摘要
目的
先天性白内障(congenital cataract)是儿童第二位的致盲眼病,是出生时或出生后第一年内发生的晶状体混浊,病因复杂。大约三分之一的病例与遗传有关,三分之一患儿是环境因素所致,其余三分之一原因不清。了解环境不利因素在先天性白内障发生中的危险性,对预防先天性白内障的发生有重要意义。
方法
收集2005~2008年在第四军医大学西京医院收治的无先天性白内障家族史的72例先天性白内障患者资料,在儿科门诊按就诊顺序取72例与白内障患儿出生时间相差在一年以内的、性别相同,发育良好,未患白内障的儿童作为对照,进行了病例对照研究。应用spss 13.0软件对调查的25个因素进行单因素和多因素Logistic回归分析。
结果
多因素Logistic回归分析显示先天性白内障的主要危险因素是患缺血缺氧性脑病(OR=6.42,95%CI 1.35~30.47)、患者母亲孕期营养不良(OR=2.55,95%CI 1.17~5.56)、患者母亲孕期服用药物(OR=4.49,95%CI 1.74~11.55)、患者出生后吸氧(OR=5.63,95%CI 1.45~21.84)。
结论
患者母亲孕期营养不良、服用药物和吸氧均为先天性白内障发病的危险因素,与以往的研究结果相似。缺血缺氧性脑病是先天性白内障的危险因素却少有报道。这为我们预防先天性白内障发生提供了新思路。
Purpose
Congenital cataract, which is the second cause of blindness in childhood, is defined as the lens opacity occurred within the first year of birth. Its causes are very complex. It is known that about one third of the cases are related to inheritance, one third of the cases are induced by environmental factors, and the reasons for the remaining one third of the cases are not clear. The aim of this study is to understand the risk factors in development of non-inheriditary cataract.
Methods
We collected 72 congenital cataract cases without the family history of congenital cataract at in-patient department of Xijing Hospital from 2005 to 2008. 72 age and gende matched , non cataract cases were obtained from the out-patient department of pediatric.This is a case-control study. 25 candidate factors were surveied with questionaire and analysed with SPSS 13.0 software with single and multiple logistic regression analysis.
Results
Logistic regression analysis showed that the major risk factors for congenital cataract are suffering from hypoxic ischemic encephalopathy (OR=6.42,95%CI 1.35-30.47), malnutrition during pregnancy (OR = 2.55,95%CI 1.17-5.56), taking medicines during pregnancy (OR = 4.49,95%CI 1.74-11.55) and having oxygen therapy (OR = 5.63,95%CI 1.45-21.84).
Conclusion
From our present study we concluded that malnutrition and taking medicines during pregnancy and having oxygen therapy after birth are the risk factors for congenital cataract.This is coinsistant with the previous studies. To our knowledge, it is the first time to report that hypoxic-ischemic encephalopathy is a risk factor for congenital cataract. This gives us the clues to prevent the non-heritarty congenitl catatract.
引文
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