长沙市年龄相关性黄斑变性患病率和相关因素分析
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摘要
目的:了解长沙地区事业机关单位45岁以上人群中年龄相关性黄斑变性(AMD)的患病率,并分析影响AMD的相关因素。
方法:我们把长沙市事业机关单位按省级、市级、区级单位进行分层;采用随机数字表法,每一层按20%的比例共随机抽取57家单位;对纳入调查人群进行视力、外眼、角膜、晶体、眼底、血常规、肝肾功能、血脂全套以及身高、体重等项目检查;从中筛选出16个可疑影响因素进行非条件logistic单因素分析,再对单因素分析有统计学意义的影响因素进行非条件logistic多因素分析,并根据标准回归系确定各因素对AMD影响的大小。
结果:共有3147人接受检查,受检率为97.8%;确诊为AMD的患者为214人,总检出率为6.8%;其中干性AMD为5.6%、湿性AMD为1.1%;45-50、50-55、55-60、60-65、65-70以及70岁以上者的患病率分别为2.4%、2.3%、5.9%、7.4%、7.6%、9.1%;男性AMD患病率为6.5%,女性为7.5%。对AMD影响有统计学意义的相关因素有6项,按对AMD影响的重要性由大到小依次为年龄、总胆固醇、平均RBC体积、荤素习惯、红细胞压积(HCT)和文化程度。
结论:1.长沙地区事业机关单位45岁以上人群中AMD的患病率为6.8%。2.AMD的患病率随着年龄增加而显剧增加;干性AMD患病率明显高于湿性AMD;性别差异无统计学意义。3.影响AMD有统计学意义的相关因素有6个。
Objective:To investigate the prevalence of age-related macular degeneration in institution unity people age above 45 in Chang Sha.And analysis of correlation factor about age-related macular degeneration.
Methods:We classify institutions unity of ChangSha city by provincial、municipal and district-leve units category.Each category being selected 20%,according to random number table,get 57 unities. 3218 persons age abover 45 are obtained from the above 57 unities.All the persons are carried out the examination of visual acuity、eyelid、cornea、lens、fundus、Blood-R、Liver and kidney function、lipid and Height weight、ets.We do non-conditional logistic single-factor analysis in 16 suspicious correlation factors being slected,and do non-conditional logistic multi-factor analysis among the above single-factor analysis with statistical significance,and then determine the important of each factor to AMD according to standard regression coefficient.
Results:6.8%of included population had AMD and 5.6%of them were dry AMD and 1.1%wase exudative type.The prevalence of AMD in the age group of 45-50、50-55、55-60、60-65、65-70 and more than 70were identified as 2.4%、2.3%、5.9%、7.4%、7.6%and 9.1%.The prevalence of mal was 6.5%and 7.5%of female.Six correlation factors were statistically significant.According important to AMD from great to small were:age,total cholesterol,RBC average capacity,eating habit, packed red cell and culture degree.
Conclusion:The prevalence of people working in institution unity age above 45 in Chang Sha was 6.8%;The prevalence of AMD is increased with aging,dry type higher than wet type,but not correlated with sex.Six correlation factors were statistically significant.
方法:我们把长沙市事业机关单位按省级、市级、区级单位进行分层;采用随机数字表法,每一层按20%的比例共随机抽取57家单位;对纳入调查人群进行视力、外眼、角膜、晶体、眼底、血常规、肝肾功能、血脂全套以及身高、体重等项目检查;从中筛选出16个可疑影响因素进行非条件logistic单因素分析,再对单因素分析有统计学意义的影响因素进行非条件logistic多因素分析,并根据标准回归系确定各因素对AMD影响的大小。
结果:共有3147人接受检查,受检率为97.8%;确诊为AMD的患者为214人,总检出率为6.8%;其中干性AMD为5.6%、湿性AMD为1.1%;45-50、50-55、55-60、60-65、65-70以及70岁以上者的患病率分别为2.4%、2.3%、5.9%、7.4%、7.6%、9.1%;男性AMD患病率为6.5%,女性为7.5%。对AMD影响有统计学意义的相关因素有6项,按对AMD影响的重要性由大到小依次为年龄、总胆固醇、平均RBC体积、荤素习惯、红细胞压积(HCT)和文化程度。
结论:1.长沙地区事业机关单位45岁以上人群中AMD的患病率为6.8%。2.AMD的患病率随着年龄增加而显剧增加;干性AMD患病率明显高于湿性AMD;性别差异无统计学意义。3.影响AMD有统计学意义的相关因素有6个。
Objective:To investigate the prevalence of age-related macular degeneration in institution unity people age above 45 in Chang Sha.And analysis of correlation factor about age-related macular degeneration.
