社区50岁以上人群眼病筛查必要性及方法探讨

摘要

Objective To explore the necessity of ophthalmopathy screening of population aged over 50 years in Bei-jing communities to find new ways of prevention of blindness. Methods A total of 3 742 people aged over 50 years from 47 com-munities of Beijing,who were given examinations of visual acuity,slit lamp,fundus photography to screen eye diseases from Oc-tober 2010 to June 2011,were divided into groups A(from Wanshou Road,n=2 564),B(from Tiancun Road,n=1 178) according to street;into groups a(aged 50-59,n=1 321),b(aged 60-69,n=1 308),c(aged 70 years or over,n=1 113)according to age. The detection rate of the main diseases causing eye diseases( including cataract,glaucoma,macular disease,diabetic retinopathy)were compared between groups A,B and among group a,b,c. ResUlts Of 3 742 people aged over 50 years,23 had binoculus blindness(0. 61%),97 had monocular blindness(2. 59%),167 had binoculus low vision (4. 46%),367 had monocular low vision(9. 81%)in everyday life vision tests. 1 158 had cataract(30. 95%),729 had suspected glaucoma(19. 48%),65 had diabetic retinopathy(1. 74%),266 had macular disease(7. 11%). There was sig-nificant difference in detection rates of cataract,suspected glaucoma,macular disease among groups a,b,c(P<0. 05),but not in detection rate of diabetic retinopathy(P>0. 05). The detection rates of cataract,glaucoma were lower in group A than in group B(P<0. 05),but there was no difference in detection rates of macular disease,diabetic retinopathy between groups A, B(P>0. 05). ConclUsion The establishment of simple,reasonable ophthalmopathy screening system,necessary for blind-ness prevention,can be achieved by strengthening and supplement of the existing community medical system and equipments.%目的：通过简单的眼科检查设备对北京市50岁以上社区人群进行眼病筛查，以探讨眼病筛查的必要性，寻找新型的防盲途径。方法2010年10月-2011年6月，采用筛查的方法，对北京市两街道47个社区50岁以上人群进行视力、裂隙灯、眼底照相检查。按街道和年龄对筛查人群进行分组：按街道分为万寿路街道组2564人，田村街道组1178人；按年龄分为50~59岁组1321人，60~69岁组1308人，≥70岁组1113人。比较各年龄组及街道组4种主要致盲眼病（白内障、青光眼、黄斑部疾病和糖尿病视网膜病变）检出率。结果共筛查50岁以上中老年人3742人，其中，日常生活视力测试双眼盲者23人（0.61%），单眼盲者97人（2.59%），双眼低视力者167人（4.46%），单眼低视力者367人（9.81%）。4种致盲眼病中，白内障患者1158人（30.95%）、可疑青光眼患者729人（19.48%）、糖尿病视网膜病变者65人（1.74%）、黄斑部疾病者266人（7.11%）。3个年龄组间白内障、可疑青光眼、黄斑部疾病检出率比较，差异均有统计学意义（ P<0.05）；而3组间糖尿病视网膜病变检出率比较，差异无统计学意义（P>0.05）。两街道组4种致盲眼病比较，万寿路街道组白内障、可疑青光眼的检出率均低于田村街道组（P<0.05）；两街道组黄斑部疾病、糖尿病视网膜病变的检出率比较，差异无统计学意义（P>0.05）。结论建立一种简单、合理的眼病筛查体系对我国目前的防盲工作非常有必要，城镇居民的眼病筛查可通过现有社区医疗的强化补充得到实现。