原发性开角型青光眼危险因素及生存质量研究
发布时间：2019-04-24 00:45
【摘要】：目的：探讨女性原发性开角型青光眼(POAG)发病的危险因素,进行原发性开角型青光眼患者生存质量的研究,并研究影响原发性开角型青光眼患者生存质量的相关影响因素,为探索提高原发性开角型青光眼患者生存质量的对策措施,综合评价原发性开角型青光眼患者的治疗和护理效果提供参考依据。 方法：采用病例对照研究的方法,收集2009-2010年间女性POAG患者128例,同期非POAG患者142例,调查两组对象的既往青光眼家族史、高血压、糖尿病、初潮年龄、绝经年龄、妊娠次数、口服避孕药的使用情况,以及激素替代疗法的使用情况,并采用多因素分析的方法,分析影响POAG发病的主要因素。采用方便抽样的方法,对2010-2011年在复旦大学附属华山医院眼科门诊就诊的原发性开角型青光眼患者进行抽样,共抽取符合条件的研究对象186例。以问卷和临床检查相结合的方式对明确诊断的原发性开角型青光眼患者进行生存质量及其影响因素的调查。调查内容包括视功能损害眼病患者生存质量、视功能检查及生存质量影响因素调查。 结果：女性POAG发病危险因素调查的Logistic回归分析显示,POAG家族史(OR=48.05,4.63-410.90)、高血压(OR=6.51,2.76-15.31)、初潮年龄晚(OR=1.42,1.04-1.95)是女性PoAG发病的危险因素；绝经年龄晚(OR=0.62,0.39-0.99)、激素替代疗法(OR=0.26,0.07-0.96)是女性POAG的保护因素。 原发性开角型青光眼生存质量及影响因素调查显示,POAG患者生存质量总得分(YT)为127.06+40.67,其中精神心理(YP)的得分最低,为20.37±11.85。多因素分析显示：双眼综合视野(回归系数β=-20.791,t=-7.010,P0.001)和综合视力(回归系数β=12.193,t=5.913,P0.001)与生存质量得分显著相关,双眼综合视野缺损越轻、综合视力级别越高的患者生存质量总得分及各部分得分越高；有青光眼药物副作用的患者生存质量得分低于没有药物副作用的患者(回归系数β=-13.469,t=-3.425,P=0.001)；年龄大的患者生存质量总得分比年龄小的患者高(回归系数β=0.579,t=4.089,P0.001),主要体现在社会活动(YS)和精神心理(YP)这两部分；文化程度高的患者生存质量得分比文化程度低的患者高(回归系数β=6.636,t=3.081,P=0.002)。 结论：POAG家族史和高血压是女性POAG的发病的危险因素,女性性激素可能是女性POAG的保护因素。原发性开角型青光眼患者生存质量普遍下降,其中精神心理(YP)的得分最低,需要关注POAG患者的生存质量,尤其应给予必要的心理疏导；双眼综合视野缺损越轻、综合视力级别越高的患者生存质量相对较好；青光眼药物的副作用可以影响患者的生存质量,治疗中除了考虑药物疗效还应注意药物的副作用；年龄大的POAG患者生存质量比年龄小的患者好,要注重年轻POAG患者的心理疏导；文化程度高的POAG患者生存质量相对比文化程度低的好。
[Abstract]:Objective: to investigate the risk factors of (POAG) in female patients with primary open-angle glaucoma, and to study the quality of life in patients with primary open-angle glaucoma and the related factors affecting the quality of life in patients with primary open-angle glaucoma. To explore the countermeasures to improve the quality of life of patients with primary open-angle glaucoma and to evaluate the treatment and nursing effect of patients with primary open-angle glaucoma. Methods: a case-control study was conducted to investigate the family history of glaucoma, hypertension, diabetes mellitus, menarche age and menopause age of 128 female POAG patients and 142 non-POAG patients from 2009 to 2010, and to investigate the family history of glaucoma, hypertension, diabetes mellitus, menarche age and menopause age between the two groups. The frequency of pregnancy, the use of oral contraceptive and the use of hormone replacement therapy (HRT) were analyzed. The main factors affecting the incidence of HRT were analyzed by multivariate analysis. A convenient sampling method was used to sample 186 patients with primary open angle glaucoma from 2010 to 2011 in the ophthalmology clinic of Huashan Hospital affiliated to Fudan University. The quality of life (QOL) and its influencing factors were investigated in patients with primary open-angle glaucoma diagnosed by questionnaire and clinical examination. The investigation included quality of life (QOL), visual function examination and influencing factors of QOL in patients with visual impairment. Results: Logistic regression analysis showed that the family history of POAG (OR=48.05,4.63-410.90), hypertension (OR=6.51,2.76-15.31), and hypertension (POAG) were analyzed by Logistic regression analysis. Late menarche age (OR=1.42,1.04-1.95) was the risk factor of PoAG in women. Late menopause (OR=0.62,0.39-0.99), hormone replacement therapy (OR=0.26,0.07-0.96) is the protective factor of POAG in women. A survey on the quality of life and its influencing factors in primary open angle glaucoma showed that the total quality of life score (YT) of POAG patients was 127.06 40.67, and the score of psycho-psychological (YP) was the lowest (20.37 卤11.85). Multivariate analysis showed that Binocular comprehensive visual field (regression coefficient 尾 =-20.791, t = 7.010, P0.001) and comprehensive visual acuity (regression coefficient 尾 = 12.193, t = 5.913, P0.001) were significantly correlated with quality of life score (QOL). The lighter the comprehensive visual field defect, the higher the total score of quality of life and the score of each part of the patients with higher comprehensive visual acuity. The scores of QOL in patients with glaucoma drug side effects were lower than those without drug side effects (regression coefficient 尾 =-13.469, t = 3.425, P < 0.001). The total quality of life score of older patients was higher than that of younger patients (regression coefficient 尾 = 0.579, t = 4.089, P0.001), which was mainly reflected in social activity (YS) and psycho-psychological (YP). The quality of life score of patients with higher education level was higher than that of patients with low education level (regression coefficient 尾 = 6.636, t = 3.881, P = 0.002). Conclusion: the family history of POAG and hypertension are the risk factors of POAG in women. The female sex hormone may be the protective factor of POAG in women. The quality of life of patients with primary open-angle glaucoma is generally decreased, and the score of psycho-psychological (YP) is the lowest. It is necessary to pay attention to the quality of life of POAG patients, especially to give necessary psychological guidance. The lighter the binocular comprehensive visual field defect, the better the quality of life of the patients with higher comprehensive visual acuity, and the side effects of glaucoma drugs can affect the quality of life of the patients, in addition to considering the efficacy of drugs, attention should be paid to the side effects of drugs. The quality of life of the older POAG patients is better than that of the younger ones, so we should pay attention to the psychological guidance of the young POAG patients, and the POAG patients with high education level have better quality of life than those with the lower education level.
