甘肃省汉族和裕固族的翼状胬肉患病率及相关危险因素研究

Prevalence and risk factors of pterygium in Han and Yugur populations in Gansu Province,China

目的:探讨甘肃省汉族与裕固族40~79岁人群的翼状胬肉患病率及相关危险因素。方法:横断面研究。本研究为中国国民健康调查的一部分,采用分层多阶段随机抽样法,在甘肃省兰州市和张掖市的肃南裕固族自治县和高台县进行样本的选取,对所有受试者收集空腹血样检测空腹血糖、低密度脂蛋白3、高密度脂蛋白、甘油三酯和总胆固醇;同时采用问卷收集受试者年龄、性别、民族、职业、出生地、现居地、迁居日期、受教育水平、抽烟、饮酒、活动水平、高血压史、糖尿病史;检查受试者身高、体重、血压、视力等项目,观察受试者是否有翼状胬肉并评级。变量间的比较采用 t检验或卡方检验,利用多因素回归,以及比值比( OR)及其95%可信区间( CI)评估受试者不同参数对翼状胬肉发病率的影响。 结果:40~79岁的受试者共4 810人,其中4 193人纳入研究(男性1 840人,女性2 353人;汉族3 035人,裕固族1 158人),年龄(54.36±8.58)岁,翼状胬肉患者391例(9.3%),年龄性别调整后患病率为9.3%。汉族及裕固族人群的患病率分别为8.8%(267例)和10.7%(124例),两者差异无统计学意义(χ 2 = 3.629, P= 0.057)。所有受试者的多因素回归分析显示,翼状胬肉的危险因素有高龄( OR=3.66,95% CI:2.26~5.92)和农村居住时长比例( OR=2.18,95% CI:1.41~3.38),保护因素有受教育程度高( OR=0.49,95% CI:0.29~0.83)。汉族亚组分析中,高龄( OR=3.84,95% CI:2.18~6.78)和农村居住时长比例( OR=2.02,95% CI:1.23~3.33)是翼状胬肉的危险因素,受教育程度高( OR=0.36;95% CI:0.20~0.66)是保护因素。裕固族人群中,高龄( OR=3.11,95% CI:1.13~8.59)和农村居住时长比例( OR=3.28,95% CI:1.09~9.88)为翼状胬肉的危险因素。 结论:甘肃省40岁以上汉族及裕固族人群的翼状胬肉总患病率约为9.3%,汉族及裕固族人群患病率无明显差异,且民族不是翼状胬肉的危险因素。高龄和农村居住增加了翼状胬肉的发生风险,而受教育程度高是翼状胬肉的保护因素。 (中华眼科杂志,2020,56:600-607)

Objective To investigate the prevalence and risk factors of pterygium in Han and Yugur populations aged 40-79 years in Gansu Province,China.Methods This was a cross-sectional study.A multistage cluster sampling method with urbanization level-based stratification was employed.Multiple logistic regression analysis was performed to evaluate the risk factors of pterygium.Results A total of 4193 people(1840 males,2353 females;3035 Hans,1158 Yugurs)aged over 40 in Gansu Province were included in the study.Among them,391 patients(9.3%)were found to have pterygium.The prevalence of pterygium adjusted for age and sex was 9.3%.The prevalence rates of Han and Yugur participants were 8.8%(267 patients)and 10.7%(124 patients),respectively,and there was no significant difference between them(χ²=3.629,P=0.057).Multivariate regression analysis showed that the risk factors of pterygium included age(OR=3.66,95%CI:2.26-5.92),length of residence in the countryside(OR=2.18,95%CI:1.41-3.38),and education level(OR=0.49,95%CI:0.29-0.83).In the Han group,the risk factors of pterygium were age(OR=3.84,95%CI:2.18-6.78)and length of rural residence(OR=2.02,95%CI:1.23-3.33),and a higher level of education(OR=0.36,95%CI:0.20-0.66)was a protective factor.Older age(OR=3.11,95%CI:1.13-8.59)and rural residential length ratio(OR=3.28,95%CI:1.09-9.88)were risk factors for pterygium in Yugur population.Conclusions The overall prevalence of pterygium in Han and Yugur populations aged over 40 in Gansu Province,China was 9.3%,with no significant difference between the two nationalities.Older age and rural residency increased the incidence of pterygium,and a higher education level was a protective factor for pterygium.(Chin J Ophthalmol,2020,56:600-607)