广东省东莞市2型糖尿病患者盲与低视力患病率及原因分析  

Prevalence and causes of low vision and blindness in type 2DM population in Dongguan City,Guangdong Province

作　　者：张立新 崔颖[2] 孟倩丽[2] 张敏[3] 罗中伶 刘辉焜 朱国平 香淦媚 刘清洋[3] 郭海科[2] 郑洋[4] 蔡晶晶[2] 

机构地区：[1]广东省东莞市横沥医院眼科,广东省东莞市523460 [2]广东省人民医院眼科,广东省广州市510080 [3]广东省东莞市人民医院眼科,广东省东莞市523000 [4]重庆医科大学第一附属医院眼科,重庆市400016

出　　处：《眼科新进展》2014年第1期46-50,共5页Recent Advances in Ophthalmology

基　　金：广东省医学科学技术研究基金(编号:A2011719)~~

摘　　要：目的探讨东莞市横沥镇居民40岁及以上2型糖尿病(diabetes mellitus,DM)人群盲与低视力的患病现状和致盲原因。方法以人群为基础的横断面现况调查。以东莞市横沥镇40岁及以上居民为调查对象,进行2型DM筛查,调查对象完成日常生活视力、最佳矫正视力、非接触眼压测量、裂隙灯眼前段检查、眼底检查和眼底照相,对于可疑青光眼或眼底病患者进行进一步眼科检查。分别根据最佳矫正视力和日常生活视力,采用世界卫生组织(1973年)盲与视力损害的标准评估DM患者盲或低视力患病率并分析主要致盲原因。结果8952人参与DM筛查和眼科检查,应答率为80.06%,现场调查筛查出2型DM患者1500人,其中完善眼科检查者1356人,应答率为90.40%。完成眼科检查者男550人(40.56%),女806人(59.44%);652人(48.08%)为农民,780人(57.52%)为文盲或接受小学以下教育者。根据最佳矫正视力评估,横沥镇2型DM患者中双眼盲12人(0.88%),单眼盲45人(3.32%),双眼低视力35人(2.58%),单眼低视力63人(4.65%);视力损伤患者(包括双眼和单眼盲与低视力患者)155人,引起视力损害的首要原因是白内障(58.06%),其次为眼底病变(除DR和年龄相关性黄斑变性外,9.68%)、角膜混浊(6.45%)、翼状胬肉(6.45%)、弱视(3.87%)和DR(3.23%)。按照日常生活视力进行盲与低视力评估,双眼盲17人(1.25%),单眼盲53人(3.91%),双眼低视力105人(7.74%),单眼低视力116人(8.55%);导致291例DM患者视力损害的首要原因仍然是白内障(44.33%)、屈光不正(包含高度近视,28.87%)、翼状胬肉(6.53%)、眼底病变(除DR和年龄相关性黄斑变性外,4.81%)、角膜混浊(3.09%)和DR(2.41%)。结论东莞市横沥镇居民2型DM患者中,白内障是致盲的首要原因,因此东莞市农村DM防盲工作重点是在定期DR筛查和干预的基础上进行白内障的防治,尤其需要重视高龄和低教育程度的DM患者视力损伤的防治。Objective To assess the prevalence and causes of low vision and blindness in a diabetic population in Dongguan City, Guangdong Province. Methods A population-based cross-sectional study. The Hart Chinese aged 40 years and older in the census of diabetes in Hengli town, Dongguan city, Guangdong province were chosen. Type 2 DM patients were screened. All the diabetic patients underwent a standard inter view, a comprehensive eye examination, including presenting visual acuity and best cor rected visual acuity, intraocular pressure, slit lamp examination （ external eye, anterior segment and ocular fundus ） and fundus photography. Low vision and blindness were defmed with the standard following the WHO （ 1973 ）. Results A total of 8952 cases participated in this study,the response rate was 80.05% ,in which 1508 cases with DM, 1500 cases with type 2 DM. A total of 1355 cases received the examination, and the re sponse rate was 90.40% ,including 550 men （40.55%） and 805 women （59.44%） ;552 farmer （48.08%） and 780 illiterate or low literate receiver （57.52%）. Based on best corrected visual acuity ,the prevalence of bilateral low vision and blindness were 2.58% （35 cases） and 0. 88% （12 cases）,respectively,the lateral low vision and blindness were 4.55% （53 cases） and 3.32% （45 cases） ,respectively,the leading causes of visu al impairment were cataract （ 58. 05% ）, other retinal diseases （ except for DR and AMD,9.68% ） ,corneal opacity （6.45%） ,pteryginm （5.45%） ,amblyopia （3.87%） and DR （3.23%）. Based on the presenting visual acuity, the prevalence of bilateral low vi sion and blindness were 7.74% （ 105 cases） and 1.25% （ 17 cases）, respectively, the lateral low vision and blindness were 8.55% （ 116 cases） and 3.91% （53 cases） ,re spectively, the leading causes of visual impairment were cataract （44.33%）, ametropia （including super-high myopia,28.87% ）, pterygium （6.53%）, fundus diseases （except for DR and AMD ,4.81% ） ,cornea

关 键 词：糖尿病 糖尿病视网膜病变 流行病学 盲 低视力 白内障 

分 类 号：R776.1[医药卫生—眼科]