青海省汉藏族翼状胬肉患病率及危险因素分析

发布时间：2018-02-03 21:58

本文关键词： 翼状胬肉患病率汉族和藏族危险因素　出处：《北京协和医学院》2016年博士论文　论文类型：学位论文

【摘要】：背景翼状胬肉是结膜向角膜生长的三角楔形纤维血管组织,可引起眼部刺激症状甚至影响视力。其具体发病机制尚不明确,针对不同人群的横断面研究所报道的患病率及危险因素存在差异。翼状胬肉具有合并恶性肿瘤的风险,且其手术治疗复发率较高,因此预防就显得尤为重要。对危险因素和保护因素越来越深入的了解使我们有望逐渐减少未来翼状胬肉的发生。目的通过横断面研究分析青海省汉族和藏族翼状胬肉的患病率及危险因素。方法本研究为2015年7月-8月进行的一项覆盖青海省4个县市的横断面研究,通过多阶段分层抽样法抽取一个能代表青海省人口的样本,采集了人口学特征、生活方式、疾病史等信息,前节检查在小瞳下采用手持裂隙灯进行。以logistic回归模型分析潜在的独立危险因素。结果4711名调查对象纳入分析,汉族2594人(55.1%),藏族2117人(44.9%)。平均年龄44岁(8-83岁)。翼状胬肉的总体患病率为8.3%(n=391),其中单眼受累者5.3%(n=248),双眼受累者3.0%(n=143),30岁以上人群年龄性别调整患病率为8.7%。多因素分析显示高龄(p＜0.001)、女性(p＜0.001)、出生于农村(p=0.02)、室外工作(p=0.001)、高血压病史(p=0.046)、远视(p=0.049)为翼状胬肉的危险因素,而高学历(趋势p=0.003)为独立保护因素；仅高BMI(趋势p=0.013)是双眼翼状胬肉的危险因素。男性中高龄(p＜0.001)、室外工作(p＜0.001)、高血压病史(p=0.01)为翼状胬肉的危险因素,目前吸烟(p=0.02)为保护因素,而吸烟指数与翼状胬肉不相关(趋势p=0.15)。女性中高龄(p＜0.001)、出生地为农村(p＜0.001)为翼状胬肉的危险因素,而高学历(p=0.04)为保护因素。在农村居住10年以内的人群患翼状胬肉的危险性和城镇居民无统计学差异(p=0.072),而居住时间满10年者患病风险显著增加,但其OR值并未随农村居住时间的延长而进一步上升。结论本研究分析了青海省藏族和汉族中翼状胬肉的患病率和危险因素。高龄、女性、农村、室外工作为翼状胬肉的危险因素,高学历为保护因素,而高血压病史及远视可能与翼状胬肉相关。多因素分析未发现汉族和藏族间患病率具有统计学差异。男性中高龄、室外工作及高血压病史为危险因素,而目前吸烟为保护因素；女性中发现高龄、农村为危险因素,高学历为保护因素。农村居住时间满10年者患翼状胬肉的风险增加,早期脱离危险因素可能更好地预防翼状胬肉的发生。
[Abstract]:Background pterygium is a triangular wedge-shaped fibrous vascular tissue with conjunctival growth to cornea, which can cause ocular irritation and even affect visual acuity. The specific pathogenesis of pterygium is not clear. The prevalence and risk factors of pterygium were different in cross-sectional study of different population. Pterygium had the risk of complicated with malignant tumor, and the recurrence rate of surgical treatment was higher. Therefore, prevention is particularly important. More and more in-depth understanding of risk factors and protective factors will lead us to gradually reduce the occurrence of pterygium. Objective to analyze the pterygium of Han nationality and Tibetan nationality in Qinghai Province by cross-sectional study. The prevalence and risk factors of pterygium. Methods A cross-sectional study covering 4 counties and cities in Qinghai Province was conducted from July 2015 to August. A multi-stage stratified sampling method was used to select a sample representing the population of Qinghai Province, and the demographic characteristics, lifestyle, disease history and other information were collected. Logistic regression model was used to analyze the potential independent risk factors. Results 4711 subjects were included in the analysis. The average age was 44 years old and 8-83 years old. The overall prevalence rate of pterygium was 8.3%. Among them, the patients with monocular involvement were 5.3and the patients with binocular involvement were 3.0and 143respectively. The age and gender adjusted prevalence rate of the population over 30 years old was 8.7%. The multivariate analysis showed that the elderly patients (p < 0.001) and the females (P < 0.001) were born in rural areas (P < 0.02). The risk factors of pterygium were found in outdoor work, hypertension, hyperopia and hyperopia. Higher educational background (trend p0.003) was the independent protective factor. High BMI (trend p0.013) was the risk factor of pterygium in both eyes. The history of hypertension (p0.01) is the risk factor of pterygium, and smoking is the protective factor. However, the smoking index was not correlated with pterygium (trend p0. 15). The elderly women (P < 0. 001) and the place of birth in the countryside (p < 0. 001) were the risk factors of pterygium. The risk of pterygium in the population living in rural areas less than 10 years was not significantly different from that of urban residents. However, there was a significant increase in the risk of disease among those who lived for more than 10 years. Conclusion the prevalence and risk factors of pterygium in Tibetan and Han nationality in Qinghai Province were analyzed. Outdoor work was the risk factor of pterygium, and higher education was the protective factor. The history of hypertension and hyperopia may be related to pterygium. There was no significant difference in prevalence rate between Han and Tibetan by multivariate analysis. Elderly men, outdoor work and hypertension history were risk factors. At present, smoking is the protective factor. The risk factors of pterygium were higher than 10 years, and the risk of pterygium was increased in women who lived in rural areas for more than 10 years. The risk factors of early detachment may be better to prevent the occurrence of pterygium.
【学位授予单位】：北京协和医学院
【学位级别】：博士
【学位授予年份】：2016
【分类号】：R777.33

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