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研究生:曹雪琳
研究生(外文):Tsao, Hsueh-Lin
論文名稱:金城鎮糖尿病患視網膜病變之流行病學研究
論文名稱(外文):Epidemiology study on diabetic retinopathy in Kin-Chen, Kinmen
指導教授:周碧瑟周碧瑟引用關係
指導教授(外文):Pesus Chou
學位類別:碩士
校院名稱:國立陽明大學
系所名稱:公共衛生學研究所
學門:醫藥衛生學門
學類:公共衛生學類
論文種類:學術論文
論文出版年:1997
畢業學年度:85
語文別:中文
論文頁數:96
中文關鍵詞:公共衛生衛生健康糖尿病視網膜
外文關鍵詞:PUBLIC-SANITATIONSANITATIONHEALTH
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在高度開發中國家中的四大失明原因中,以糖尿病視網膜病變所造成的失明最為嚴重,對社會的衝擊最大。
本研究乃以社區為基礎的縱斷性研究,以1992至1994年於金門縣金城鎮篩選出來30歲以上的糖尿病患360人為研究樣本。由陽明十字軍於1996及 1997年前往收集資料。兩年均由同一位眼科專科醫師以間接眼底鏡進行散瞳眼底檢查,並收集問卷資料、測量血壓、身高、體重等生理指標、檢查尿液之尿蛋白及微量白蛋白尿、抽止作糖化血色素及生化檢查。
橫斷研究部份:
1996-1997間發現有36位糖尿病視網膜病變,期盛行率為15.2%,包括背景期糖尿病視網膜病變7.2%、前增殖期糖尿病視網膜病變7.2%、增殖期糖尿病視網膜病變0.8%。
單變項分析發現性別、糖尿病患病期間、受檢時年齡、糖化血色素、肌酸酐、微量白蛋白尿等變項與視網膜病變有相關。對數迴歸模式分析的結果顯示,糖尿病患病期間,糖化血色素、微量白蛋白尿、性別與視網膜病變有相關。
追蹤研究部份:
一、1996年至1997年一年的追蹤研究
有117人糖尿病患在1996年時未患有糖尿病視網膜病變,於1997年時有14人新發生視網膜病變,6位有惡化現象,年發生率為11.97%,惡化比率為33.33%,其中惡化至增殖期者為11.11%
單變項分析發現患病期間、血中尿素氮等變項與糖尿病視網膜病變具有統計上的相關。對數迴歸模式分析的結果顯示,糖尿病患病期間為視網膜病變發生的最重要危險因子。
二、1992年至1997年五年的追蹤研究
若以1996年檢查時尚未患有糖尿病視網膜病變之117住糖尿病患,推論其於 1992年時應無糖尿病視網膜病變,依其於 1997年之眼底檢查結果,而對 1992年之糖尿病視網膜病變的危險因子進行分析,則單變項分析中,患病期問與空腹血漿糖具有統計顯著意義。對數迴歸模式分析的結果顯示,空腹血漿糖為視網膜病變發生的最重要危險因子。
The four major causes of blindness in highly advanced countries, diabetic retinopathy is the most serious and the greatest impact in the society.
Total samples used in this community-based longitudinal study, include 360 diabetic patients who over 30 years in Kin-chen, Kinmen in 1992-94. We investigate the patients'' disease condiction by questionaire, blood test (HbAlc、biochemistry), urine test (urine protein、microalbumin) and physical examination ( body weight 、 body height 、 blood pressure et al.) and ophthalmological examination in 1996 and 1997. Patients were performed by the same ophthalmologist using the indirect ophthalmoscopy through an dilated pupil in two years. The analysis is summarized as follows.
Cross-sectional Analysis:
There are 37 persons who are diabetic retinopathy in 1996-97. The period prevalence is 15.2 % , including background diabetic retinopathy 7.2 % , preproliferative diabetic retinopathy 7.2 % and proliferative diabetic retinopathy 0.8%.
The univariate analysis disclosed that diabetic retinopathy was correlated with gender, duration of diabetes, age, hemoglobin Ale, serum creatinine and urine micoalbumin. By stepwise logistic regression analysis, duration of diabetes, hemoglobin Ale and urine micoalbumin were related to diabetic retinopathy.
Longitudinal Analysis:
一、The one-year follow-up study from 1996 to 1997
Among the 117 subjects who had no diabetic retinopathy in 1996, 14 subjects developed diabetic retinopathy 1 year later giving a 1-year incidence of 11.97 % . Of the 18 subjected intially with background or preproliferative retinopathy, evidence of deterioration developed in 6 subjects. The incidence of progression was 33.33 % including the incidence of progression to proliferative of 11.11%.
The univariate analysis disclosed that the development of retinopathy was correlated with duration of diabetes and blood urea nitroqen. Stepwise logistic regression analysis revealed that duration of diabetes was the most significant risk factors related to the development of retinopathy.
二、The five-year follow-up study from 1992 to 1997
Assume 117 subjects who had no retinopathy should be free of disease in 1992. According to the results offundus examination in 1997, We analysis the risk factors of diabetic retinopathy in 1992. The univariate analysis disclosed that diabetic retinopathy was correlated with duration of diabetes and fasting plasma glucose. By stepwise logistic regression analysis, fasting plasma glucose was the most important risk factor related to the development of diabetic retinopathy.
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