干眼病危险因素的病例对照研究

The risk factors of dry eye in wuhan:a case-control analysis

目的探讨干眼病的危险因素,为干眼的科学预防及其病因学研究提供参考依据。方法采用以医院为基础的病例对照研究,对在武汉大学人民医院确诊的556例干眼患者,按照年龄和性别1∶1匹配,选取同期门诊或病房非干眼患者556例对照研究,进行统一的问卷调查和相关检查(包括裂隙灯检查、泪膜破裂时间、SchirmerⅠ试验、角膜荧光素染色)获取资料。应用SPSS13.0统计软件包进行单因素和多因素Logistic回归分析。结果多因素Logistic回归分析显示,丙型肝炎(OR=5.956,95%CI:2.028～17.497)、结缔组织病(OR=2.284,95%CI:1.631～3.197)、创伤后应激障碍(OR=1.750,95%CI:1.144～2.678)、绝经后雌激素治疗(OR=1.945,95%CI:1.022～3.700)、头颈部的放射治疗(OR=6.829,95%CI:1.394～33.448)、抗组胺药(OR=2.133,95%CI:1.452～3.134)、角膜接触镜(OR=6.380,95%CI:2.071～19.657)、视频终端使用超过6h(OR=2.695,95%CI:1.399～5.192)为干眼的独立危险因素;经常食用Ω-3脂肪酸类食物(OR=0.486,95%CI:0.283～0.835)可能为干眼的保护因素。结论干眼的独立危险因素为丙型肝炎史、结缔组织病史、头颈部的放射治疗、绝经后雌激素治疗、抗组胺药、角膜接触镜、视频终端和创伤后应激障碍;经常食用含Ω-3脂肪酸类食物是干眼的保护因素。本研究结果将有助于临床预防与治疗,对降低干眼的患病率有重要意义。

Objective To explore the risk factors of dry eye,and provide the reference for dry eye scientific prevention and the study of etiology. Methods A hospital-based matched case-control study was carried out in wuhan. Matched by age and sex,556 pairs of cases and controls were recruited and studied. Both cases and controls were interviewed face to face, with uniformed questionnaire and examination （including slit lamp examination, tear film breakup time, Schirmer I test, corneal fluoreseein staining）. Conditional logistic regression model was used on univariate and multivariate logistic regression analysis with SPSS 13.0 software. Results Data from multiple conditional logistic regression analysis showed that the risk factors of dry eye would include with Hepatitis C （ OR = 5. 956,95% CI： 2. 028-17.497 ）, connective tissue disease （ OR = 2. 284,95% CI： 1. 631-3. 197 ）, post-traumatic stress disorder （ OR = 1. 750,95% CI： 1. 144-2. 678 ）, postmenopausal estrogen therapy （ OR = 1. 945,95% CI： 1. 022-3. 700）, radiotherapy （ OR = 6. 829,95% CI： 1. 394-33.448 ）, antihistamines drugs （ OR = 2. 133,95% CI： 1. 452-3. 134） ,use of contact lens（ OR = 6. 380,95% CI：2. 071-19. 657） and VDT use（ OR = 2. 695,95% CI： 1. 399-5. 192）. The protective factor of dry eye, however, was regular consumption with eontainingomega-3 fatty acid foods （ OR = 0. 486,95% CI： O. 283-0. 835 ）. Conehmions Hepatitis C, connective tissue disease, post-traumatic stress disorder, postmenopausal estrogen therapy, radiotherapy, antihistamines drugs, use of contact lens and VDT use were the independent risk factors for dry eye;regular consumption with containingomega-3 fatty acid foods was the protective factor for dry eye. The results of this study would contribute to the clinical prevention and treatment, is of great importance to reducing the prevalence of dry eye.