我国九省眼病调查中北京市顺义区50岁及以上人群白内障患病率和手术状况的调查

Prevalence and surgery status of cataract among adults aged 50 years or above in the Shunyi district of Beijing： the China Nine-Province Survey

目的了解北京市顺义区50岁及以上人群中白内障患病率、白内障手术效果、白内障手术覆盖率和白内障盲人社会负担率。方法采用整群随机抽样方法。2006年4—8月在顺义区抽取50岁及以上成人5118名进行视力和眼部检查，包括评价晶状体混浊程度和自内障手术情况。应用多元逻辑回归分析不同年龄、性别和受教育程度对白内障患病率、白内障手术覆盖率、白内障盲人社会负担率及白内障术后视力效果的影响。结果在5118名受检者中，发现白内障797例，患病率为15．57％。高龄、女性和受教育程度低的人群白内障患病率明显增高，差异均有统计学意义（P〈0．01）。在施行白内障手术的189只眼中，采用现代白内障囊外摘除联合人工晶状体（IOL）植入术（包括小切口白内障手术）123只眼（65．08％），白内障超声乳化吸除术联合IOL植入术44只眼（23．28％），IOL植入率为89．42％。术后日常生活视力和最佳矫正视力≥0．7的眼分别占总数的30．16％和61．38％，术后视力差的主要原因是晶状体后囊膜混浊和屈光不正。白内障手术覆盖率为62．22％，白内障盲人社会负担率为2．64％。随着年龄的增长和受教育程度的降低，白内障手术覆盖率逐渐降低，白内障盲人社会负担率逐渐增高，这种变化趋势有统计学意义（P〈0．01）。结论白内障是常见的致盲眼病。虽然顺义区的白内障手术覆盖率较高，但在高龄人群中白内障手术覆盖率仍然较低。白内障手术的视力预后有待于进一步提高。

Objective To assess the prevalence of cataract, the outcomes of cataract surgery, the rate of cataract surgical coverage, and the rate of cataract blindness social burden. Methods Cluster sampling was used in 5118 randomly selected individuals aged i〉 50 years in the Shunyi district of Beijing from April to August 2006. All individuals were received visual acuity and eye examination, including the evaluation of lens status and cataract surgical status by slit lamp biomicroscopy. Data bank was established by Epi-info Software. Statistical analyses were performed using Stata/SE Statistical Software, release 9. 0 （ Stata Corp, College Station,TX）. Multiple logistic regression analysis was employed to analyzed the prevalence of cataract, cataract surgical coverage rate, cataract blindness social burden rate and outcomes of surgery among different ages, sex and educational background. Results In 5118 individuals, 797 cases of cataract were found ,the prevalence of cataract was 15.57% among adults aged 50 or above. The prevalence of cataract was higher in the aged, female, illiterate persons（P 〈 0. 01 ）. In 189 eyes with cataract surgery,65.08% and 23.28% of eyes were performed by the modern extra-capsular surgery and phocoemusification respectively. The rate of intraocular lens implantation was 89.42% . Post-operative presenting and best corrected visual acuity more than 0.7 was 30. 16% and 61.38% of operated eyes respectively. The main causes of the post-operated eyes with worse visual acuity were post-capsular opacity and refractive error. The cataract surgical coverage rate was 62. 22%, and the cataract blindness social burden rate was 2. 64%. The cataract surgical rate was lower and cataract blindness social burden rate was higher in the aged persons （ P 〈 0. 01 ）. Conclusions Cataract is the most common eye disease that may lead into blindness and severe visual impairment among older adults aged equal or more than 50 years. The cataract surgical coverage rate is high in the Shunyi district, but still is lower in the aged persons. The visual outcomes of the surgery should be further improved in the future.