上海市北新泾街道60岁及以上人群盲和视力损伤的现况调查  

A prevalence survey of blindness and visual impairment in adults aged equal or more than 60 years in Beixinjing blocks of Shanghai, China

作　　者：黄晓波[1] 邹海东[1] 王宁[1] 王伟伟[2] 傅炯[2] 沈彬杰 谢田华[1] 陈轶卉[1] 许迅[1] 张皙[1] 

机构地区：[1]上海交通大学附属第一人民医院眼科,200080 [2]上海市长宁区北新泾社区卫生服务中心

出　　处：《中华眼科杂志》2009年第9期786-792,共7页Chinese Journal of Ophthalmology

基　　金：卫生部“视觉第一中国行动”项目课题（200801）;上海市视觉复明临床医学中心课题（FN-040102-305）

摘　　要：目的调查上海市北新泾街道60岁及以上老年人低视力、盲的患病率及致盲原因，并与以前调查结果相比较，评价近年该地区实施防盲治盲项目的效果。方法应用横断面研究的流行病学调查方法。由上海交通大学附属第一人民医院和上海市长宁区北新泾社区卫生服务中心于2007年11月至2008年4月采用整群随机抽样方法在上海市长宁区北新泾街道抽取8个社区，对其中所有的60岁及以上老年人进行调查，检查日常生活视力和针孔镜矫正视力，应用裂隙灯显微镜、直接检眼镜和眼底照相机等仪器检查受检者外眼、眼前节及眼底等情况。观察低视力及盲的患病情况，分析致盲的主要原因。正式调查前先进行预试验，通过计算kappa值进行不同检查者诊断结果的重复性检验，保证调查质量。结果在应检录4153人中，受检人数为3851人，受检率为92．73％。按照世界卫生组织视力损伤标准：双眼盲29人，其中男性11人（占37．93％）、女性18人（占62．07％）。双眼低视力104人，其中男性37人（占35．58％）、女性67人（占64．42％）。双眼盲和双眼低视力的患病率分别为0．75％和2．70％。致盲的主要原因依次为：黄斑变性、白内障、角膜瘢痕或混浊及视网膜脱离。按照日常生活视力和视力损伤标准：重度双眼盲61人，其中男性20人（占32．79％）、女性41人（占67．21％）。轻度双眼盲66人，其中男性27人（占40．91％）、女性39人（占59．09％）。单眼盲276人，其中男性120人（占43．48％）、女性156人（占56．52％）。重度双眼盲、轻度双眼盲、单眼盲的患病率分别为1．58％、1．71％和7．17％。致盲的主要原因依次为：黄斑变性、白内障、屈光不正及角膜瘢痕或混浊。结论黄斑变性仍是致盲的首要原因，眼底病患病率逐渐上升，社区防盲项目已视显成效.Objective To investigate the prevalence rate of blindness and low vision and the leading cause of blindness in residents aged ≥60 years in Beixinjing blocks, Shanghai. Methods A cross-sectional study was carried out by Shanghai First People＇s Hospital, affiliated Shanghai Jiaotong University and Shanghai Beixinjing Community hospital from November 2007 to April 2008. Randomly cluster sampling method was used,and all the individuals aged ≥60 years in 8 communities from Beixinjing blocks, Shanghai was enrolled in this study. The pinhole visual acuity and presenting visual acuity were measured separately in each eye. External eye, anterior segment and ocular fundus were examined by the ophthalmologist using slit lamp-microscopes, direct ophthalmoscopy and non-mydriatic digital camara. Assigned ophthalmologic doctors assured the leading blind causes of every blind person. The survey was preceded by a pilot study where operational methods were refined and quality assurance evaluation was carried out. Results 3851 individuals were examined, and the response rate was 92. 73%. According to WHO diagnostic criteria： 29 persons were diagnosed as blindness, 11 male （37. 93% ） and 18 female （62. 07% ）. 104 persons were diagnosed as low vision, 37 male （35.58%） and 67 female （64.42%） . The prevalence rates of blindness and low vision were 0. 75% and 2. 70%. The leading causes of blindness were macular degeneration, cataract, corneal diseases, and retinal detachment. According to presenting vision diagnostic criteria： 61 persons were diagnosed as severe binocular blindness, 20 male （32. 79% ） and 41 female （67. 21% ） . 66 persons were diagnosed as slight binocular blindness, 27 male （40. 91% ） and 39 female （59. 09% ） . 276 persons were diagnosed as monocular blindness, 120 male （43.48%） and 156 female （56. 52% ）. The prevalence of severe binocular blindness, slight binocular blindness and monocular blindness was 1.58% , 1.71% and 7. 17% , respectively. The leading causes of bli

关 键 词：视力 低 盲 患病率 流行病学 数据收集 上海 

分 类 号：R686[医药卫生—骨科学]