年龄相关性黄斑变性危险因素的病例对照研究

Case-control study of risk factors in age-related macular degeneration

目的:探索年龄相关性黄斑变性(age-related macular degeneration,AMD)的潜在影响因素。方法:采用以医院为基础的多中心病例对照研究设计,使用统一的问卷调查年龄、性别等一般人口学资料,AMD家族史,疾病史及吸烟、饮酒等行为因素;使用标准化的方法进行体格检查、血生化检查和眼科检查;使用卡方检验分析病例组(545人)和对照组(480人)中各影响因素的分布差异。结果:有AMD家族史者患AMD的危险性是无家族史者的4.21倍(P<0.001),有气管炎/哮喘病史者患AMD的危险性是无该病史者的1.87倍(P=0.008),吸烟者患AMD的危险性是不吸烟者的1.91倍(P<0.001),饮酒者患AMD的危险性是不饮酒者的1.53倍(P=0.003)。在血生化指标中,总蛋白(P=0.004)、高密度脂蛋白胆固醇(P=0.016)和载脂蛋白A1(P=0.012)水平与AMD之间存在相关性。结论:家族史、气管炎/哮喘病史、吸烟和饮酒是AMD的危险因素;总蛋白、高密度脂蛋白胆固醇和载脂蛋白A1水平与AMD有相关性。

Objective：To examine the potential influence factors of age-related macular degeneration （AMD）. Methods： A nationwide muhicenter case-control study conducted between Jan. 2008 and May 2010. A total of 545 AMD patients and 480 controls, aged 50 years or older consented to participate in the study. Questionnaires were designed to collect information about demographic characteristics （age, gender）, family history, disease history, and behavior factors （smoking, drinking）. Moreover, physical examinations, biochemical examinations and ophthalmology examinations were conducted for each participant. Results： The subjects who had AMD family history were 4.21 times more likely to have AMD （P 〈 0. 001 ）. The subject who had the history of tracheitis/asthma were 1.87 times more likely to have AMD （P=0.008）. Both smoking and drinking were risk factors to AMD （OR = 1.91,P 〈 0. 001; OR = 1.53, P = 0.003, respectively）. Total protein （P = 0.004）, high-density lipoprotein cholesterol ester （P = 0. 016） and apolipoprotein A1 （P = 0.012） were associated with AMD. Conclusion： Family history, smoking, drinking and history of tracheitis/asthma are the risk factors of AMD. Total protein, high-density lipoprotein cholesterol ester and apolipoprotein A1 are associated with AMD.