CAJ | 학술논문

目的调查上海市北新泾街道60岁及以上老年人低视力、盲的患病率及致盲原因,并与以前调查结果相比较,评价近年该地区实施防盲治盲项目的效果.方法应用横断面研究的流行病学调查方法.由上海交通大学附属第一人民医院和上海市长宁区北新泾社区卫生服务中心于2007年11月至2008年4月采用整群随机抽样方法在上海市长宁区北新泾街道抽取8个社区,对其中所有的60岁及以上老年人进行调查,检查日常生活视力和针孔镜矫正视力,应用裂隙灯显微镜、直接检眼镜和眼底照相机等仪器检查受检者外眼、眼前节及眼底等情况.观察低视力及盲的患病情况,分析致盲的主要原因.正式调查前先进行预试验,通过计算kappa值进行不同检查者诊断结果的重复性检验,保证调查质量.结果在应检录4153人中,受检人数为3851人,受检率为92.73%.按照世界卫生组织视力损伤标准:双眼盲29人,其中男性11人(占37.93%)、女性18人(占62.07%).双眼低视力104人,其中男性37人(占35.58%)、女性67人(占64.42%).双眼盲和双眼低视力的患病率分别为0.75%和2.70%.致盲的主要原因依次为:黄斑变性、白内障、角膜瘢痕或混浊及视网膜脱离.按照日常生活视力和视力损伤标准:重度双眼盲61人,其中男性20人(占32.79%)、女性41人(占67.21%).轻度双眼盲66人,其中男性27人(占40.91%)、女性39人(占59.09%).单眼盲276人,其中男性120人(占43.48%)、女性156人(占56.52%).重度双眼盲、轻度双眼盲、单眼盲的患病率分别为1.58%、1.71%和7.17%.致盲的主要原因依次为:黄斑变性、白内障、屈光不正及角膜瘢痕或混浊.结论黄斑变性仍是致盲的首要原因,眼底病患病率逐渐上升,社区防盲项目已初显成效.
목적 조사상해시북신경가도60세급이상노년인저시력、맹적환병솔급치맹원인,병여이전조사결과상비교,평개근년해지구실시방맹치맹항목적 효과.방법 응용횡단면연구적류행병학조사방법.유상해교통대학부속제일인민의원화상해시장저구북신경사구위생복무중심우2007년11월지2008년4월채용정군수궤추양방법재상해시장저구북신경가도추취8개사구,대기중소유적60세급이상노년인진행조사,검사일상생활시력화침공경교정시력,응용렬극등현미경、직접검안경화안저조상궤등의기검사수검자외안、안전절급안저등정황.관찰저시력급맹적환병정황,분석치맹적주요원인.정식조사전선진행예시험,통과계산kappa치진행불동검사자진단결과적중복성검험,보증조사질량.결과 재응검록4153인중,수검인수위3851인,수검솔위92.73%.안조세계위생조직시력손상표준:쌍안맹29인,기중남성11인(점37.93%)、녀성18인(점62.07%).쌍안저시력104인,기중남성37인(점35.58%)、녀성67인(점64.42%).쌍안맹화쌍안저시력적환병솔분별위0.75%화2.70%.치맹적주요원인의차위:황반변성、백내장、각막반흔혹혼탁급시망막탈리.안조일상생활시력화시력손상표준:중도쌍안맹61인,기중남성20인(점32.79%)、녀성41인(점67.21%).경도쌍안맹66인,기중남성27인(점40.91%)、녀성39인(점59.09%).단안맹276인,기중남성120인(점43.48%)、녀성156인(점56.52%).중도쌍안맹、경도쌍안맹、단안맹적환병솔분별위1.58%、1.71%화7.17%.치맹적주요원인의차위:황반변성、백내장、굴광불정급각막반흔혹혼탁.결론 황반변성잉시치맹적수요원인,안저병환병솔축점상승,사구방맹항목이초현성효.
Objective To investigate the prevalence rate of blindness and low vision and the leading cause of blindness in residents aged ≥60 years in Beixinjing blocks, Shanghai. Methods A cross-sectional study was carried out by Shanghai First People's Hospital, affiliated Shanghai Jiaotong University and Shanghai Beixinjing Community hospital from November 2007 to April 2008. Randomly cluster sampling method was used ,and all the individuals aged ≥60 years in 8 communities from Beixinjing blocks, Shanghai was enrolled in this study. The pinhole visual acuity and presenting visual acuity were measured separately in each eye. External eye, anterior segment and ocular fundus were examined by the ophthalmologist using slit lamp-microscopes, direct ophthalmoscopy and non-mydriatic digital camara. Assigned ophthalmolngic doctors assured the leading blind causes of every blind person. The survey was preceded by a pilot study where operational methods were refined and quality assurance evaluation was carried out. Results 3851 individuals were examined, and the response rate was 92. 73%. According to WHO diagnostic criteria: 29 persons were diagnosed as blindness, 11 male (37.93%) and 18 female (62.07%). 104 persons were diagnosed as low vision, 37 male (35. 58% ) and 67 female (64. 42% ) . The prevalence rates of blindness and low vision were 0. 75% and 2. 70%. The leading causes of blindness were macular degeneration, cataract, corneal diseases, and retinal detachment According to presenting vision diagnostic criteria: 61 persons were diagnosed as severe binocular blindness, 20 male (32. 79% ) and 41 female (67. 21% ) . 66 persons were diagnosed as slight binocular blindness, 27 male (40. 91% ) and 39 female (59. 09% ) . 276 persons were diagnosed as monocular blindness, 120 male (43.48%) and 156 female (56. 52% ). The prevalence of severe binocular blindness, slight binocular blindness and monocular blindness was 1.58% , 1.71% and 7. 17%, respectively. The leading causes of blindness were macular degeneration, cataract, ametropia and corneal diseases. Conclusion The leading cause of blindness was macular degeneration. The prevalence of degenerative retinopathy in this area is on the rise.