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中华眼科医学杂志(电子版) ›› 2018, Vol. 08 ›› Issue (04) : 157 -162. doi: 10.3877/cma.j.issn.2095-2007.2018.04.003

所属专题： 文献；

论著

重庆市农村地区50岁及以上土家族人群年龄相关性黄斑变性的流行病学调查
王皓1, 周希瑗1,†(), 刘苏1, 刘胜春1, 武明星1, 熊晓菁1, 张编文1   
  1. 1. 400010　重庆医科大学附属第二医院眼科
  • 收稿日期:2018-06-26 出版日期:2018-08-28
  • 通信作者: 周希瑗
  • 基金资助:
    重庆市科委面上项目(cstc2015shmszx120068)

Epidemiological investigation of age-related macular degeneration of over 50 years old Tuijia ethnic group in Chongqing rural district

Hao Wang1, Xiyuan Zhou1,†(), Su Liu1, Shengchun Liu1, Mingxing Wu1, Xiaojing Xiong1, Bianwen Zhang1   

  1. 1. Departartment of Ophthalmology, Second Affiliated Hosipital of Chongqing Medical University, Chongqing 400010, China
  • Received:2018-06-26 Published:2018-08-28
  • Corresponding author: Xiyuan Zhou
  • About author:
    Corresponding authuo: Zhou Xiyuan, Email:
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引用本文：

王皓, 周希瑗, 刘苏, 刘胜春, 武明星, 熊晓菁, 张编文. 重庆市农村地区50岁及以上土家族人群年龄相关性黄斑变性的流行病学调查[J]. 中华眼科医学杂志(电子版), 2018, 08(04): 157-162.

Hao Wang, Xiyuan Zhou, Su Liu, Shengchun Liu, Mingxing Wu, Xiaojing Xiong, Bianwen Zhang. Epidemiological investigation of age-related macular degeneration of over 50 years old Tuijia ethnic group in Chongqing rural district[J]. Chinese Journal of Ophthalmologic Medicine(Electronic Edition), 2018, 08(04): 157-162.

目的

研究重庆市黔江酉阳农村地区50岁及以上土家族人群年龄相关性黄斑变性(AMD)的患病率及相关危险因素。

方法

本调查采用整群随机抽样的方法，对重庆市黔江区、酉阳土家族苗族自治县农村地区50岁及以上的土家族人群进行年龄相关性黄斑变性的流行病学调查。现场调查内容包括：详细的调查问卷、一般体格检查、眼科常规检查、直接眼底照相，采用国际AMD临床分级系统标准进行诊断。按照性别、年龄、生活习惯等进行分组，采用例数和百分比描述AMD患病率，组间比较采用卡方检验或者Fisher精确概率法。

结果

本次调查中10个调查点各调查点50岁及以上土家族户籍人口数为2556人，实际完成2122人检查，应答率为83.0%。其中，男性739(34.8%)人，女性1383(65.2%)人。AMD患者有200人(338只眼)，总患病率为9.4%，男性患病率为7.0%，女性患病率为10.7%；按年龄50～59岁，60～69岁，70～79岁及>80岁分层，其患病率分别为5.3%，9.4%，12.9%及7.5%。本研究发现随年龄的增加，AMD发病率升高(χ2＝18.14，P<0.05)；随日光暴露的增加，AMD患病率增加(χ2＝11.18，P<0.05)，吸烟人群较不吸烟人群患病率更高(χ2＝9.27，P<0.05)；高血压病史尤其是收缩压高人群AMD发病率更高(χ2＝7.80，P<0.05)；有翼状胬肉病史者AMD患病率更高(χ2＝6.1，P<0.05)。

结论

重庆市黔江、酉阳农村地区50岁及以上土家族AMD的患病率为9.4%；随年龄的增加AMD患病率显著增加；随每日日光暴露的时间延长，AMD患病率显著增加。重庆市黔江、酉阳农村地区50岁及以上土家族人群AMD的危险相关因素包括性别、年龄、吸烟、高血压、收缩压、日光暴露、翼状胬肉病史。

关键词: 年龄相关性黄斑变性, 流行病学, 危险因素
Objective

To understand the prevalence and associated risk factors of age-related macular degeneration (AMD) of over 50 years old Tuijia ethnic group in Chongqing Qianjiang JiuYang district.

Methods

By inquiring the Tujia and Miao region over 50 years old people with randomly cluster sampling method to investigate epidemiological age-related macular degeneration.Site investigation includes detailed questionnaires, general physical examination, routine examination of ophthalmology, direct fundus photo, using international AMD grading standard specified age-related macular degeneration diagnostic. And analyze data.

Results

by using SPSS21.0 statistical software.results: there is a total population of 2556 of over 50 years old Tujia people being investigated in this survey. 2122 of them are actually completed the check, the response rate was 83.02%. Including a total of 739 (34.8%) of men and 1383 (65.2%) of women. 200 (338 eyes) of the AMD patients, the total prevalence rate was 9.4%, 7.0% of men and 10.7% of women; By age from 50 to 59, 60 to 69 years old, 70 to79 years old, and over 80 years old prevalence was 5.3%, 9.4%, 13%, 7.5%, respectively. This study found that with the increase of age, the higher incidence of AMD (χ2=18.14, P<0.05); With the increase of sun exposure, AMD prevalence increased (χ2=11.18, P<0.05), smokers was higher than non-smokers (χ2=9.27, P<0.05); History of high blood pressure, especially high systolic blood pressure patients, the higher prevalence of AMD was found (χ2=7.80, P<0.05); A history of alar Nu head AMD also showed a higher prevalence (χ2=6.1, P<0.05).

Conclusion

The patients od AMD of over 50 years of age Tujia ethnic people in southeast part of Chongqing, the prevalence is 9.4%; Along with the age increasing, the prevalence rate increased significantly; With the extension of the daily sun exposure time, AMD prevalence rate increased significantly. Chongqing Tujia ethnic people in southwest China AMD risk factors including gender, age, smoking, hypertension, systolic blood pressure, sun exposure and history of pterygium.

Key words: Age-related macular degeneration, Epidemiology, Risk factors.
表1 年龄相关性黄斑病变的国际临床分级标准
分级 临床特征
1 无玻璃膜疣，或<10个小玻璃膜疣并不伴色素异常
2 ≥10个小玻璃膜疣，或<15个中等大小玻璃膜疣，或相关色素异常
? ? a：玻璃膜疣；b：RPE改变(色素增多和色素减少)；c：同时有玻璃膜疣及色素改变
3 ≥15个中等大小玻璃膜疣，或任何大玻璃膜疣
? ? a：无玻璃膜疣性色素上皮脱离；b：有玻璃膜疣性色素上皮脱离
4 地图样萎缩累及黄斑中心凹，或未累及中心凹的直径至少350 μm的萎缩
5 渗出性AMD，包括非玻璃膜疣性色素上皮脱离、浆液性或出血性视网膜脱离、脉络膜新生血管膜伴神经上皮层下或色素上皮层下出血或纤维化以及AMD治疗后持续不变的瘢痕
? ? a：浆液性色素上皮脱离，无脉络膜新生血管膜；b：脉络膜新生血管膜或盘状瘢痕
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