内蒙古呼伦贝尔地区气候性滴状角膜变性流行病学调查

Epidemiology of climatic droplet keratopathy in Hunlunbeier area of Inner Mongolia

目的调查气候性滴状角膜变性(CDK)在内蒙古呼伦贝尔地区的发病情况,并初步分析其相关因素。方法对内蒙古呼伦贝尔地区牧业四旗进行人群抽样调查,共调查2558人,其中游牧人群1210人,农耕人群1348人,并对可能相关因素进行问卷调查。结果调查人群中发病年龄最小为20岁,总患病率为21.6%,男性为21.7%,女性为21.6%,男女患病率和严重程度差异无统计学意义(χ2=2.88,1.87,P=0.090,0.3929);患病率随年龄增加而增高,40岁以上人群患病率为38.9%;20岁以上人群中1级病变311人,占15.3%,2级病变242人,占11.9%,未发现3级病变患者;牧业四旗之间患病率比较,差异有统计学意义(χ2=38.12,P=0.00);游牧人群患病率和严重程度明显高于农耕人群,二者比较差异有统计学意义(χ2=630.41,P=0.00);调查发现:巴尔虎蒙古族患病率最高(52.8%),其次为布力亚特蒙古族(46.5%)、鄂温克族(40.8%),达斡尔族(1.6%)、汉族(1.3%)和科尔沁蒙古族(0.8%)最低,各民族患病率比较差异有统计学意义(χ2=646.19,P=0.00);通过相关因素分析发现CDK与年龄、放牧时间、民族及生活方式相关。结论CDK在内蒙古呼伦贝尔地区患病率较高,游牧人群高于农耕人群;不同民族患病率不同,其发生及严重程度与放牧时间、年龄、民族及生活方式有关。

Objective To investigate the prevalence, distribution and related risk factors of climatic droplet keratopathy （CDK） in Hunlunbeier area of Inner Mongolia, China. Methods Randomly selected individuals sampling survey was conducted in 3 groups of stockman and 1 group of non-stockman in each of four districts in Hunlunbeier grassland area. A detailed history including age, gender, nationality, occupation, eating habit and duration of grazing was obtained by questionnaire. Results 2 558 individuals who lived in four districts of Hunlunbeier grassland area were examined by slit-lamp,including 1 210 stockmen and 1 348 non-stockman. CDK was found in 553 （21.6%）examinee with the youngest 20 years old. The prevalence of CDK for male patients was 21.7% ,showing a similar prevalence to female patients（21.6% ）. There was significant difference in the severity of CDK between them （ P = 0. 392 9）. The prevalence of CDK was increased with the age, showing 38.9% rate for the patients over 40 years old. In the individuals over 20 years old, the number of grade 1 patients was in 311 （ 15.3% ） and grade 2 in 242（ 11.9% ）. The prevalence of CDK in four districts showed a significant difference （χ^2 = 38.12, P = 0. 000）, and the prevalence of stockman group was 13 times higher than that of non-stockman group. Regarding to the nationalities settled in HunLunbeier area,the Barag Mongolia showed the highest CDK prevalence （52.8%）, then the Buryat Mongolia （46. 5% ）, Ewenki nationality （40. 8% ） and Dawuer （ 1.6% ） nationality, Han nationality and Korqin Mongolia showed lower prevalence （1.3% and 0. 8% ,respectively）（χ^2 = 646.19 ,P = 0.000）. CDK showed a positive correlation with age, nationality, duration of grazing and eating habit. Conclusion The prevalence of CDK is high in Hunlunbeier of Inner Mongolia. Stockman, age, nationality ,duration of grazing and eating habit are the risk factors of CDK.