吸烟、饮酒与年龄相关白内障关系

发布时间：2018-03-17 11:34

本文选题：年龄相关白内障　切入点：吸烟　出处：《辽宁医学院》2012年硕士论文　论文类型：学位论文

【摘要】：目的调查中老年人群年龄相关白内障（Age-related cataract，ARC）的流行病学现状，探讨年龄相关白内障的社会人口学特征、生活方式因素（吸烟、饮酒）与年龄相关白内障发病的关系。方法研究对象为2010年4月～2011年10月，在锦州市的三级甲等医院眼科病房住院，临床诊断为ARC，并实施手术治疗，术后经病理检验证实为ARC的360例患者，年龄为45~85岁。对照为同期住院的非ARC患者组成，病例与对照以1：1方式进行匹配。采用标准调查表对所有研究对象进行调查，调查内容包括人口学特征、生活方式（吸烟、饮酒）、膳食摄入情况、可能与ARC有关的疾病既往史及生化指标等因素，同时对研究对象进行身高、体重、腰围及臀围的测量。采用SPSS13.0统计分析软件，对所调查资料进行分析，以确定吸烟、饮酒与ARC之间的关系。结果 1、本研究共收集病例和对照各360例，病例组年龄为45~85岁，平均（69.65±10.89）岁，其中女性174名（48.33%）。对照组年龄为45~85岁，平均（69.23±10.34）岁,其中女性174名（48.33%）。病例与对照均为当地居住10年以上的常住人口。对两组研究对象的一般人口学特征进行均衡性检验的结果显示，2组研究对象的年龄（χ2=1.599，P=0.660）、性别（χ2=0.000，P=1.000）、民族（χ2=0.196，P=0.973）、居住地（χ2=2.920，P=0.232）、文化程度（χ2=6.225，P=0.101）、职业（χ2=3.125，P=0.373）分布的差异均无统计学意义。 2、病例和对照吸烟史分布的差异具有统计学意义（χ2=6.246，P=0.044）,206例（57.22%）病例为现行吸烟者（36.39%）和曾吸烟者（20.83%），175例（48.61%）对照为现行吸烟者（28.61%）和曾吸烟者（20.00%）。病例组高于对照组。 3、2组研究对象饮酒史分布的差异也具有统计学意义（χ2=6.675，P=0.036），分别有113例（31.39%）和16例（4.44%）病例为现行饮酒者和曾饮酒者，而对照中现行饮酒者和曾饮酒者分别为142例（39.44%）和21例（5.83%）。病例组低于对照组。 4、吸烟状况与ARC的关系调整多因素后吸烟与年龄相关白内障关联的OR及其95%CI的结果表明：病例和对照吸烟史分布的差异具有统计学意义（χ2=6.246，P=0.044），与从不吸烟的对照相比较，现行吸烟（OR=1.817，95%CI：1.323~2.479，P=0.005）和曾吸烟（OR=1.295，95%CI：0.847~1.943，P=0.203）的病例发生ARC的危险性均升高，但仅现行吸烟者具有统计学意义。与从不吸烟的对照相比较，现行吸烟20~30支/d（OR=2.102，95%CI：1.226~3.508，P=0.003）和≥30支/d（OR=2.303，95%CI：1.194~4.235，P=0.012）的病例发生ARC的危险性明显升高，吸烟量越大，发生ARC的危险性越高。曾吸烟者的每日吸烟量与ARC无关。吸烟1~20年、20~30年和≥30年的病例发生ARC的危险性分别是从不吸烟对照的1.431（95%CI：1.005~2.038，P=0.047）、1.836（95%CI：1.121~2.896，P=0.022）和2.081倍（95%CI：1.685~3.627，P=0.001）。将戒烟时间分为20和≥20年后，进行分析的结果显示，与从不吸烟者相比，戒烟≥20年者发生ARC的危险性约下降27%（OR=0.729，95%CI：0.341~0.969，P=0.027）。 5、饮酒状况与ARC的关系 2组研究对象饮酒史分布的差异具有统计学意义（χ2=6.675，P=0.036）。与从不饮酒的对照相比较，现行饮酒的病例发生ARC的危险性显著下降（OR=0.539，95%CI：0.284~0.979，P=0.018），虽然曾饮酒者发生ARC的危险性也下降，但差异无统计学意义（OR=0.755，95%CI：0.544~1.048，P=0.093）。随着每日酒精摄入量的增加，ARC的发病危险性并不呈一致性的降低，与从不饮酒者比较，酒精摄入量45~60g/d （OR=1.331，95%CI：0.842~2.430，P=0.572）和≥60g/d（OR=1.714，95%CI：1.051~3.130，P=0.024）者发生ARC的危险性升高，饮酒的保护作用降低，酒精摄入量与ARC发病危险性呈U型关系。本研究并未发现饮酒的年限与ARC相关联的证据。对饮用酒的类型和数量与ARC的关联性进行分析的结果显示：饮用任何类型酒≥4标准杯/d的病例发生ARC的危险性比从不饮酒的对照升高72%（OR=1.719，95%CI：1.034~2.930，P=0.027）。饮用烈性酒1~4标准杯/d的研究对象发生ARC的危险性下降了约一半（OR=0.466，95%CI：0.264~0.823，P=0.008），而≥4标准杯/d却可使发生ARC的危险性升高（OR=1.641，95%CI：1.027~3.023，P=0.039）。饮用啤酒与发生ARC的危险性无关。饮用葡萄酒1~4标准杯/d和≥4标准杯/d均与ARC呈显著性负相关（分别有OR=0.537，95%CI：0.166~0.968，P=0.032和OR=0.609，95%CI：0.230~0.974，P=0.016）。 6、吸烟并饮酒与ARC的关系调整多种潜在性混杂因素后，不同吸烟状况的研究对象酒精摄入量与ARC的关系不同，现行吸烟又重度饮酒者（≥45g/d）发生ARC的危险性显著升高，是现行吸烟但从不饮酒者的2.149倍（OR=2.149，95%CI：1.132~3.936，P=0.020）。戒烟者中，与从不饮酒者相比较，，酒精摄入量45g/d与ARC呈显著性负相关（OR=0.453，95%CI：0.223~0.921，P=0.029），酒精摄入量≥45g/d者发生ARC的危险性升高，但差异无统计学意义（OR=1.418，95%CI：0.813~3.452，P=0.146）。结论 1、吸烟是ARC的危险因素，吸烟量与ARC呈正相关，吸烟时间与ARC呈正相关，戒烟可使发生ARC的危险性下降。 2、饮酒与ARC的发病存在相关关系，与从不饮酒的对照相比较，现行饮酒的病例发生ARC的危险性下降。饮酒量与ARC发病危险性呈U型关系。本研究并未发现饮酒的年限与ARC相关联的证据。 3、饮用烈性酒≥4标准杯/d可使发生ARC的危险性升高，饮用啤酒与发生ARC的危险性无关，饮用葡萄酒与ARC呈显著性负相关。 4、现行吸烟又重度饮酒者发生ARC的危险性显著升高。 5、戒烟者中，与从不饮酒者相比较，酒精摄入量45g/d与ARC呈显著性负相关，酒精摄入量≥45g/d者发生ARC的危险性升高，吸烟、饮酒可能会对中老年发生白内障的危险性产生实质性影响。探讨吸烟、饮酒与白内障发生发展的关系，确定吸烟、饮酒是白内障的危险因素还是保护性因素。为高危人群提供关于发生白内障的危险因素的理论根据，以及提供他们改变这些危险因素，降低发生白内障危险性的措施。如果这一调查结果能在我国白内障患病的人群中得到证实，就应当倡导不吸烟，吸烟的人群戒烟、适度饮酒，保持健康的生活方式，这无疑会降低ARC发病的危险性。
[Abstract]:objective
Objective to investigate the epidemiological status of Age-related cataract (ARC) among middle-aged and elderly people, to explore the social demographic characteristics of age related cataract, and the relationship between lifestyle factors (smoking and drinking) and the incidence of age-related cataract.
Method
