糖尿病網膜症進展に対する患者管理からみた危険因子

Risk factors from patient management for progression of diabetic retinopathy

（25A-11）　眼科初診後5年間の経過観察を行った糖尿病患者617例を対象に，患者管理からみた糖尿病網膜症（以下，網膜症）進展における危険因子についてロジスティックモデルを用いて検討した。5年後の網膜症変化は，改善13.6％．不変68.6％，悪化17.8％であった。糖尿病発見後眼科初診までの期間．糖尿病発見理由，眼科受診状況が，網膜症進展に対する危険因子として統計的に有意であり，眼科初診までの期間の相対危険度は2.72と最も高い値を示した。網膜症に対する適切な治療のタイミングを逸しない上で，これらの要因を十分に考慮して患者管理にあたる必要があると考えられた。

We reviewed 617 diabetic patients observed for 5 years after initially seen by us. A logistic regression model was used in the analysis. We paid particular attention to the patient management as a risk factor in the progression of diabetic retinopathy. After 5 years, the state of retinopathy improved in 13.6%, remained stationary in 68.6% and progressed in 17.8%. We identified the following items as significant risk factors for progression of retinopathy : duration between detection of diabetes and initial ophthalmological consultation, reasons for detection of diabetes and the irregular visits to ophtalmologists. Among these factors, the first item was the most important with the relative risk of 2.72. It is recom-mended that the management of diabetic patients be conducted with these risk factors in mind in order not to miss the timing of adequate treatment for diabetic retinopathy.