基于Logistic回归模型分析某医院眼科563例年龄>60岁白内障患者术中IFIS风险的相关影响因素

Logistic regression model-based analysis of factors influencing risk of intraoperative IFIS in 563 cataract patients aged >60 years in ophthalmology department

目的对平顶山市第二人民医院宝丰分院眼科563例年龄>60岁白内障患者术中虹膜松弛综合征(IFIS)发生情况进行调查,构建logistic回归模型进一步分析IFIS发生的影响因素。方法前瞻性选取2020年4月至2022年6月来平顶山市第二人民医院宝丰分院拟行白内障超声乳化吸出术老年患者563例作为研究对象,统计其服药史、散瞳前后瞳孔直径及IFIS发生情况,并采用Logistic回归方程分析IFIS的影响因素。结果563例老年白内障患者术中发生IFIS 46例,发生率为8.17%(46/563)。其中轻度15例、中度25例,6例重度。两组年龄、α-1受体拮抗剂应用史、FPG、HbA1c、散瞳直径、抗精神病药物应用史、苯二氮卓类药物应用史比较,差异有统计学意义(P<0.05)。年龄(O^R=2.919)、α-1受体拮抗剂应用史(O^R=4.232)、空腹血糖(FPG)(O^R=1.405)、糖化血红蛋白(HbA1c)(O^R=3.038)、散瞳直径(O^R=0.456)、抗精神病药物应用史(O^R=2.553)、苯二氮卓类药物应用史(O^R=2.807)是白内障患者IFIS影响因素,差异有统计学意义(P<0.05)。结论白内障患者术中IFIS发生受年龄、α-1受体拮抗剂应用史、FPG、HbA1c、散瞳直径、抗精神病药物应用史、苯二氮卓类药物应用史等因素影响,建议临床根据上述影响因素,针对患者制定预防性措施,以有效改善预后。

【Objective】To investigate the occurrence of intraoperative floppy iris syndrome(IFIS)in 563 cataract patients aged>60 years in our ophthalmology department,and construct a logistic regression model to further analyze the factors influencing the occurrence of IFIS.【Methods】Prospectively,563 elderly patients who came to our hospital for proposed cataract ultrasound emulsion aspiration from April 2020 to June 2022 were selected as study subjects,and their medication history,pupil diameter before and after dilatation,and the occurrence of IFIS were counted,and the factors influencing IFIS were analyzed by logistic regression equation.【Results】Intraoperative IFIS occurred in 46 cases of 563 elderly cataract patients,with an incidence of 8.17%(46/563).There were 15 cases of mild,25 cases of moderate,and 6 cases of severe.The were statistically significant differences in age,history ofα-1 receptor antagonist application,fasting blood glucose(FPG),glycosylated hemoglobin(HbA1c),dilated pupil diameter,history of antipsychotic application,and history of benzodiazepine application between the two groups(P<0.05).Age(O^R=2.919),history ofα-1 receptor antagonist application(O^R=4.232),FPG(O^R=1.405),HbA1c(O^R=3.038),dilated pupil diameter(O^R=0.456),history of antipsychotic drug application(O^R=2.553),and history of benzodiazepine application(O^R=2.807)were factors influencing IFIS in cataract patients,with statistically significant differences(P<0.05).【Conclusion】The occurrence of intraoperative IFIS in cataract patients is influenced by age,history ofα-1 receptor antagonist application,FPG,HbA1c,dilated pupil diameter,history of antipsychotic application,and history of benzodiazepine application,etc.It is recommended that clinical preventive measures be developed for patients based on the above influencing factors to effectively improve prognosis.