The object of the study is from April 2010 to October 2011, in the ophthalmology ward three grade a hospital in Jinzhou City, a clinical diagnosis of ARC, and the implementation of surgical treatment, postoperative pathology confirmed 360 cases of ARC patients, aged 45~85 years old. The control group for the same period in non ARC patients, cases and controls with 1:1 method matching. By using a structured questionnaire to investigate all the research object, questionnaire including demographic characteristics, lifestyle (smoking, drinking), dietary intake, may be associated with ARC disease history and biochemical indexes and other factors, at the same time the study object of height, weight, waist circumference and hip circumference measurement. Using SPSS13.0 statistical analysis software the investigation, data analysis, to determine the relationship between smoking, drinking and ARC.
Result
This study collected a total of 1, and the control of the 360 cases, patients aged 45~85 years old, the average (69.65 + 10.89) years old, including 174 women (48.33%). The control group were 45~85 years old, the average (69.23 + 10.34) years old, including 174 women (48.33%). The cases and controls for when the resident population of more than 10 years of residence. The general demographic characteristics of two groups of subjects were balanced test results indicated that the 2 groups of subjects age (x 2=1.599, P=0.660), gender (2=0.000, P=1.000), national (x 2=0.196, P=0.973), where (x 2=2.920, P=0.232). The culture degree (x 2=6.225, P=0.101), occupation (2=3.125, P=0.373) the distribution of the difference was not statistically significant.
2, the difference of smoking history distribution between cases and controls was statistically significant (chi 2=6.246, P=0.044), and 206 cases (57.22%) were current smokers (36.39%) and smokers (20.83%), 175 cases (48.61%) were smokers (28.61%) and smokers (20%). The case group was higher than that of the control group.
The 3,2 group studied history of alcohol consumption between the distribution was also statistically significant (2=6.675, P=0.036), there were 113 cases (31.39%) and 16 cases (4.44%) were current drinkers and had drinkers, whereas current drinkers and drinkers had respectively 142 cases (39.44%) and 21 cases (5.83% cases). Group than the control group.
4, the relationship between smoking status and ARC
OR and 95%CI smoking and age related cataract after adjusting the results show that the difference between cases and controls the distribution of smoking was statistically significant (2=6.246, P=0.044), and compared to never smokers, current smoking (OR=1.817,95%CI:1.323~2.479, P=0.005) and former smokers (OR=1.295,95%CI:0.847~1.943, P=0.203) dangerous cases ARC were increased, but the only current smokers were statistically significant. Compared with never smokers on smoking, current 20~30 /d (OR=2.102,95%CI:1.226~3.508, P=0.003) and more than 30 /d (OR=2.303,95%CI:1.194~4.235, P=0.012) the risk of ARC cases increased significantly, the greater the amount of smoking, the risk of ARC is higher. Daily smoking and smoking. Smokers had ARC 1~20 years, 20~30 years and the risk of more than 30 years were ARC respectively is never smoking on According to the 1.431 (95%CI:1.005~2.038, P=0.047), 1.836 (95%CI:1.121~2.896, P=0.022) and 2.081 times (95%CI:1.685~3.627, P=0.001). The smoking time is divided into 20 after 20 years and above, the analysis results showed that compared with never smokers, the risk of smoking more than 20 years has decreased about 27% ARC (OR=0.729,95%CI:0.341~0.969, P=0.027).
5, the relationship between drinking status and ARC
