常规体检中年龄≥45岁人员视网膜出血的影响因素的研究

发布时间：2018-07-27 21:39

【摘要】：目的视网膜出血对视功能损害严重，甚至可致失明，是眼底检查时常见的视网膜病变，可由全身疾病或眼部病变引起，多因视力损害而就诊。及时准确地对视网膜出血进行诊断和治疗是恢复、提高视功能以及防止病变继续发展的有效措施。本文着重探讨医院常规体检中45岁以上人员视网膜出血的患病相关危险因素及防治策略。方法调查地点是山西省太原市迎泽区山西医科大学第一医院体检中心。研究对象为在山西医科大学第一医院体检中心接受体检的年龄"g45岁的体检人员5077名，其中男性2753名，女性2324名。年龄45岁 86岁，平均年龄62.8±5.4岁。受检者进行了血生化、血糖、血脂、血压、内科、外科、眼科、腹部B超及心脏彩超等多项目检查，本文所述诊断均以本次体检各相关科室的诊断为准。对该人群进行问卷调查和免散瞳数码眼底照相并确定视网膜出血人群，所得资料对年龄、性别、吸烟、饮酒、糖尿病、心脏病、脑卒中、服用阿斯匹林及高血压病进行Spearsoχ2检验和非条件多因素logistic回归分析，得出视网膜出血的相关因素。结果受检人群中共有视网膜出血者193人，占所有年龄"g45岁调查总人口的3.8%，其中男性104人，女性89人。视网膜出血的危险因素包括年龄、性别、吸烟、饮酒、糖尿病、心脏病、脑卒中、服用阿斯匹林及高血压病。对全部因素进行Spearsonχ2检验，发现除性别外，其余各因素均与视网膜出血相关，P值都"f0.05。将所有单因素分析Spearsonχ2检验有统计学意义的因素引入多因素非条件logistic回归方程，，显示与视网膜出血的相关因素有年龄（OR=2.263,P㩳0.05）、糖尿病（OR=9.215,P㩳0.05）、服用阿司匹林（OR=8.372, P㩳0.05）和高血压病（OR=6.598, P㩳0.05）,而吸烟、饮酒、心脏病和脑卒中四项因素均未进入回归方程。结论 1.视网膜出血与年龄具有相关性，视网膜血管异常随年龄增加而增多。 2.糖尿病受检者的视网膜出血风险是非糖尿病受检者的9.2倍（OR=9.215）,证明糖尿病是视网膜出血的高危险因素。 3.高血压病也是视网膜出血的一个高危险因素，有效控制血压对于保护视功能至关重要。
[Abstract]:Objective Retinal hemorrhage is a common retinopathy in fundus examination, which can cause serious damage to visual function or even blindness. It can be caused by systemic or ocular diseases. Timely and accurate diagnosis and treatment of retinal hemorrhage is an effective measure to recover, improve visual function and prevent the further development of retinal hemorrhage. This paper focuses on the risk factors and prevention strategies of retinal hemorrhage in patients over 45 years of age in general physical examination in hospitals. Methods the investigation site was the physical examination Center of the first Hospital of Shanxi Medical University, Yingze District, Taiyuan City, Shanxi Province. The subjects of the study were 5077 medical examiners aged 45 years, 2753 males and 2324 females, who underwent physical examination at the first Hospital of Shanxi Medical University. The average age was 62.8 卤5.4 years. Blood biochemistry, blood glucose, blood lipid, blood pressure, internal medicine, surgery, ophthalmology, abdominal B-ultrasound and cardiac ultrasound were examined. A questionnaire survey and digital fundus photography were conducted to determine the number of people with retinal hemorrhage. Data were obtained on age, sex, smoking, alcohol consumption, diabetes, heart disease, stroke. The factors related to retinal hemorrhage were obtained by Spearso 蠂 2 test and non conditional multivariate logistic regression analysis. Results there were 193 cases of retinal hemorrhage in the tested population, accounting for 3.8% of the total population of all age "g45 years, including 104 males and 89 females." Risk factors for retinal hemorrhage include age, sex, smoking, alcohol consumption, diabetes, heart disease, stroke, aspirin and hypertension. Spearson 蠂 2 test showed that all the other factors except sex were related to retinal hemorrhage (P < 0.05). All the factors with statistical significance in univariate Spearson 蠂 2 test were introduced into the multivariate conditional logistic regression equation. The results showed that the factors associated with retinal hemorrhage were age (OR2.263), diabetes mellitus (OR9.215P0. 05), aspirin (OR8.372, P0. 05) and hypertension (OR6.598, P0. 05). Four factors of heart disease and stroke did not enter the regression equation. Conclusion 1. Retinal hemorrhage was associated with age, and retinal vascular abnormalities increased with age. 2. 2. The risk of retinal hemorrhage in diabetic subjects was 9.2 times higher than that in non-diabetic subjects (OR=9.215), suggesting that diabetes was a high risk factor for retinal hemorrhage. Hypertension is also a high risk factor for retinal hemorrhage. Effective blood pressure control is essential to protect visual function.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R774.1

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