无锡市滨湖区50岁及以上糖尿病人群中干眼流行病学调查  

Epidemiology study on incidence of dry eye in over 50-year residents with type 2 diabetes mellitus in Binhu district, Wuxi

作　　者：曹葭[1] 姚勇[1] 傅东红[1] 朱靖[1] 谢田华[1] 殷丽[1] 禹倩倩[1] 栾兰[1] 

机构地区：[1]无锡市人民医院眼科,214023

出　　处：《中华实验眼科杂志》2014年第11期1036-1040,共5页Chinese Journal Of Experimental Ophthalmology

基　　金：江苏省医学重点学科（实验室）开放课题项目（WFK0811）

摘　　要：背景 糖尿病的并发症可涉及人体各组织和器官,关于糖尿病的眼部并发症研究多聚焦于视网膜和白内障,而近年来糖尿病合并眼表疾病的研究正在受到关注,相关的流行病学调查研究可为更好地制定糖尿病人群干眼的防治措施提供依据.目的 调查无锡市滨湖区50岁及以上糖尿病人群干眼的患病情况,了解其患病特征.方法 采用横断面调查研究方法,于2012年9-12月对无锡市滨湖区50岁及以上糖尿病人群进行回访调查,对纳入的受检者进行问卷调查,并进行裂隙灯显微镜、泪膜破裂时间（BUT）、角膜荧光素染色、Schirmer Ⅰ试验、直接检眼镜及眼底照相等检查,依据目前国内公认的干眼诊断标准进行诊断,评估糖尿病患者干眼发病的危险因素.结果 该社区确诊为糖尿病患者703例,调查受检人数631例,应答率为89.76％,其中男260例,女371例.确诊为干眼者312例,患病率为49.45％,其中男105例,女207例,患病率分别为40.38％和55.80％.50 ～59岁组、60 ～ 69岁组、70 ～ 79岁组和80岁以上组糖尿病患者干眼构成比分别为32.05％、43.91％、19.23％和4.81％,其中以60 ～ 69岁组干眼的构成比最高.50～59岁、60 ～ 69岁组中女性干眼患病率明显高于男性（55.88％比39.34％,χ^2 =4.61,P=0.03;58.78％比37.04％,χ^2=12.10,P=0.00）.糖尿病人群干眼患病的相关因素有性别（χ^2=14.52,P=0.00）、吸烟史（χ^2=40.08,P=0.00）、饮酒史（χ^2=130.20,P=0.00）、过敏史（χ^2=4.68,P=0.03）、长期使用滴眼液（χ^2=13.59,P=0.00）、用眼持续时间长（χ^2=10.53,P=0.01）、文化程度高（χ^2=7.74,P=0.01）等.干眼的症状以干涩、异物感、烧灼感为主,糖尿病干眼患者BUT、角膜荧光素染色及Schirmer Ⅰ试验结果的异常率均明显高于非干眼患者,差异均有统计学意义（χ^2=199.66、48.88、40.80,均P=0.00）.糖尿病干眼患者睑板腺功能障碍和泪河高度异常的发生眼数均�Background The complications of diabetic mellitus （DM） in ophthalmology are thought to be retinopathy and cataract mainly before.However,DM-associated ocular surface disease is increasingly concerned recently.The related epidemiological study can offer evidence for the prevention and treatment of DM-associated dry eyes.Objective This survey was to estimate the prevalence rate and risk factor of dry eyes in residents of type 2 DM aged ≥ 50 years in Binhu district,Wuxi.Methods The graduate-returning survey was used in selecting residents aged ≥ 50 years in Binhu district from September to December 2012 using a cross-sectional study.The questionnaire survey,examination of slit lamp microscope,dry eye-related examination and fundoscopy were performed in 631 individuals,and the risk factors of DM-associated dry eyes were evaluated.The data were compared and analyzed with SPSS software version 13.0.Written informed consent was obtained prior to any medical examination from each subject.Results DM was diagnosed in 703 subjects in this district,and 631 finished examinations,with the response rate 89.76%,including 260 males and 371 females.Dry eye was diagnosed in 49.45% （312/631）,with the male 105 cases （40.38%） and female 207 cases （55.80%）.The proportion of dry eyes in 50-59,60-69,70-79 and over 80 years old groups was 32.05%,43.91%,19.23% and 4.81%,respectively,with the highest constituent ratio in the 60-69 years old group.The incidence of dry eyes was significantly increased in the female subjects than those of male subjects in 50-59 and 60-69 years old groups （55.88% versus 39.34%,χ^2 =4.61,P=0.03 ;58.78% versus 37.04%,χ^2 =12.10,P=0.00）.The relevant factors of DM-associated dry eyes were showed to be gender （χ^2 =14.52,P =0.00）,smoking history （χ^2 =40.08,P =0.00）,alcohol drinking history （χ^2 =130.20,P =0.00）,allergic history （χ^2 =4.68,P =0.03）,long-term usage of eyedrops （χ^2 =13.59,P =0.00）,continual watching （χ^2=10.53,P=0.01） and high level education �

关 键 词：糖尿病/并发症 干眼 患病率 流行病学调查 危险因素 横断面研究 

分 类 号：R587.2[医药卫生—内分泌] R777.34[医药卫生—内科学]