中华眼科杂志
中華眼科雜誌
중화안과잡지
Chinese Journal of Ophthalmology
2012年
3期
226-233
,共8页
王利华%毕宏生%李运%杨少远%王婷%刘丽萍%周成超
王利華%畢宏生%李運%楊少遠%王婷%劉麗萍%週成超
왕리화%필굉생%리운%양소원%왕정%류려평%주성초
盲%视觉障碍%患病率%中年人%老年人
盲%視覺障礙%患病率%中年人%老年人
맹%시각장애%환병솔%중년인%노년인
Blindness%Visual impairment%Prevalence%Middle aged%Aged
目的 调查山东省农村50岁及以上人群盲和中、重度视力损伤的患病率.方法 采用以人群为基础的随机整群抽样方法.2008年4-7月在山东省3个不同经济发展水平的县(市)中各选择1个县(市)作为调查地[乳山市(人均国内生产总值高)、滕州市(人均国内生产总值中等)、鄄城县(人均国内生产总值低)],另外选择1个人均国内生产总值中等城市市区的郊区农村作为调查地(济南市槐荫区).各调查地按照单纯随机抽样方法在编号排序的基本抽样单位中抽取调查点(村).受检者在当地设置的检查站进行视力检查和眼科检查,对一只眼日常生活视力(PVA)≤0.5者检查其最佳矫正视力(BCVA).不同组之间盲和中、重度视力损伤患病率的比较采用x2检验.年龄、性别、受教育程度、地区差异对视力的影响采用多分类logistic回归分析,各地调查结果的比较采用调整的疾病优势比.结果 4个调查地共检录≥50岁样本人数19 583人,实际受检人数17 816人,总受检率为90.98％.以PVA为标准,较好眼中、重度视力损伤(0.05≤视力＜0.3)患病率为7.01％(6.63％ ～7.39％,年龄标化率为6.56％)；盲(视力＜0.05)患病率为1.58％(1.39％ ～ 1.76％,年龄标化率为1.48％).以BCVA为标准,较好眼中、重度视力损伤患病率为3.66％(3.38％ ～ 3.94％,年龄标化率为3.38％)；盲患病率为1.33％(1.16％～1.50％,年龄标化率为1.24％).应用PVA标准的中、重度视力损伤患病率高于应用BCVA标准的中、重度视力损伤患病率(x2=201.262,P=0.000)；应用两种标准的盲患病率的差异无统计学意义(x2=0.117,P=0.732).以PVA为标准,中、重度视力损伤和盲患病率与高龄、女性、受教育程度低和调查地区经济水平低均有相关性(P≤0.05).以BCVA为标准,中、重度视力损伤患病率与高龄、女性、文化水平低和调查地区经济水平低有相关性(P≤0.05)；盲患病率与高龄、受教育程度低和调查地区经济水平有相关性,与性别无相关性.结论 在山东省农村50岁及以上人群中,盲和中、重度视力损伤仍然是重要的公共卫生问题；未矫正的屈光不正是中、重度视力损伤的主要原因之一.
目的 調查山東省農村50歲及以上人群盲和中、重度視力損傷的患病率.方法 採用以人群為基礎的隨機整群抽樣方法.2008年4-7月在山東省3箇不同經濟髮展水平的縣(市)中各選擇1箇縣(市)作為調查地[乳山市(人均國內生產總值高)、滕州市(人均國內生產總值中等)、鄄城縣(人均國內生產總值低)],另外選擇1箇人均國內生產總值中等城市市區的郊區農村作為調查地(濟南市槐蔭區).各調查地按照單純隨機抽樣方法在編號排序的基本抽樣單位中抽取調查點(村).受檢者在噹地設置的檢查站進行視力檢查和眼科檢查,對一隻眼日常生活視力(PVA)≤0.5者檢查其最佳矯正視力(BCVA).不同組之間盲和中、重度視力損傷患病率的比較採用x2檢驗.年齡、性彆、受教育程度、地區差異對視力的影響採用多分類logistic迴歸分析,各地調查結果的比較採用調整的疾病優勢比.結果 4箇調查地共檢錄≥50歲樣本人數19 583人,實際受檢人數17 816人,總受檢率為90.98％.以PVA為標準,較好眼中、重度視力損傷(0.05≤視力＜0.3)患病率為7.01％(6.63％ ～7.39％,年齡標化率為6.56％)；盲(視力＜0.05)患病率為1.58％(1.39％ ～ 1.76％,年齡標化率為1.48％).以BCVA為標準,較好眼中、重度視力損傷患病率為3.66％(3.38％ ～ 3.94％,年齡標化率為3.38％)；盲患病率為1.33％(1.16％～1.50％,年齡標化率為1.24％).應用PVA標準的中、重度視力損傷患病率高于應用BCVA標準的中、重度視力損傷患病率(x2=201.262,P=0.000)；應用兩種標準的盲患病率的差異無統計學意義(x2=0.117,P=0.732).以PVA為標準,中、重度視力損傷和盲患病率與高齡、女性、受教育程度低和調查地區經濟水平低均有相關性(P≤0.05).以BCVA為標準,中、重度視力損傷患病率與高齡、女性、文化水平低和調查地區經濟水平低有相關性(P≤0.05)；盲患病率與高齡、受教育程度低和調查地區經濟水平有相關性,與性彆無相關性.結論 在山東省農村50歲及以上人群中,盲和中、重度視力損傷仍然是重要的公共衛生問題；未矯正的屈光不正是中、重度視力損傷的主要原因之一.