Methods:We classify institutions unity of ChangSha city by provincial、municipal and district-leve units category.Each category being selected 20%,according to random number table,get 57 unities. 3218 persons age abover 45 are obtained from the above 57 unities.All the persons are carried out the examination of visual acuity、eyelid、cornea、lens、fundus、Blood-R、Liver and kidney function、lipid and Height weight、ets.We do non-conditional logistic single-factor analysis in 16 suspicious correlation factors being slected,and do non-conditional logistic multi-factor analysis among the above single-factor analysis with statistical significance,and then determine the important of each factor to AMD according to standard regression coefficient.
Results:6.8%of included population had AMD and 5.6%of them were dry AMD and 1.1%wase exudative type.The prevalence of AMD in the age group of 45-50、50-55、55-60、60-65、65-70 and more than 70were identified as 2.4%、2.3%、5.9%、7.4%、7.6%and 9.1%.The prevalence of mal was 6.5%and 7.5%of female.Six correlation factors were statistically significant.According important to AMD from great to small were:age,total cholesterol,RBC average capacity,eating habit, packed red cell and culture degree.
Conclusion:The prevalence of people working in institution unity age above 45 in Chang Sha was 6.8%;The prevalence of AMD is increased with aging,dry type higher than wet type,but not correlated with sex.Six correlation factors were statistically significant.
引文
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[1]National Statistics Office.National population projections,www.Statistics,gov.uk/CCI/nugget.asp(accessed 9 Feb 2003)
[2]World Health Organization.Fact sheet No.144.Blindness and visual dis-ability Part ⅢI of Ⅶ.
[3]何光明,许京京,吴开力,等.广东省斗门县老年性黄斑变性流行病学调查.中华眼底病杂志,1998,14:122-124.
[4]张文芳,黎晓新,律鹏,等.青海玛沁县40岁以上世居藏族人群眼底病的流行病学调查.中华眼底病杂志,2006,22:321-323.
[5]吴乐正,陈又昭,曹心媛,等.藏族和汉族的老年性黄斑变性流行病学调查.中华眼底病杂志,1978,3:179-181.
[6]邹海东,张暂,许迅,等.上海市静安区曹家渡街道年龄相关性黄斑变性的患病率调查.中华眼科杂志,2005,41:15-19.
[7]Klein R,Klein BEK,Linton KLP.Prevalence of age-related maculopathy:the Beaver Dam eye study.Ophthalmology 1992;99:933-943.
[8]Vingerling JR,Dielemans I,Hofman A,et al.The prevalence of age-related maculopathy in the Rotterdam study.Ophthalmology 1995;102:205-210.
[9]Mitchell P,Smith W,Attebo K,Wang JJ.Prevalence of age-related maculopathy in Australia.The Blue Mountains eye study.Ophthalmology 1995;102:1450-1460.
[10]Campochiaro PA,Soloway P,Ryan SJ,et al.The pathogenesis of choroidal neovascularization in patients with age-related macular degeneration.Mol Vis,1999,5:34-38.
[11]Ciulla TA.Evolving pathophysiological paradigms for age-related macular degeneration.Br Jophhalmol,2001,85:510-512.
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[16] Friedman E, Krupsky S , Lane AM, et al.Ocular Blood Flow Velocity I in Age-related Macular Degeneration [J].Ophthalmology, 1995 , 102(4): 640-646.
[17] Mares-perlman J A, Brady W E R , Vandenlangenberg G M, et al.Dietary fat and age-related maculopathy [J]. Arch Ophthalmol ,1995 , 113 : 743 - 748.
[18] Snow K K, Seddon J M, Do age-related macular degeneration and cardiovascular disease share common antecedents [J].Ophthalmic Epidemiology , 1999 , 6 (2) : 125 - 143.
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[21] Bressler NM , Bressler SB , Fine SL. Agerelated macular degeneration. Surv Ophthalmol, 1998 , 32 : 375—413
[22] Gale CR,Hall NF,Phillips DI,el,al.Lutein and zeaxanthin status and risk of age-related macular degeneration.Invest Ophthalmol Vis Sci,2003,44:2461-2465.
[23] Tomany SC, Cruick shank s KJ , Klein R, et al. Sunlight and the 10-year incidence of age-related maculopathy: the Beaver Dam Eye Study. Arch Ophthalmol, 2004, 122: 750-757.
