山东省农村50岁及以上人群盲和中、重度视力损伤病因分析  

Causes of moderate to severe visual impairment and blindness in population aged 50 years or more in rural Shandong province

作　　者：李运[1] 毕宏生[2] 王利华[1] 王婷 杨少远[4] 刘丽萍[1] 周成超[5] 

机构地区：[1]山东大学附属省立医院眼科中心山东省防盲治盲指导组办公室,,济南250021 [2]山东中医药大学附属眼科医院 [3]山东省眼科医院 [4]山东省千佛山医院眼科 [5]山东大学公共卫生学院

出　　处：《中华眼科杂志》2013年第2期144-150,共7页Chinese Journal of Ophthalmology

基　　金：山东省科学技术发展计划（2008GG10002051）;山东省医药卫生科技发展计划（2005HW101）

摘　　要：目的调查山东省农村50岁及以上人群盲和中、重度视力损伤的主要眼病构成。方法采用以人群为基础的随机整群抽样方法。2008年4月至7月在山东省3种不同经济发展水平的县（市）中各选择1个县（市）作为调查地，另外选择1个人均国内生产总值中等城市的郊区农村作为调查地。各调查地按照单纯随机抽样方法在编号排序的基本抽样单位（BSU）中抽取调查点（村）。受检者在当地设置的检查站进行眼科检查，对任一只眼日常生活视力（PVA）≤0．5者检查最佳矫正视力（BCVA），应用裂隙灯和直接眼底镜进行眼前节和眼底检查，怀疑青光眼者应用Schiotzs眼压计测量眼压。根据检查结果对所有PVA〈0．3的眼做出引起盲和视力损伤的主要眼病的诊断。分别以PVA和BCVA为标准，计算引起盲和中、重度视力损伤的眼病构成比。结果以PVA为标准，按人数计算，引起盲的前3位主要眼病依次为白内障（59．8％，168／281）、眼底病（12．1％，34／281）、角膜混浊或瘢痕（4．3％，12／281）和未矫正的屈光不正（4．3％，12／281）；引起盲和中、重度视力损伤的前3位主要眼病依次为白内障（55．2％，844／1530）、未矫正的屈光不正（18．2％，278／1530）、眼底病（11．9％，182／1530）。以BCVA为标准，按人数计算，引起盲的前3位主要眼病依次为白内障（64．6％，153／237）、眼底病（10．5％，25／237）、角膜混浊或瘢痕（4．7％，11／237）；引起盲和中、重度视力损伤的前3位主要眼病依次为白内障（66．4％，590／889）、眼底病（16．0％，142／889）、视神经萎缩（3．0％，27／889）。按眼数计算，年龄越轻者未矫正的屈光不正和眼底病所占构成比越大，年龄越大者白内障所占构成比越大；男性和女性的眼病构成比基本相同；在不同调查地区中，济南市槐荫区的白内障构Objective To investigate the etiological spectrum of moderate to severe visual impairment and blindness in population aged 50 years or more in rural Shandong province, China. Methods A population based, random cluster sampling was used to screening the adults aged 50 years or more living in rural Shandong Province from April to July 2008. Three counties and one suburb representing the different levels of socioeconomic development within Shandong area were selected as the investigated areas. Geographically defined cluster sampling was used in randomly selecting a cross-section of residents aged ≥50 years from each county. Best corrected visual acuity and intra-ocular pressure were evaluated in those with presenting visual acuity≤ 0. 5 and suspected glaucoma respectively. The major causes of visualimpairment and blindness were diagnosed in those with presenting visual acuity ≤0. 3. According to the results of presenting visual acuity and best corrected visual acuity, the etiology constituent ratios of the moderate to severe visual impairment and blindness were analyzed respectively. Results According to the number of people, the first three principal causes for blindness based on the presenting visual acuity were eataract（59. 8% , 168/281 ） , fundus disease （ 12. 1% , 34/281 ） and corneal opacity （ 4. 3% , 12/281 ） or ametropia（4. 3% ,12/281 ）. The first three principal causes for moderate to severe visual impairment and blindness were cataract （ 55.2 % , 844/1530 ） , uncorected refractive error （ 18.2 % , 278/1530 ） and fundus disease（11.9%,182/1530）. Based on the best eorrected visual acuity, the first three principal causes for blindness were cataract（64. 6% , 153/237 ）, fundus disease （ 10. 5 %, 25/237 ） and corneal opacity （ 4. 7%, 11/237）, respectively. The first three principal causes for moderate to severe visual impairment and blindness were cataract （ 66. 4% , 590/889 ）, fundus disease （ 16. 0%, 142/889 ） and optic nerve atrophy （3.0% ,27/889）. Acc

关 键 词：盲 视觉障碍 屈光不正 黄斑变性 中年人 老年人 

分 类 号：R77[医药卫生—眼科]