients,and focus on male,poor naked eye vision diabetic patients.
作者
彭慧
杨飞飞
张颜菲
薛俊磊
于宏杰
季莹
袁红
彭谦
王颖
PENG Hui;YANG Fei-fei;ZHANG Yan-fei;XUE Jun-lei;YU Hong-jie;JI Ying;YUAN Hong;PENG Qian;WANG Ying(Department of School Health and Eye Disease Prevention,Shanghai Center for Disease Control and Prevention of Jiading District,Shanghai 201899,China;Department of Social Medicine,School of Public Health,Fudan University,Shanghai 200032,China)
出处
《复旦学报（医学版）》
CAS
CSCD
北大核心
2023年第3期337-344,361,共9页
Fudan University Journal of Medical Sciences
基金
上海市加强公共卫生体系建设三年行动计划(2015—2017年)项目(GWIV3.3)
上海市嘉定区公共卫生优秀人才培养计划-学科后备带头人项目。
关键词
糖尿病
视网膜病变
累积发病率
发病密度
diabetic mellitus
retinopathy
cumulative incidence
incidence density
