北京农村及城市特定人群原发性闭角型青光眼的患病率及其影响因素

The prevalence and its effective factors of primary angle-closure glaucoma in defined populations of rural and urban in Beijing

目的了解北京地区农村及城市人群原发性闭角型青光眼(PACG)的患病率并探讨相关影响因素。方法于2001年6—10月,对北京地区农村及城市特定区域40岁以上的4451人进行青光眼筛查,其中农村1980人,城市2471人,男性1939人,女性2512人。检查项目包括采用vanHerick法和前房角镜检查法检测周边前房深度和前房角,常规检测视力、眼压、屈光状态并行眼底照相和阈值视野检测。对可疑青光眼和青光眼患者进行青光眼的标准检查。结果本次调查40岁以上人群农村及城市的应答率分别为796%(1980/2488)和871%(2471/2836);人群PACG的患病率为12%[95%可信区间(CI)为09%～15%]。其中农村PACG患病率为16%(95%CI为12%～20%),高于城市的11%(95%CI为08%～14%);女性PACG的患病率为17%(95%CI为13%～21%),高于男性的08%(95%CI为05%～11%);患病率随年龄增大而增高,并有一患病率骤升的年龄段。农村PACG患病率骤升的年龄段(60～69岁)较城市患病率骤升的年龄段(70岁以上)早10年。农村PACG单眼低视力(393%)及单眼盲(286%)的比率高于城市(分别为206%和147%)。随年龄增大,屈光度增加,周边前房深度也逐渐变浅。结论PACG的患病率农村高于城市,PACG患病率与周边前房深度、屈光状态、性别、年龄因素有关。(中华眼科杂志,2005,41814)

Objective To investigate the prevalence of primary angle-closure glaucoma (PACG) of urban and rural residents in Beijing, China. A quantitative comparison was made based on the data collected from this epidemiological survey. We also identify some of the most typical risk factors associated with PACG. Methods Glaucomatous screening examination was applied to specific age group populations (aged 40 and older) in the defined district of Beijing and its remote rural county, from June to October, 2001. There are 4451 subjects in all, 1980 rural subjects and 2471 urban subjects,1939 males and 2512 females. The screen and diagnostic methods used in this survey included van Herick methods and gonioscopy examination to estimate the peripheral depth of the anterior chamber, visual acuity, intraocular pressure, refraction status, stereoscopic fundus photography, and threshold-related visual field tests. Subjects regarded as suspected glaucoma and glaucoma patients are reexamined with standard glaucomatous examination. Results The response rate of rural and urban population is 79.6%(1980/2488), 87.1%(2471/2836), respectively. The prevalence of PACG (in aged 40 years or older population) resulted from this survey was 1.2% (95%CI 0.9%-1.5%). However, the prevalence was different between urban and rural residents, 1.1% (95%CI 0.8%-1.4%) vs. 1.6% (95%CI 1.2%-2.0%). The prevalence of PACG in female was more than that in male, 1.7% (95%CI 1.3%-2.1% ) vs.0.8% (95%CI 0.5%-1.1%). A drastic increase in prevalence of PACG with age increase was identified in both survey sites, however, this increase in rural subjects (aged 60-69 years group) occurred ten years earlier than those from urban subjects (aged more than 70 years group). Compared to urban residents, rural residents showed higher prevalence of unilateral low vision (39.3% vs. 20.6%) and blindness (28.6% vs. 14.7%). This survey also confirmed that, as people aging, refraction status became hyperopia, the depth of peripheral anterior chamber became narrow. In the different age groups, female and male groups, the changes of refraction status and the depth of peripheral anterior chamber paralleled the prevalence of PACG. Conclusions The prevalence of PACG was obviously different in different groups. This could due to several factors including gender, age, change of refraction status and chamber angle as well.