【学位授予单位】：复旦大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R775.2
本文编号：2463957
[Abstract]:Objective: to investigate the risk factors of (POAG) in female patients with primary open-angle glaucoma, and to study the quality of life in patients with primary open-angle glaucoma and the related factors affecting the quality of life in patients with primary open-angle glaucoma. To explore the countermeasures to improve the quality of life of patients with primary open-angle glaucoma and to evaluate the treatment and nursing effect of patients with primary open-angle glaucoma. Methods: a case-control study was conducted to investigate the family history of glaucoma, hypertension, diabetes mellitus, menarche age and menopause age of 128 female POAG patients and 142 non-POAG patients from 2009 to 2010, and to investigate the family history of glaucoma, hypertension, diabetes mellitus, menarche age and menopause age between the two groups. The frequency of pregnancy, the use of oral contraceptive and the use of hormone replacement therapy (HRT) were analyzed. The main factors affecting the incidence of HRT were analyzed by multivariate analysis. A convenient sampling method was used to sample 186 patients with primary open angle glaucoma from 2010 to 2011 in the ophthalmology clinic of Huashan Hospital affiliated to Fudan University. The quality of life (QOL) and its influencing factors were investigated in patients with primary open-angle glaucoma diagnosed by questionnaire and clinical examination. The investigation included quality of life (QOL), visual function examination and influencing factors of QOL in patients with visual impairment. Results: Logistic regression analysis showed that the family history of POAG (OR=48.05,4.63-410.90), hypertension (OR=6.51,2.76-15.31), and hypertension (POAG) were analyzed by Logistic regression analysis. Late menarche age (OR=1.42,1.04-1.95) was the risk factor of PoAG in women. Late menopause (OR=0.62,0.39-0.99), hormone replacement therapy (OR=0.26,0.07-0.96) is the protective factor of POAG in women. A survey on the quality of life and its influencing factors in primary open angle glaucoma showed that the total quality of life score (YT) of POAG patients was 127.06 40.67, and the score of psycho-psychological (YP) was the lowest (20.37 卤11.85). Multivariate analysis showed that Binocular comprehensive visual field (regression coefficient 尾 =-20.791, t = 7.010, P0.001) and comprehensive visual acuity (regression coefficient 尾 = 12.193, t = 5.913, P0.001) were significantly correlated with quality of life score (QOL). The lighter the comprehensive visual field defect, the higher the total score of quality of life and the score of each part of the patients with higher comprehensive visual acuity. The scores of QOL in patients with glaucoma drug side effects were lower than those without drug side effects (regression coefficient 尾 =-13.469, t = 3.425, P < 0.001). The total quality of life score of older patients was higher than that of younger patients (regression coefficient 尾 = 0.579, t = 4.089, P0.001), which was mainly reflected in social activity (YS) and psycho-psychological (YP). The quality of life score of patients with higher education level was higher than that of patients with low education level (regression coefficient 尾 = 6.636, t = 3.881, P = 0.002). Conclusion: the family history of POAG and hypertension are the risk factors of POAG in women. The female sex hormone may be the protective factor of POAG in women. The quality of life of patients with primary open-angle glaucoma is generally decreased, and the score of psycho-psychological (YP) is the lowest. It is necessary to pay attention to the quality of life of POAG patients, especially to give necessary psychological guidance. The lighter the binocular comprehensive visual field defect, the better the quality of life of the patients with higher comprehensive visual acuity, and the side effects of glaucoma drugs can affect the quality of life of the patients, in addition to considering the efficacy of drugs, attention should be paid to the side effects of drugs. The quality of life of the older POAG patients is better than that of the younger ones, so we should pay attention to the psychological guidance of the young POAG patients, and the POAG patients with high education level have better quality of life than those with the lower education level.
【学位授予单位】：复旦大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R775.2
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