The 2 groups studied the history of alcohol consumption between the distribution was statistically significant (2=6.675, P=0.036). And never drink compared to the control, the risk of the occurrence of cases of current drinking ARC decreased significantly (OR=0.539,95%CI:0.284~0.979, P=0.018), although the risk has occurred ARC drinkers also decreased, but the difference was not statistically significant (OR=0.755,95%CI:0.544~1.048. P=0.093). With the increase of daily alcohol intake and the risk of ARC is not a lower consistency, compared with never drinkers, alcohol intake (OR=1.331,95%CI:0.842~ 2.430, 45~60g/d P=0.572) and 60g/d (OR=1.714,95%CI:1.051~3.130, P=0.024) the risk of occurrence of the increase of ARC, reduce the protective effect of drinking, alcohol intake was U type relationship and the risk of ARC. This study shows that the duration of drinking are associated with the ARC evidence.
Related to drinking wine and the type and quantity of ARC analysis results showed that the control risk of any type of drinking wine is more than 4 standard cup /d cases occurred ARC than never drinkers increased 72% (OR=1.719,95%CI:1.034~2.930, P=0.027). The risk of the research object of drinking liquor 1~4 standard /d ARC drop cup about half (OR=0.466,95%CI:0.264~0.823, P=0.008), and more than 4 standard cup /d can make the risk of ARC increased (OR=1.641,95%CI:1.027~3.023, P=0.039). Drinking beer has nothing to do with the risk of ARC. Wine standard 1~4 drinking cup /d cup and above 4 standard /d and ARC were significantly negatively correlated (respectively. OR=0.537,95%CI:0.166~0.968, P=0.032 and OR=0.609,95%CI:0.230~0.974, P=0.016).
6, the relationship between smoking and drinking with ARC
The adjustment for multiple potential confounding factors, the relationship between different research objects on smoking status, alcohol intake and ARC, current smoking and heavy drinkers (more than 45g/d) significantly increased the risk of ARC, is the current smoking but never drinkers 2.149 times (OR=2.149,95%CI:, 1.132~3.936, P=0.020). Smokers compared with never drinkers., a significant negative correlation between alcohol intake and 45g/d ARC (OR=0.453,95%CI:0.223~0.921, P=0.029), the risk of alcohol intake was larger than 45g/d ARC increased, but the difference was not statistically significant (OR=, 1.418,95%CI:0.813~3.452, P=0.146).
conclusion
1, smoking is a risk factor for ARC, the amount of smoking is positively correlated with ARC, and the time of smoking is positively related to ARC. Smoking cessation can reduce the risk of ARC.
2, alcohol consumption is associated with the incidence of ARC. Compared with those who never drank alcohol, the risk of ARC is decreasing. The relationship between alcohol consumption and the risk of ARC is U type.
3, drinking liquor is more than 4 standard drinks /d can increase the risk of ARC increased, drinking beer has nothing to do with the risk of ARC, a significant negative correlation between drinking Wine and ARC.
4, there is a significant increase in the risk of ARC in the current and severe drinkers.
5, smokers, compared with never drinkers, a significant negative correlation between alcohol intake and 45g/d ARC, the risk of alcohol intake was larger than 45g/d ARC,
Smoking and drinking may have a substantial impact on the risk of elderly cataract. To investigate the relationship between smoking, drinking, and cataract development identified smoking, drinking were risk factors of cataract or protective factors. The risk factors for high risk population to provide the theoretical basis on the occurrence of cataract, and provide them to change these risk factors to reduce the risk of cataract, measures. If the findings can be confirmed in our country of cataract in the crowd, we should advocate not smoking, smokers quit smoking, moderate alcohol consumption, maintaining a healthy lifestyle, which will undoubtedly reduce the incidence of ARC.

【学位授予单位】：辽宁医学院
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R776.1

【参考文献】