목적 조사산동성농촌50세급이상인군맹화중、중도시력손상적환병솔.방법 채용이인군위기출적수궤정군추양방법.2008년4-7월재산동성3개불동경제발전수평적현(시)중각선택1개현(시)작위조사지[유산시(인균국내생산총치고)、등주시(인균국내생산총치중등)、견성현(인균국내생산총치저)],령외선택1개인균국내생산총치중등성시시구적교구농촌작위조사지(제남시괴음구).각조사지안조단순수궤추양방법재편호배서적기본추양단위중추취조사점(촌).수검자재당지설치적검사참진행시력검사화안과검사,대일지안일상생활시력(PVA)≤0.5자검사기최가교정시력(BCVA).불동조지간맹화중、중도시력손상환병솔적비교채용x2검험.년령、성별、수교육정도、지구차이대시력적영향채용다분류logistic회귀분석,각지조사결과적비교채용조정적질병우세비.결과 4개조사지공검록≥50세양본인수19 583인,실제수검인수17 816인,총수검솔위90.98％.이PVA위표준,교호안중、중도시력손상(0.05≤시력＜0.3)환병솔위7.01％(6.63％ ～7.39％,년령표화솔위6.56％)；맹(시력＜0.05)환병솔위1.58％(1.39％ ～ 1.76％,년령표화솔위1.48％).이BCVA위표준,교호안중、중도시력손상환병솔위3.66％(3.38％ ～ 3.94％,년령표화솔위3.38％)；맹환병솔위1.33％(1.16％～1.50％,년령표화솔위1.24％).응용PVA표준적중、중도시력손상환병솔고우응용BCVA표준적중、중도시력손상환병솔(x2=201.262,P=0.000)；응용량충표준적맹환병솔적차이무통계학의의(x2=0.117,P=0.732).이PVA위표준,중、중도시력손상화맹환병솔여고령、녀성、수교육정도저화조사지구경제수평저균유상관성(P≤0.05).이BCVA위표준,중、중도시력손상환병솔여고령、녀성、문화수평저화조사지구경제수평저유상관성(P≤0.05)；맹환병솔여고령、수교육정도저화조사지구경제수평유상관성,여성별무상관성.결론 재산동성농촌50세급이상인군중,맹화중、중도시력손상잉연시중요적공공위생문제；미교정적굴광불정시중、중도시력손상적주요원인지일.
Objective To describe the prevalence of visual impairment/blindness among older adults aged ≥50 years in rural populations in Shandong Province,China.Methods Population-based,crosssectional study was designed in this survey.Three counties and one suburbs representative of the different levels of socioeconomic development were selected as the study areas within the province from April to July 2008.Geographically defined cluster sampling was used in randomly selecting a cross-section of residents aged ≥50 years from each county.Eligible persons were invited to local examination sites for visual acuity (VA) testing and eye examination.Those presenting with VA ≤0.5 in either eye were refracted to achieve best-corrected VA.x2-test was used to compare the prevalence of blindness and visual impairment in the different groups.Multiple logistic regressions were used to investigate the association of age,gender,education,and county with presenting and best-corrected visual impairment and blindness.Adjusted odds ratio was used to compare the prevalence of blindness and visual impairment in the different counties.Results Of 19 583 enumerated eligible persons,17 816(90.98％ ) were examined and tested for VA.The prevalence of presenting visual impairment (0.05- ＜ 0.3 ) in the better-seeing eye was 7.01％ ( the age-standardized rate was 6.56％ ) and presenting blindness ( ＜ 0.05 ) was 1.58％ ( the age-standardized rate was 1.48％ ).Across the 4 counties,presenting visual impairment ranged from 4.51％ to 8.65 ％,and presenting blindness from 1.35％ to 1.77％.With best-corrected VA,the prevalence of visual impairment was 3.66％ ( the agestandardized rate was 3.38％ ),and 1.33％ for blindness ( the age-standardized rate was 1.24％ ).The ranges across the 4 counties were 2.63％ to 4.38％ for visual impairment and 1.06％-1.54％ for blindness.The prevalence of visual impairment with presenting VA was higher than that with best-corrected VA ( x2 =201.262,P =0.000).There was no significant difference between the prevalence of blindness with presenting VA and that with best-corrected VA( x2 =0.117,P =0.732).Based on both presenting and bestcorrected VA,visual impairment and blindness were associated with older age,female gender,lack of education,and county (P ≤0.05 ).Conclusions Visual impairment and blindness are important public health problems in rural older adults aged ≥50 years in Shandong Province.Un-corrected refractive error is one of the main causes of visual impairment.
