CAJ | 학술논문

背景特发性黄斑前膜常导致患者视力的进行性下降。研究该病的危险因素有助于对其发病机制的研究，并指导临床上对高危人群的筛查和制定预防、治疗策略。目的分析健康体检人群中特发性黄斑前膜发生的相关因素。方法对2009年11月至2010年10月在北京协和医院体检中心进行健康体检的人群进行眼科检查，并对体检中发现的特发性黄斑前膜患者与无该病人群的临床特点进行分析比较，通过多因素logistic回归模型分析特发性黄斑前膜与年龄、体重指数、高血压、糖尿病、高脂血症、血清白蛋白、肾功能及白内障的相关性。结果研究期间共27 400人进行了眼科检查，发现特发性黄斑前膜76例。特发性黄斑前膜患者均无明显的眼科主诉，40岁以下患病者12例(12/11 659)，51 ～ 60岁患病者21例(21/4595)，60岁以上患病者32例( 32/2544)。发生特发性黄斑前膜的人群中42％合并高血压，5％合并糖尿病，66％合并血脂水平异常，6％合并肾功能不全，18％合并白内障。在单因素logistic回归分析中，51岁以上患高血压、高脂血症和白内障者发生特发性黄斑前膜病变的风险增加，与50岁以下无高血压、无高脂血症和无白内障者比较差异均有统计学意义(P＜0.01)。多因素logistic回归模型中，与年龄40岁以下的患者比较，51 ～60岁的人群患病风险增加(OR=2.50,95％ CI:1.20～5.40，P=0.02)，＞60岁的人群患病风险增加(OR=7.30，95％CI:3.40 ～15.60，P＜0.01)，高脂血症仍与特发性黄斑前膜的发生有明显相关性(OR=2.10，95％CI:1.30 ～ 3.50，P＜0.01)。结论50岁以上人群及高脂血症患者发生特发性黄斑前膜的风险显著增加。
배경 특발성황반전막상도치환자시력적진행성하강。연구해병적위험인소유조우대기발병궤제적연구，병지도림상상대고위인군적사사화제정예방、치료책략。 목적 분석건강체검인군중특발성황반전막발생적상관인소。방법 대2009년11월지2010년10월재북경협화의원체검중심진행건강체검적인군진행안과검사，병대체검중발현적특발성황반전막환자여무해병인군적림상특점진행분석비교，통과다인소logistic회귀모형분석특발성황반전막여년령、체중지수、고혈압、당뇨병、고지혈증、혈청백단백、신공능급백내장적상관성。결과연구기간공27 400인진행료안과검사，발현특발성황반전막76례。특발성황반전막환자균무명현적안과주소，40세이하환병자12례(12/11 659)，51 ～ 60세환병자21례(21/4595)，60세이상환병자32례( 32/2544)。발생특발성황반전막적인군중42％합병고혈압，5％합병당뇨병，66％합병혈지수평이상，6％합병신공능불전，18％합병백내장。재단인소logistic회귀분석중，51세이상환고혈압、고지혈증화백내장자발생특발성황반전막병변적풍험증가，여50세이하무고혈압、무고지혈증화무백내장자비교차이균유통계학의의(P＜0.01)。다인소logistic회귀모형중，여년령40세이하적환자비교，51 ～60세적인군환병풍험증가(OR=2.50,95％ CI:1.20～5.40，P=0.02)，＞60세적인군환병풍험증가(OR=7.30，95％CI:3.40 ～15.60，P＜0.01)，고지혈증잉여특발성황반전막적발생유명현상관성(OR=2.10，95％CI:1.30 ～ 3.50，P＜0.01)。 결론50세이상인군급고지혈증환자발생특발성황반전막적풍험현저증가。
Background Idiopathic epiretinal membranes(ERMs) is a common eye disease condition that leads to progressive decline of visual acuity. Studying the risk factors relating to this disease will shed light on its pathogenesis and allow opthalmologists to screen the affected individuals among the high-risk population and prepare for prevention and management strategies. Objective This survey was to investigate the risk factors of idiopathic ERMs in the population undergoing routine health check-ups. Methods The clinical data of idiopathic ERMs was obtained from the population of routine health check-ups in Peking Union Medical College Hospital from November 2009 to October 2010. The examination outcomes were compared between the individuals with and without idiopathic ERMs. The demographic and clinical factors associated with idiopathic ERMs were analyzed and assessed using univariate and multivariate logistic regression analyses. Result A total of 27 400 people were included in the survey and idiopathic ERMs were diagnosed in 76 cases. No obvious eye complaint was obtained from the idiopathic ERMs. The number of people affected with idiopathic ERMs was 12 ( 12/11 659 ) in the below 40 years group, 21 (21/4595) in the 51-60 years group and 32 (32/2544) in the over 60 years group. Hypertension, diabetes, diedyslipidemia, renal function insufficiency ,and cataract were found in 42％ ,5％ ,66％ ,6％ and 8％ of the patients, respectively. The univariate logistic regression analyses revealed that significant correlations were found between age,hypertension,hyperlipidemia and history of cataract( P＜0. 01 ). Multivariate regression models showed that the risk of idiopathic ERMs increased in age of 51-60( OR=2. 5,95％ CI:1. 2-5.4,P=0.02) and over 60 years( OR =7.3,95％ CI:3.4-15.6 ,P＜0.01 ) and patients suffering from hyperlipidemia ( OR--2. 1,95％ CI:1. 3-3.5, P＜0. 01 ). Conclusions Over the age of 50 years and hyperlipidemia are primary risk factors of idiopathic ERM.