重庆地区公安人员眼病患病现状与影响因素分析

Current status and influencing factors of eye disease in public security personnel in Chongqing

目的了解重庆地区公安人员眼病的患病情况及影响因素,为该人群眼病的防治提供流行病学依据。方法选择2018年1月1日—12月31日在重庆医科大学附属第二医院健康管理(体检)中心进行体检的重庆市公安人员2227人作为研究对象,所有研究对象均进行视力、裂隙灯检查、小瞳孔下眼底照相、直接检眼镜检查,并测定其身高、体质量、腰围、臀围、血压、空腹血糖、血脂、血黏度等指标,以及行腹部超声、胸片、动脉硬化等检查。结果研究对象共检出眼病1216人,检出率为54.60%,男性眼病检出率较女性高(P<0.05)。研究对象检出率排前3位的眼病依次为白内障、屈光不正、豹纹状眼底改变,检出率分别为36.51%、32.64%、16.57%。卡方分析结果显示:腰臀比(WHR)超标、身体质量指数(BMI)超标、血黏度偏高、甘油三酯(TG)偏高、总胆固醇(TC)偏高、低密度脂蛋白(LDL)偏高、脂肪肝、有糖尿病史、空腹血糖升高、有高血压病史、收缩压高、舒张压高的研究对象眼病检出率越高(P<0.05)。多因素Logistic回归分析结果显示:年龄、血黏度偏高、WHR超标、TG偏高、TC偏高、空腹血糖升高和舒张压高均是研究对象白内障检出的危险因素(P<0.05);年龄、血黏度偏高、高血压病史、舒张压高、踝臂血压指数(ABI)值异常(单侧0.5-0.8、双侧0.8-0.9、双侧0.5-0.8)均为研究对象眼底视网膜动脉硬化检出的危险因素(P<0.05)。年龄、TG偏高、糖尿病史、空腹血糖升高、ABI值异常(单侧0.5-0.8、双侧0.8-0.9)均为研究对象糖尿病视网膜病变检出的危险因素(P<0.05)。结论除了高血压、高血糖之外,血黏度偏高、TG偏高、TC偏高也是白内障检出的危险因素。高TG与糖尿病视网膜病变有关。眼底视网膜动脉硬化与心血管系统疾病伴行,视网膜血管的改变在一定程度上反映了全身其他血管的情况。眼底检查在高血压、糖尿病等慢性疾病患者的长期健康管理中具有重要意义。

Objective This paper aims to understand the status and influencing factors of eye diseases among public security personnel in Chongqing to provide epidemiological evidence for its prevention and treatment in this population.Methods A total of 2227 public security personnel in Chongqing who underwent ophthalmic physical examination in the Health Management(Physical Examination)Center of our hospital from January 1 to December 31,2018 were selected as the study participants.All participants underwent visual acuity,slit-lamp examination,fundus photography under the small pupil,and direct ophthalmoscopy.Besides,the height,body mass,waist circumference,hip circumference,blood pressure,fasting blood glucose,blood lipids,blood viscosity,and other biochemical parameters were measured.They also received abdominal ultrasound,chest radiography,and arteriosclerosis examinations.Results A total of 1216 cases of ophthalmopathy were detected in participants,with a detection rate of 54.60%.The detection rate of ophthalmopathy in males was significantly higher than that in females(P<0.05).The top three eye diseases were cataract,refractive error,and leopard fundus changes,and the detection rates were 36.51%,32.64%,and 16.57%,respectively.Chi-square analysis showed that the detection rate of ophthalmopathy was higher in participants with excessive waist-to-hip ratio(WHR),excessive body mass index(BMI),high blood viscosity,high triglyceride(TG),high total cholesterol(TC),high low-density lipoprotein(LDL),fatty liver,history of diabetes,elevated fasting blood glucose,history of hypertension,high systolic blood pressure,or high diastolic blood pressure(P<0.05).The results of multivariate logistic regression analysis showed that age,high blood viscosity,excessive WHR,high TG,high TC,elevated fasting blood glucose,and high diastolic blood pressure were all risk factors for cataract detection in the participants(P<0.05).Age,high blood viscosity,history of hypertension,high diastolic blood pressure,and abnormal ankle-brachial index(ABI)values(unilateral 0.5 to 0.8,bilateral 0.8 to 0.9,bilateral 0.5 to 0.8)were all risk factors for retinal arteriosclerosis detection in the fundus of participants(P<0.05).Age,high TG,history of diabetes,elevated fasting blood glucose,and abnormal ABI values(0.5~0.8 unilateral and 0.8~0.9 bilateral)were all risk factors for the detection of diabetic retinopathy in participants(P<0.05).Conclusion In addition to hypertension and hyperglycemia,high blood viscosity,TG,and TC are also risk factors for cataract detection.High TG was associated with diabetic retinopathy.Fundus retinal arteriosclerosis was associated with cardiovascular system diseases.Changes in retinal vessels,to some extent,demonstrate the condition of other vessels throughout the body.Fundus examination is important in the long-term health management of patients with chronic diseases such as hypertension and diabetes.