息肉状脉络膜血管病变的危险因素分析

Ocular risk factors for polypoidal choroidal vasculopathy

目的评估和分析息肉状脉络膜血管病变(polypoidal choroidal vasculopathy,PCV)发病的潜在危险因素以及PCV亚型间潜在危险因素的差异。方法回顾性病例对照研究。收集2016年7月至2018年1月于我院就诊的PCV患者64例(64眼)作为PCV组,并根据脉络膜厚度分为厚脉络膜型PCV(厚PCV组)和薄脉络膜型PCV(薄PCV组)两型。收集2016年1月至2017年12月收入我院眼科病房行老年性白内障手术的患者42例(42眼)作为对照组。收集所有研究对象的详细病史,包括年龄、性别、最佳矫正视力、血压、血脂、心血管疾病、吸烟史、饮酒史和眼轴长度。单因素分析和Logistic回归分析与对照组相比,PCV组以及PCV亚组(厚PCV组和薄PCV组)潜在的危险因素。结果单因素分析结果显示,PCV组较对照组具有更大的年龄(P=0.046)、更高的高血压比例(P=0.021)、吸烟者比例更大(P=0.036)、眼轴长度更短(P=0.005),而血脂异常、心血管疾病和饮酒史在两组间差异均无统计学意义(均为P>0.05),Logistic回归结果显示,两组年龄、高血压、吸烟史和眼轴长度差异仍具有统计学意义(均为P<0.05)。亚组间Logistic回归结果显示,厚PCV组与对照组间高血压、吸烟史和眼轴长度差异均具有统计学意义(均为P<0.05),薄PCV组与对照组间年龄、吸烟史和眼轴长度差异均有统计学意义(均为P<0.05),厚PCV组与薄PCV组仅年龄和眼轴长度差异具有统计学意义(均为P<0.05)。结论年龄、高血压、吸烟史和眼轴长度是PCV的危险因素。在PCV两种亚型中,厚脉络膜型PCV比薄脉络膜型PCV患者更年轻且具有更短的眼轴长度,但两种亚型患病的全身系统性危险因素是相似的。

Objective To evaluate potential risk factors for polypoidal choroidal vasculopathy（ PCV） and PCV subtypes. Methods This was a retrospective case-control study. Totally 64 patients（ 64 eyes） of PCV（ PCV group） in our hospital from July 2016 to January 2018 were enrolled and subgrouped into thick PCV and thin PCV. Additional 42 patients（ 42 eyes） who underw ent cataract surgery in our hospital from January 2016 to D ecember 2017 were collected as controls. Then the detailed history of all subjects were collected,including age,gender,best corrected visual acuity（ BC VA）,hypertension,dyslipidemia,cardiovascular diseases,ever-smoking history,alcohol consumption,and axial length. U nivariate analysis and Logistic regression analysis was used to analyze the potential risk factors in patients from PCV group and PCV subgroups compared with controls. Results U nivariate analysis show ed that PCV had an older age（ P = 0.046）,a higher incidence of hypertension（ P = 0. 021）,a greater proportion of smokers（ P = 0.036）,and a shorter axial length（ P = 0. 005） than controls,while there was no statistical difference in dyslipidemia,cardiovascular diseases and alcohol consumption betw een the two groups（ all P〈0. 05）. Logistic regression showed that age,hypertension,ever-smoking history,and axial length were still statistically significant（ all P〈0. 05）. In addition,comparison betw een thick PCV patients and controls revealed a statistically significant difference in hypertension,ever-smoking history,and axial length（ all P〈0. 05）,and there was a statistically significant difference betw een age,ever-smoking history and axial length betw een the thin PCV group and control group（ all P〈0. 05）. Thick PCV group and thin PCV group had statistically significant differences only in age and axial length（ both P〈0. 05）. Conclusion The potential risk factors for PCV includes age,hypertension,ever-smoking history,and axial length. In both PCV subtype groups,thick PCV patients are younger and have a shorter axial length than thin PCV patients,but systemic risk factors of thick PCV patients are similar to the thin PCV ones.