脉络膜色素痣患病率及相关因素：北京眼病研究

Prevalence and associations of choroidal nevi in adult chinese.The Beijing Eye Study

目的研究北京城乡地区人群脉络膜色素痣患病率及相关影响因素。设计以人群为基础的横断面研究。研究对象2001年北京眼病研究基线调查4439人,本研究纳入其中有可评估眼底照片的4277人。方法对研究人群进行问卷及详细的眼科检查。散瞳45度服底照相.通过阅读眼底照片诊断脉络膜色素痣。主要指标脉络膜色素痣患病率,脉络膜色素痣的大小、位置。结果按人计算,脉络膜色素痣患病率为2.9%(126/4277),按眼计算为1.5%(127/8477)。男性患病率(3.9%)高于女性(2.2%)(X^2=10.78,P=0.001,OR=1.78;95%CI:1.26,2.52).农村(3.8%)高于城区(2.3%)(X^2=7.631,P=0.006,OR=1.62,95%CI:1.15,2.29),各年龄段患病率无显著差异(X^2=0.589,P=0.90)。脉络膜色素痣最大径为0.51～3.46 mm,中位数1.27 mm。未检测到典型的脉络膜色素痣恶变体征。在Logistic回归分析中,仅性别与脉络膜色素痣患病率呈显著相关性(P=0.02)。结论40岁以上中国人脉络膜色素痣患病率为2.9%.低于高加索人。大多数脉络膜色素痣均较小,无典型恶变征兆。

Objective To determine the prevalence and associations of choroidal nevi in adult Chinese. Design Population-based study. Participants The Beijing Eye Study in 2001, included 4439 subjects （response rate 83.4%） with an age of 40＋ years. The present investigation consisted of 4277 （96.4%） subjects for whom readable fundus photographs were available and gradable for the assess- ment of choroidal nevi. Methods Assessment of fundus photographs. Main Outcome Measures Prevalence, size and location of ehoroidal nevi. Results The prevalence rate of choroidal nevi was 2.9% （126 / 4277） per subject or 1.5%（127/8477）per eye. The prevalence of choroidal nevi was significantly higher in men （3.9%） than in women （2.2%）（X2=10.78, P=0.O01, OR=1.78; 95%C1：1.26, 2.52）, and in the rural area （3.8%） higher than in the urban area （2.3%） （~2= 7.631, P=0.006, OR=1.62, 95%CI：1.15, 2.29）. It was not significantly associated with age （X2=0.589, P=0.90）. The greatest diameter of the nevi varied from 0.51 to 3.46 mm with a medium of 1.27 mm. None of the nevi showed signs of malignant transformation. In a binary logistic regression analysis, only male gender was sig- nificantly （P=0.02） associated with prevalence of choroidal nevi. Conclusion The prevalence of choroidal nevi（2.9%） in adult Chinese may be lower than in Caucasian populations according to previous population-based studies. Most nevi detected were small, without signs predictive of malignant transformation.