多层级专科门诊中开角型青光眼亚型分布与人口学特征研究

Subtype distribution and demographic characteristics of open-angle glaucoma in multi-level specialist clinics

目的分析开角型青光眼(open-angle glaucoma,OAG)在多层级青光眼门诊中疾病亚型分布情况及人口学特点。设计回顾性病例系列。研究对象青光眼专科门诊586例OAG患者。方法回顾2018年9月至2020年2月北京同仁医院(主要眼科诊疗中心)、成都市中西医结合医院(次级眼科诊疗机构A类)、邯郸市眼科医院(次级眼科诊疗机构B类)青光眼门诊患者资料。分析OAG患者疾病亚型、性别、年龄、患者来源地。主要指标患者人口学特征及OAG亚型构成比。结果诊疗9584人次中,纳入OAG患者586例。平均年龄(52.35±16.48)岁,男性占59.7%。各OAG亚型中原发性开角型青光眼(primary open-angle glaucoma,POAG)429例(73.2%),平均年龄(51.74±16.61)岁,男性占61.8%;正常眼压青光眼(normal-tension glaucoma,NTG)108例(18.4%),平均年龄(54.97±15.31)岁,男女均为50.0%;继发性OAG 49例(8.4%)。与主要眼科诊疗中心比,次级眼科诊疗机构NTG比例更低(分别为23.0%、10.6%,χ^(2)=14.06,P<0.01),继发性OAG比例较高(分别为5.1%、13.8%,χ^(2)=13.42,P<0.01)。主要眼科诊疗中心外省市患者占73.2%,远高于次级眼科诊疗机构(A类9.2%,χ^(2)=110.58,P<0.01;B类3.5%,χ^(2)=96.97,P<0.01)。结论青光眼专科门诊中OAG患者性别、年龄分布与既往人群研究结果相似,但NTG患者比例较人群研究结果低。主要眼科诊疗中心青光眼门诊中外省市患者比例高,NTG患者较多,继发性OAG患者较少。

Objective To analyze the distribution of disease subtypes and patient demographic characteristics of open-angle glaucoma(OAG)in multi-level glaucoma clinics of China.Design Retrospective case series.Participants 586 OAG patients in the glaucoma specialty clinic.Methods The diagnosis and treatment data of glaucoma specialist outpatients in Beijing Tongren Hospital(major ophthalmological center),Chengdu Integrated TCM&Western Medicine Hospital(minor ophthalmological center,group A)and Handan City Eye Hospital(minor ophthalmological center,group B)from September 2018 to February 2020 were collected.The disease subtype,gender,age and place of origin for all OAG patients were recorded.Main Outcome Measures Demographic characteristics and OAG subtype composition ratio.Results This study recorded 9584 visits of diagnosis and treatment data,and included 586 OAG patients,with an average age of 52.35±16.48 years old,and males accounted for 59.7%.Among the subtypes of OAG patients,429 patients with primary open-angle glaucoma(POAG),accounting for 73.2%,with an average age of 51.74±16.61 years old,and more male patients,reaching 61.8%.There were 108 patients with normal-tension glaucoma(NTG),accounting for 18.4%,and the average age was 54.97±15.31 years old.Both male and female patients were 50.0%.There were 49 patients with secondary OAG,accounting for 8.4%.Compared with major ophthalmological center,the proportion of NTG in minor ophthalmological center is lower(23.0%vs.10.6%,χ^(2)=14.06,P<0.01),and the proportion of secondary OAG is higher(5.1%vs.13.8%,χ^(2)=13.42,P<0.01).The proportion of local patients in the major ophthalmological center was 26.8%,which was much lower than that of the minor ophthalmological center(90.8%in group A,χ^(2)=110.58,P<0.01;96.5%in group B,χ^(2)=96.97,P<0.01).Conclusion In the glaucoma specialist clinic,the gender and age characteristics of OAG patients are similar to the past population-based survey data,and the proportion of NTG patients is lower than the results of the past population-based data.Major ophthalmological center has a higher proportion of patients from other provinces and cities,with more NTG patients and fewer secondary OAG patients than minor ophthalmological center.