目的：分析影响2型糖尿病视网膜病变(DR)发生玻璃体积血(VH)的危险因素。

方法：选取2016-11/2018-11收治的DR患者165例临床资料进行回顾性分析。采用多因素Logistic回归分析DR患者发生VH的独立相关因素。

结果：选取165例DR患者中59例59眼为非增殖性糖尿病性视网膜病变(NPDR)，包括NPDR轻度18例18眼，NPDR中度21例21眼，NPDR重度20例20眼，106例106眼为增殖性糖尿病性视网膜病变(PDR)，其中87例87眼发生VH，发生率为82.1%； 无VH组和VH组间年龄、收缩压、舒张压、空腹血糖(FPG)、糖化血红蛋白(HbA1c)、甘油三酯(TG)、胆固醇(TC)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)和肌酐(CRE)比较有差异(P<0.05)； 以是否发生VH为因变量，经多因素Logistic分析结果显示，HbA1c是VH发生的独立危险因素(P<0.05)，HDL是VH发生的独立保护因素(P<0.05)。

结论：HbA1c和HDL是影响DR患者发生VH的独立相关因素，临床中应严格控制血糖和血脂，减少DR进展为VH的几率。

METHODS: The clinical data of 165 patients with DR admitted to the hospital from November 2016 to November 2018 were retrospectively analyzed. Multivariate Logistic regression was performed to analyze independent relevant factors of VH occurrence in patients with DR.

RESULTS: Totally 165 patients with DR, 59 cases(59 eyes)with non-proliferative diabetic retinopathy(NPDR), including 18 cases(18 eyes)with mild NPDR, 21 cases(21 eyes)with moderate NPDR and 20 cases(20 eyes)with severe NPDR. And there were 106 cases(106 eyes)with proliferative diabetic retinopathy(PDR). Among them, there were 87 cases(87 eyes)with VH, and the incidence rate was 82.1%. There were significant differences in age, systolic blood pressure, diastolic blood pressure, fasting plasma glucose(FPG), glycosylated hemoglobin(HbA1c), triglyceride(TG), cholesterol(TC), high density lipoprotein(HDL), low density lipoprotein(LDL)and creatinine(CRE)between non-VH group and VH group(P<0.05). Taking the presence or absence of VH as dependent variable, multivariate Logistic analysis showed that HbA1c was an independent risk factor for occurrence of VH(P<0.05), and HDL was an independent protective factor for occurrence of VH(P<0.05).

CONCLUSION: HbA1c and HDL are independent relevant factors influencing the occurrence of VH in patients with DR. In clinical practice, blood glucose and lipids should be strictly controlled to reduce the probability of DR progression to VH.