[24] Mozaffarieh M, Sacu S, Wedrich A. The role of the carotenoids,lutein and zeaxanthin, in protecting against age-related macular degeneration: a reviewbased on controversial evidence.Nutr J 2003 ;2: 20
[25] Chowers I, Wong R, Dentchev T, et al. The iron carrier transferrin is up-regulated in retinas from patients with age-related macular degeneration. Invest Ophthalmol Vis Sci. 2006 May;47(5):35-40
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[28] Anderson DH, Talaga KC, Rivest AJ , et al. Characterization of beta amyloid assemblies in drusen: the deposits associated with aging and age-related macular degeneration. Exp Eye Res, 2004,78: 243-256.
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[33] Javitt JC, Zhou Z, Maguire MG, et al. Incidence of exudative age-related macular degeneration among elderly Americans. Ophthalmology, 2003, 110: 1534-1539.
[34] Klaver CC, Wolfs RC,Assink JJ,et al. Genetic risk of age-related maculopathy. Population-based familial aggregation study .Arch Ophthalmol, 1998,116:1646-1651.
[35] Akimoto A, Akimoto M,Kuroiwa S,et al.Lack of association of mutations of the bestrophin gene with age-related macular degeneration in non-familial Japanese patients. Graefes Arch Clin Exp Ophthalmol,2001,239:66-68.
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[39]Mitchell P,Wang JJ,Foran S,et al.Five-year incidence of age-related maculopathy lesions:the Blue Mountains eye study.Ophthalmology,2002,109:1092-1097.
[40]Klein R,Klein BE,Tomany SC,et al.Incidence of age-related maculopathy and smoking and drinking:the Beaver Dam eye study.Am J Epidemiol,2002,156:589-598.
[41]Cho E,Hung S,Willett WC,et al.Prospective study of dietary fat and the risk of age-related macular degeneration.Am J Clin Nutr,2001,73:209-218.
[42]Obisesan TO,Hirsch R,Kosoko O,et al.Moderate wine consumption is associated with decreased odds of developing age-related macular degeneration in NHANES-1.J Am Geriatr Soc,1998,46:1-7.
[43]Tomany SC,Cruick shanks KJ,Klein R,et al.Sunlight and the 10-year incidence of age-related maculopathy:the Beaver Dam Eye Study.Arch Ophthalmol,2004,122:750-757.
[44]Darzins P,Mitchell P,heller RF.Sunlight incidence of age-related maculopathy.Ophthalmology,1997,104:770.
[45]Van Leeuwen R,Ikram M K,Vingerling JR,et al.Blood pressure,atherosclerosis,and the incidence of age-related maculopathy:the Rotterdam Study.Invest Ophthalmol Vis Sci,2003,44:3771-3777.
[46]Wachter A,Sun Y,Dasch B,et al.Muenster age and retina study(MARS):association between risk factors for arteriosclerosis and Age-related macular degeneration.Ophthalmologe,2004,101:50-53.
[47]Hyman L,Schachat AP,He Q,et al.Hypertension,cardiovascular disease,and age-related macular degeneration.Arch Ophthalmol,2000,118:351-358.
[48]Seddon JM,Cote J,Davis N,et al.Progression of age-related macular degeneration:association with body mass index,waist circumference,and waist-hip ratio.Arch Ophthalmol,2003,121:785-792.
[49]Klein R,Klein BE,Wong TY,et al.The association of cataract and cataract surgery with the long-term incidence of age-related maculopathy:the Beaver Dam eye.study.Arch Ophthalmol,2002,120:1551-1558.
[50]Ikram M K,van Leeuwen R,Vingerling JR,et al.Relationship between refraction and prevalent as well as incident age-related maculopathy:the Rotterdam Study.Invest Ophthalmol Vis Sci,2003,44:3778-3382.
[51] Clemons TE, Milton RC, Klein R, et al. Risk factors for the incidence of advanced age-related macular degeneration in the Age-Related Eye Disease Study (AREDS) AREDS report no. 19. Ophthalmology, 2005, 112: 533-539.
[52] Tomany SC, Klein R, Klein BE. The relationship between iris color, hair color, and skin sun sensitivity and the 10-year incidence of age-related maculopathy: the Beaver Dam Eye Study. Ophthalmology, 2003, 110: 1526-1533.
[53] McCarty CA, Mukesh BN, Fu CL, et al. Risk factors for age-related maculopathy:the Visual Impairment Project.Arch Ophthalmol 2001;119: 1455-1462
[54] Miyazaki M , Nakamura H, Kubo M , et al. Risk factors or age related maculopathy in a Japanese population: the Hisayama study Br J Ophthalmol. 2003, 87: 469-472.
[55] Grizzard SW , Arnett D, Haag SL. Twin study of age-related macular degeneration. Ophthalmic Epidemiol, 2003, 10: 315-322.
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