陕西省农村50岁及以上人群白内障流行病学调查

An epidemiological survey of cataract among adults aged 50 years and above in rural,Shaanxi Province

目的:调查陕西省农村50岁及以上人群白内障患病率及手术情况,并评价由白内障造成的致盲率及术后效果。方法:于2011-01/12采用整体随机分层抽样方法,在陕西省留坝县、黄陵县、蓝田县调查3 494人,其中≥50岁人群2 124人。所有调查对象均进行标准问卷调查及详细的眼科检查。采用WHO视力诊断标准和我国白内障诊断标准进行评价。结果:实际受检者1 912人,应答率为90.0%。调查人群的白内障患病率为36.66%,其中50岁人群白内障患病率为15.80%,70岁以上人群则上升到68.71%,白内障的患病率随着年龄增长而明显上升(P<0.01)。此人群白内障致双眼盲和双眼低视力患病率分别为1.99%和7.17%,其中50岁人群双眼盲、单眼盲、双眼低视力、单眼低视力患病率分别为0.51%,0.63%,1.90%,2.53%,70岁以上人群患病率分别上升到4.55%,5.35%,16.44%,18.81%。不同年龄组白内障致盲与低视力患病率均有显著差异,且随着年龄增长而明显升高,差异均有统计学意义(P<0.01)。在86只白内障手术眼中,实施ECCE手术眼58只,实施PHACO手术眼23只,实施ICCE手术眼5只。其中术后矫正视力≥0.3术眼中ECCE占69.09%,PHACO占23.64%,ICCE占7.27%,脱残率为63.95%,脱盲率为91.86%。结论:目前白内障在陕西省农村仍然是一个比较严重的公共卫生问题。陕西省防盲工作取得了一定的成绩,白内障的患病率、致盲率均有一定程度的降低。PHACO手术已在农村开展,但PHACO的普及率和手术技术需进一步提高。

AIM： To investigate prevalence of cataract and status surgery of cataract among adults aged 50 years and above in rural, Shaanxi Province, and to evaluate the rate of blindness caused by cataracts and postoperative effects. METHODS： Cluster sampling was used in randomly selection in Shaanxi Province from Jan.to Dec.in 2011, among the 3494 individuals from Liuba county, Huangling county, Lantian county and Baqiao district, 2124 aged 50 years and above received questionnaire survey and eye examination in the study. WHO diagnostic criteria and cataracts diagnostic criteria were used in the evaluation. RESULTS： Of 1912 participated the eye survey and response rate was 90%, the prevalence of cataracts was 36.66%, and the prevalence of cataracts among adults aged 50 years and above was 15.80%, the prevalence of cataracts among adults aged 70 years and above was 68.71%. The prevalence of age -related cataracts increased obviously with aging （ P 〈0.01 ）. The prevalence of bilateral blindness and low vision caused by cataract was 1.99%and 7.17%, respectively.The rate of bilateral blindness and low vision and monocular blindness and low vision was 0.51%, 0.63%, 1.90%, 2.53%respectively, increasing to 4.55%, 5.35%, 16.44%, and 18.81%in those aged 70 years and above.There was statistically significant difference in cataract blindness of different age groups and incidence of low vision, increased obviously with aging （P〈0.01）.Among 86 eyes with cataract surgery, 58 eyes were given ECCE, and 23 eyes were given PHACO, and 5 eyes were given ICCE.The corrected vision after cataract surgery ≥0.3 occupied 69.09%, 23.64%, 7.27% in ECCE, PHACO and ICCE respectively.The rate of off-disability and off-blindness was 63.95%, 91.86%, respectively. CONCLUSION： Cataract blindness is a serious public health problem in rural, Shaanxi Province.Prevention of blindness in Shaanxi Province has made some achievements, and the prevalence of cataract and visual impairment have decreased to some extent.PHACO has been carried out in rural areas, however, the penetration and surgical techniques of PHACO should be further improved.