中国陕西省农村原发性开角型青光眼流行病学调查

摘要

· AIM: To assess the prevalence and related risk factors of primary open angle glaucoma (POAG) in a rural population in Shaanxi Province.· METHODS: By using a stratified, duster-based, random sampling technique, 8 500 persons of all ages were selected randomly, from the North, the South and the Middle of Shaanxi Province from July to December in 2003. All participants had an interview with a standard questionnaire and those questions related to glaucoma of previous diagnosis and treatment, family history and outbreak history. Then a detailed and relative eye examination was performed, including logarithm of the minimum angle of resolution visual acuity, external eye examination with slit-lamp biomicroscopy and fundus examination. The intraocular pressure was measured with Perkins applanation tonometry to those persons aged 50years old or more and those with suspected increased IOP. A further examination was performed to those persons with suspicious glaucoma, including repeated tonometric examination, gonioscopy, dark room test, automated visual field testing, et al.· RESULTS: 6 815 of the eligible 8 500 persons of all ages were interviewed and examined from July to December in 2003, a response rate of 80.18%. 9 participants were found to have POAG, with the prevalence of 0.13%, age ranging from 38 to 80 years (mean year:62.0). In those aged 30 years old or more, the prevalence of the disease was 0.23%, 0.28% and 0.39% for those more than 40 and 50 years old, respectively. The rate of suspicious POAG was 0.18% (12 cases) with age ranging from 35 to 77 years (mean year: 54.7). With multiple logistic analyses, the prevalence increased significantly with age (P=0.023). Other than increasing age, myopia was also a strong risk factor for POAG. Of 9participants with POAG, only 2 cases (22.22%) had been previously diagnosed. No one with POAG was received any treatment previously. 66.67% (6 cases) participants with POAG suffered from visual impairment in various degrees secondary to POAG. The percentage of blindness in either eye was 33.33%.· CONCLUSION: The prevalence of POAG is close to that from other Chinese populations, increasing with age. A majority of glaucoma was undiagnosed and untreated previously.%目的:调查陕西省农村人群原发性开角型青光眼的患病率及相关影响因素.方法:2003-07/12,采用按比例随机整群抽样的方法在陕南、陕北及关中3个地区农村调查8 500人,所有受检人员均进行标准问卷调查,包括询问青光眼确诊史、家族史、发作史及手术史,并进行了相关的眼科检查,包括视力、外眼、眼前节、眼底检查.≥50岁人群及怀疑有高眼压者对其应用压平式眼压计测量眼压.对可疑青光眼者进行进一步检查,包括复查眼压、前房角镜检查、视野检查.结果:8 500人中共有6 815人完成了青光眼的相关检查,受检率为80.18%.原发性开角型青光眼患者共有9例,年龄为38～80(平均62.0)岁,患病率为0.13%,≥30岁、≥40岁和≥50岁人群患病率分别为0.23%、0.28%和0.39%.可疑原发性开角型青光眼患者有12例(0.18%),年龄为35～77(平均54.7)岁,比原发性开角型青光眼患者平均年龄约小7岁.多因素logistic回归分析显示患病率随着年龄的增长而增加(P=0.023).除年龄外,高度近视也是该人群开角型青光眼发生的危险因素.有青光眼确诊史的患者占22.22%,其中无1例接受过药物或手术治疗.66.67%(6例)原发性开角型青光眼患者存在不同程度的视力损伤,其中盲目占33.33%.结论:原发性开角型青光眼的患病率与国内其他报道相近,且随着年龄的增长而增加.绝大部分患者无青光眼确诊史,并且从未接受过任何相关治疗.