中华眼视光学与视觉科学杂志
中華眼視光學與視覺科學雜誌
중화안시광학여시각과학잡지
CHINESE JOURNAL OF OPTOMETRY OPHTHALMOLOGY AND VISUAL SCIENCE
2010年
1期
11-14
,共4页
角膜磨镶术,激光原位%屈光回退%Logistic回归分析
角膜磨鑲術,激光原位%屈光迴退%Logistic迴歸分析
각막마양술,격광원위%굴광회퇴%Logistic회귀분석
Keratomileusis,laser in situ%Refractive regression%Conditional Logistic regression
目的 探讨准分子激光原位角膜磨镶术(LASIK)后屈光同退的危险因素.方法 回顾分析2001至2004年在武汉同济医院眼屈光治疗中心接受LASIK手术的7537例患者资料,收集其中屈光同退的病例298例(484眼),按1:1病例对照研究方法选取相等例数非屈光回退病例作为对照组,两组的性别、手术时间等条件配比.收集两组病例的一般资料,如年龄、性别、家族史和眼部相关检查结果(等效球镜度、最佳矫正视力、中央角膜厚度、切削直径等)等相关因素.应用SPSS 13.0软件对两组的一般情况行X~2检验和t检验,对LASIK术后屈光回退的危险因素进行单因素和多因素条件Logistic回归分析.结果 分析结果提示,有12个变量纳入多因素条件Logistic 回归模型,有4个因素进入Lo-gistic回归预测模型,其中年龄(OR=1.062,P=0.004)和等效球镜度(SE)(OR=3.747,P=0.001)是屈光回退的危险因素,而中央角膜厚度(CCT)(OR=0.475,P=0.002)和切削直径(LAD)(OR=0.982,P=0.000)是屈光回退的保护因素.Logistic回归预测模型为:P=1/1+Exp∑(-7.582-0.060AGE-1.321SE+0.744LAD+0.018CCT),表示P值越大,术后越易发生屈光回退.判断术后屈光回退的灵敏度为79.54%,特异度为76.78%.结论 年龄越大,屈光度越高和中央角膜厚度越薄者,术后越容易出现屈光回退.术中采用较大的激光切削直径将有助于提高LASIK的预测性,减少屈光回退的发生.本研究建立的Logistic回归模型能较好地预测术后屈光同退的发生概率.
目的 探討準分子激光原位角膜磨鑲術(LASIK)後屈光同退的危險因素.方法 迴顧分析2001至2004年在武漢同濟醫院眼屈光治療中心接受LASIK手術的7537例患者資料,收集其中屈光同退的病例298例(484眼),按1:1病例對照研究方法選取相等例數非屈光迴退病例作為對照組,兩組的性彆、手術時間等條件配比.收集兩組病例的一般資料,如年齡、性彆、傢族史和眼部相關檢查結果(等效毬鏡度、最佳矯正視力、中央角膜厚度、切削直徑等)等相關因素.應用SPSS 13.0軟件對兩組的一般情況行X~2檢驗和t檢驗,對LASIK術後屈光迴退的危險因素進行單因素和多因素條件Logistic迴歸分析.結果 分析結果提示,有12箇變量納入多因素條件Logistic 迴歸模型,有4箇因素進入Lo-gistic迴歸預測模型,其中年齡(OR=1.062,P=0.004)和等效毬鏡度(SE)(OR=3.747,P=0.001)是屈光迴退的危險因素,而中央角膜厚度(CCT)(OR=0.475,P=0.002)和切削直徑(LAD)(OR=0.982,P=0.000)是屈光迴退的保護因素.Logistic迴歸預測模型為:P=1/1+Exp∑(-7.582-0.060AGE-1.321SE+0.744LAD+0.018CCT),錶示P值越大,術後越易髮生屈光迴退.判斷術後屈光迴退的靈敏度為79.54%,特異度為76.78%.結論 年齡越大,屈光度越高和中央角膜厚度越薄者,術後越容易齣現屈光迴退.術中採用較大的激光切削直徑將有助于提高LASIK的預測性,減少屈光迴退的髮生.本研究建立的Logistic迴歸模型能較好地預測術後屈光同退的髮生概率.
목적 탐토준분자격광원위각막마양술(LASIK)후굴광동퇴적위험인소.방법 회고분석2001지2004년재무한동제의원안굴광치료중심접수LASIK수술적7537례환자자료,수집기중굴광동퇴적병례298례(484안),안1:1병례대조연구방법선취상등례수비굴광회퇴병례작위대조조,량조적성별、수술시간등조건배비.수집량조병례적일반자료,여년령、성별、가족사화안부상관검사결과(등효구경도、최가교정시력、중앙각막후도、절삭직경등)등상관인소.응용SPSS 13.0연건대량조적일반정황행X~2검험화t검험,대LASIK술후굴광회퇴적위험인소진행단인소화다인소조건Logistic회귀분석.결과 분석결과제시,유12개변량납입다인소조건Logistic 회귀모형,유4개인소진입Lo-gistic회귀예측모형,기중년령(OR=1.062,P=0.004)화등효구경도(SE)(OR=3.747,P=0.001)시굴광회퇴적위험인소,이중앙각막후도(CCT)(OR=0.475,P=0.002)화절삭직경(LAD)(OR=0.982,P=0.000)시굴광회퇴적보호인소.Logistic회귀예측모형위:P=1/1+Exp∑(-7.582-0.060AGE-1.321SE+0.744LAD+0.018CCT),표시P치월대,술후월역발생굴광회퇴.판단술후굴광회퇴적령민도위79.54%,특이도위76.78%.결론 년령월대,굴광도월고화중앙각막후도월박자,술후월용역출현굴광회퇴.술중채용교대적격광절삭직경장유조우제고LASIK적예측성,감소굴광회퇴적발생.본연구건립적Logistic회귀모형능교호지예측술후굴광동퇴적발생개솔.
Objective To investigate the risk factors for refractive regression after laser in situ keratomileusis (LASIK). Methods This study was a 1:1 case-control study with 298 cases of refrac-tive regression and 298 controls who were matched by gender and date of surgery. Participants were selected from 7537 patients at Tongji hospital. Data for all cases included age, family history of myopia and ocular region examination results like SE and LAD were collected. Univariate analysis and multivariate conditional logistic regression were used to analyze the associations between the exposure factors and refractive regression with SPSS 13.0 software. Results Refractive regression was closely related to 4 factors: age (OR=1.062, P=0.004), spherical equivalent (OR=3.747, P=0.001), central corneal thickness (OR=0.475, P=0.002), and laser ablation diameter (OR=0.982, P=0.000). The first two factors are risk factors and the latter two are protective factors. The Logistic regression equation was as follows: P=1/1+Exp∑ (-7.582-0.060AGE-1.321SE+0.744LAD+0.018CCT). The sensitivity and specificity of the Logistic model were 79.54% and 76.78%, respectively. Conclusion In cases with older age, thinner preoperative corneal thickness and higher myopic diopter, refractive regression oc- curs easily after surgery. A large laser ablation diameter will help to improve predictability and reduce regression. The Logistic regression model based on these factors is reliable in predicting refractive re-gression after LASIK.
