山东省菏泽市60岁及以上人群盲和低视力流行病学调查

Epidemiological investigation on blindness and low vision among people aged 60 and above in Heze City,Shandong Province

目的探讨山东省菏泽市60岁及以上人群盲和低视力的患病率及致病原因。方法采用分层整群随机抽样方法,抽取菏泽市60岁及以上6,334例居民为调查对象,进行问卷调查及眼部专科检查。结果6,334例入选对象中,5,720例居民接受检查,应答率为90.31%,其中260例(4.55%)为盲,61例(1.07%)为双眼盲,199例(3.48%)为单眼盲;640例(11.19%)为低视力,343例(6.00%)为双眼低视力,297例(5.19%)为单眼低视力。双眼盲、单眼盲、双眼低视力及单眼低视力的患病率在不同年龄段之间差异具有统计学意义,且随着年龄增长患病率逐渐增加(χ^(2)_(双盲)=89.176,χ^(2)_(单盲)=21.397,χ^(2)_(双低视力)=654.882,χ^(2)_(单低视力)=291.512,均P=0.000)。双眼低视力的患病率在性别之间的差异,女性患病率高于男性,具有统计学意义(χ^(2)=39.496,P=0.000)。盲和低视力的患病率在不同文化程度居民之间差异具有统计学意义,且随着文化程度的提高盲和低视力的患病率逐渐降低(χ^(2)_(盲)=16.146,χ^(2)_(低视力)=201.055,均P=0.000)。盲和低视力的患病率在不同经济收入水平之间差异具有统计学意义,随着收入水平的提高盲和低视力的患病率逐渐降低(χ^(2)_(盲)=19.790,χ^(2)_(低视力)=228.04,均P=0.000)。盲和低视力致病原因前5位依次为:老年性白内障、黄斑变性、糖尿病视网膜病变、角膜瘢痕/角膜混浊、屈光不正。结论在经济欠发达地区,防盲治盲任务任重而道远,应持续开展白内障复明手术根治白内障盲,关注未矫正的屈光不正老人的眼健康,尽快研发高效率的筛查软件,加强对糖尿病视网膜病变及黄斑变性等眼底疾病的筛查及尽早干预。

OBJECTIVE To investigate the prevalence and causes of blindness(bl)and low vision(lv)among people aged 60 and above in Heze City,Shandong Province.METHODS Stratified cluster random sampling method was used for sample selection.A total of 6,334 residents aged 60 and above in Heze City were selected as the subjects for questionnaire survey and eye specialist examination.RESULTS Among the 6,344 selected subjects,5,720 residents were examined,and the response rate was 90.31%,of which 260(4.55%)were blindness,61(1.07%)were binocular blindness(bbl),and 199(3.48%)were monocular blindness(mbl);640(11.19%)had low vision,343(6.00%)had binocular low vision(blv),and 297(5.19%)had monocular low vision(mlv).The prevalence of binocular blindness,monocular blindness,binocular low vision and monocular low vision had significant differences among different age groups,the prevalence increased gradually with age(χ^(2)_(bbl)=89.176,χ^(2)_(mbl)=21.397,χ^(2)_(blv)=654.882,χ^(2)_(mlv)=291.512,all P=0.000).The prevalence of binocular low vision was statistically higher in women than in men(χ^(2)=39.496,P=0.000).The prevalence of blindness and low vision was significantly different among residents with different educational levels,and the prevalence of blindness and low vision gradually decreased with the improvement of educational level(χ^(2)_(bl)=16.146,χ^(2)_(lv)=201.055,all P=0.000).The prevalence of blindness and low vision has statistical significance among different economic income levels.With the increase of income level,the prevalence of blindness and low vision decreases gradually(χ^(2)_(bl)=19.790,χ^(2)_(lv)=228.04,all P=0.000).The top five causes of blindness and low vision were senile cataract,macular degeneration,diabetic retinopathy,corneal scar/corneal opacity and ametropia.CONCLUSIONS There is a long way to go in the task of prevention and treatment of blindness in economically underdeveloped areas.We should continue to carry out cataract surgery to cure cataract blindness,pay attention to the eye health of the elderly with uncorrected ametropia,develop efficient screening software as soon as possible,to strengthen the screening and early intervention of diabetic retinopathy,macular degeneration and other fundus diseases.