江苏省阜宁县农村50岁及以上人群翼状胬肉流行病学调查及相关危险因素分析

Prevalence and associated factors for pterygium in rural people aged 50 years and above in Funing County,Jiangsu Province

目的调查江苏省阜宁县农村地区50岁及以上人群翼状胬肉患病率并分析其相关危险因素。方法采用整群随机抽样方法,抽取江苏省阜宁县(30个调查点)50岁及以上人群作为调查对象,进行问卷调查,视力检测,眼表、眼前节及眼底检查;应用裂隙灯显微镜检查对翼状胬肉进行诊断和分级;应用Logistic回归分析翼状胬肉相关的危险因素。结果根据调查点居民户口本获得所有50岁及以上人群人员名单并进行检录,结合调查对象纳入标准,应调查6145人,实际调查5947人,受检率为96.8%。翼状胬肉患者1950例,患病率为32.79%[95%可信区间(CI):31.60%~33.98%];其中双眼翼状胬肉1228例,患病率为20.65%(95%CI:19.62%~21.68%);其中男性受检者2467人,男性患者838例,患病率为33.97%(95%CI:32.10%~35.84%);女性受检者3480人,女性患者1112例,患病率为31.95%(95%CI:30.40%~33.51%),不同性别受检者翼状胬肉患病率比较,差异无统计学意义(P=0.135)。多因素Logistic回归分析结果显示,高龄[50~<60岁:比值比(OR)=1.00;60~<70岁:OR=1.54,P<0.001;70~<80岁:OR=1.83,P<0.001;≥80岁:OR=1.99,P<0.001]、低教育程度(文盲:OR=1.00;小学:OR=0.87,P=0.031;初中:OR=0.72,P=0.002;高中及以上:OR=0.63,P=0.002)、农民职业(OR=1.34,P=0.020)及长户外工作时间(OR=1.13,P=0.026)为翼状胬肉危险因素,性别、婚姻状态、收入、吸烟史、饮酒史、糖尿病和高血压均未发现与翼状胬肉患病相关(均P>0.05)。结论江苏省阜宁县50岁及以上人群翼状胬肉患病率较高,高龄、低教育程度、较长户外工作时间是翼状胬肉患病的危险因素。

Objective To investigate the prevalence and associated risk factors for pterygium among people aged 50 years and above in Funing County,Jiangsu Province.Methods A cluster random sampling method was performed,the subjects aged 50 years or above were randomly selected from 30 survey sites in Funing County,Jiangsu Province.Questionnaires,visual acuity tests,the examinations of eye surface,anterior segment,fundus examinations were conducted.Pterygium was diagnosed and graded clinically by slit lamp examination.The risk factors were acquired from questionnaires and analyzed by the multivariate logistic regression analysis.This study protocol was approved by Ethic Committee of Affiliated Hospital of Nantong University(NO.2010-05).Written informed consent was obtained from each subject prior to entering study cohort.Results A total of 6 145 persons aged 50 years and above were enumerated,and actually 5 947(96.8%)participants were examined.Among them,1 950 cases were diagnosed as pterygium in either eye and 1 228 cases were diagnosed as pterygium in binoculus,which was equivalent to the 32.79%[95%confidence interval(CI):31.60%-33.98%]of pterygium in either eye and 20.65%(95%CI:19.62%-21.68%)in bilateral pterygium.Among 2 467 male subjects,838 were diagnosed as pterygium(33.97%,95% CI:32.10%-35.84%).Among 3 480 female subjects,1 112 were diagnosed as pterygium(31.95%,95% CI:30.40%-33.51%).There was no significant difference in the prevalence of pterygium between genders(P=0.135).Multivariate Logistic analysis showed that,older age(50~<60 years:odds ratio[OR]=1.00;60~<70 years:OR=1.54,P<0.001;70~<80 years,OR=1.83,P<0.001;≥80 years:OR=1.99,P<0.001),low educational level(no education:OR=1.00;<primary:OR=0.87,P=0.031;primary education:OR=0.72,P=0.002;≥secondary education:OR=0.63,P=0.002),farmer occupations(OR=1.34,P=0.020),and long outdoor work time(OR=1.13,P=0.026)were independent risk factors for pterygium.Gender,marriage,income,hypertension,diabetes,smoking and alcohol use history were not associated with pterygium(all at P>0.05).Conclusions The prevalence of pterygium in Funing County is 32.79% in people aged 50 years and above.The high prevalence of pterygium may be associated with older age,low education level and long outdoor work time.