老年糖尿病患者前部缺血性视神经病变的风险更大

Elderly Diabetics at More Risk of Anterior Ischemic Optic Neuropathy

老年糖尿病患者前部缺血性视神经病变的风险更大海南医学院附属医院内分泌科王新军

NEW YORK (Reuters Health) Apr 14 - Diabetes mellitus significantly increases the risk of nonarteritic anterior ischemic optic neuropathy (NAION) in the elderly, researchers reported March 24th online in Ophthalmology.

纽约（路透社）4月14 ?研究人员3月24日在眼科在线报道，在老年人，糖尿病大大增加了非动脉炎性前部缺血性视神经病变（(NAION）的风险。
This is the first study to show that the incidence of NAION is increased among diabetics, coauthor Dr. Michael S. Lee told Reuters Health by email.

这是首次研究表明糖尿病患者中缺血性视神经病变发病率增加，该研究的共同作者Michael S. Lee博士在电子邮件中告诉路透社健康频道记者。
"The annual incidence of NAION among those 68 and older is much higher than previously reported," he added. "We found an incidence of 82 per 100,000. Previous studies had shown an incidence of 2 per 100,000 and 10 per 100,000."

“在68岁以上的人群，NAION的年发病率远远高于此前报道，”他补充说。“我们发现每发病率是82/10万。以往的研究先是发病率为2~10/10万。“
Dr. Lee of the University of Minnesota, Minneapolis and colleagues used claims data from a 5% sample of Medicare beneficiaries to identify 25,515 patients with diabetes. All were at least 68 years old in 1994 when they were first diagnosed with diabete s. They were compared with an equal number of matched controls.

美国明尼苏达州立大学Lee博士和他的同事研究了5％的医疗保险受益人索赔抽样数据，共有25,515例糖尿病患者。所有患者在1994年至少68岁时首次诊断出患有糖尿病。他们与相同数量的匹配对照组进行了比较。

The subjects were followed for up to 13 years (mean, 7.6 years). In total, 319 patients (0.6%) were diagnosed with NAION, giving an annual incidence of 82 per 100,000 persons.

受试者随访长达13年（平均7.6年）。总共有319例（0.6％）被诊断为缺血性视神经病变，每年发病率为82/10万。

In the diabetic group, 188 (0.7%) developed AION, significantly more than the 131 controls with this finding (0.5%). After adjustment, the risk in diabetics was 40% greater. Being male also carried a 32% increased risk. There were no other significant associations.

在糖尿病组，188例（0.7％）发生了AION，显着高于对照组（0.5％）。校正后，糖尿病患者的风险是40％以上。男性的风险增加了32％。未发现其他显著相关性。

The high incidence established, say the investigators, "may relate to the older age of our cohort or the fact that this study included a national database compared with regional databases. The higher incidence may also relate to misdiagnosis of other optic neuropathies reported by US providers."

关于发病率高的原因，调查人员说，“可能与我们的研究队列年龄较大有关，也可能由于这项研究纳入的是全国性的数据库，而不是区域性的数据库。较高的发病率可能也可能与其他视神经病变误诊有关”。

Those with NAION are rarely unaware of the condition. As Dr. Lee pointed out, "These patients come in complaining of visual loss." However, he added, "There is no clear, evidence-based treatment for NAION."

这些缺血性视神经病变的患者很少知晓。正如Lee博士指出的，“这些病人以视力丧失为首发就诊症状。”不过，他补充说，“没有明确的以证据为基础的缺血性视神经病变的治疗方法。”
 

SOURCE: http://bit.ly/eaMaaQ

Ophthalmology 2011.