年龄相关性白内障患者14万例角膜前表面散光的分布特征  

Distribution of the anterior corneal astigmatism in over 140000 patients with age-related cataract

作　　者：李黄恩 王勇 陈茂盛 李雪婷 徐艳雪 唐琼燕 周衍文 武哲明 司马晶 巫雷 曾庆森 曹向荣[9] 高岩 党秀红 邱志方[12] 李莉 李志强 单明华 祖皮丽娅 徐惠芳 李海祥 Li Huang'en;Wang Yong;Chen Maosheng;Li Xueting;Xu Yanxue;Tang Qiongyan;Zhou Yanwen;Wu Zheming;Sima Jing;Wu Lei;Zeng Qingsen;Cao Xiangrong;Gao Yan;Dang Xiuhong;Qiu Zhifang;Li Li;Li Zhiqiang;Shan Minghua;Zupiliya;Xu Huifang;Li Haixiang(Wuhan Aier Eye Hospital,Aier School of Ophthalmology,Central South University,Wuhan 430061,China;Chongqing Aier Eye Hospital,Aier School of Ophthalmology,Central South University,Chongqing 400020,China;Changsha Aier Eye Hospital,Aier School of Ophthalmology,Central South University,Changsha 410015,China;Shenyang Aier Eye Hospital,Aier School of Ophthalmology,Central South University,Shenyang 110001,China;Guangzhou Aier Eye Hospital,Aier School of Ophthalmology,Central South University,Guangzhou 510030,China;Shenzhen Aier Eye Hospital,Aier School of Ophthalmology,Central South University,Shenzhen 518048,China;Chengdu Aier Eye Hospital,Chengdu 610015,China;Ningboguangming Aier Eye Hospital,Ningbo 315020,Zhejiang Province,China;Tianjin Aier Eye Hospital,Tianjin 300190,China;Taiyuan Aier Eye Hospital,Aier School of Ophthalmology,Central South University,Taiyuan 030012,China;Harbin Aier Eye Hospital,Aier School of Ophthalmology,Central South University,Harbin 150076,China;Xiangyang Aier Eye Hospital,Xiangyang 441002,Hubei Province,China;Nanning Aier Eye Hospital,Aier School of Ophthalmology,Central South University,Nanning 530001,China;Shaoxing Aier Eye Hospital,Shaoxing 312099,Zhejiang Province,China;Tangshan Aier Eye Hospital,Tangshan 063016,Hebei Province,China;Adiya Aier Eye Hospital,Wulumuqi 830004,China;Yinchuan Aier Eye Hospital,Yinchuan 750001,China;Zunyi Aier Eye Hospital,Zunyi 563003,Guizhou Province,China)

机构地区：[1]中南大学爱尔眼科学院,武汉爱尔眼科医院,430061 [2]中南大学爱尔眼科学院,重庆爱尔眼科医院,400020 [3]中南大学爱尔眼科学院,长沙爱尔眼科医院,410015 [4]中南大学爱尔眼科学院,沈阳爱尔眼科医院,110001 [5]中南大学爱尔眼科学院,广州爱尔眼科医院,510030 [6]中南大学爱尔眼科学院,深圳爱尔眼科医院,518048 [7]成都爱尔眼科医院,610015 [8]浙江省宁波爱尔光明眼科医院,315020 [9]天津爱尔眼科医院,300190 [10]中南大学爱尔眼科学院,太原爱尔眼科医院,030012 [11]中南大学爱尔眼科学院,哈尔滨爱尔眼科医院,150076 [12]湖北省襄阳爱尔眼科医院,441002 [13]中南大学爱尔眼科学院,南宁爱尔眼科医院,530001 [14]浙江省绍兴爱尔眼科医院,312099 [15]河北省唐山爱尔眼科医院,063016 [16]阿迪娅爱尔眼科医院,乌鲁木齐830004 [17]银川爱尔眼科医院,750001 [18]贵州省遵义爱尔眼科医院,563003

出　　处：《中华眼科杂志》2021年第1期56-62,共7页Chinese Journal of Ophthalmology

基　　金：武汉市卫生计生委医学科学研究项目(WX15D03,WX17B22);爱尔眼科医院集团科研基金(AM1902D1)。

摘　　要：目的分析中国18家医院的14万例年龄相关性白内障患者角膜前表面散光的分布特征。方法回顾性系列病例研究。连续性收集2015年7月至2018年10月于中国18家爱尔眼科医院就诊的40岁以上年龄相关性白内障患者143889例(143889只右眼)的眼部生物学参数资料。角膜前表面散光度数和轴向、前房深度、角膜屈光力、眼轴长度等眼球参数采用IOLMaster 500测量,获取3次测量结果的平均值。各医院将资料整理分析后提交给武汉爱尔眼科医院进行总体分析。非正态分布数据以M(P25~P75)表示;采用Mann-Whitney检验、Kruskal-Wallis检验、χ^(²)检验等分析角膜前表面散光度数和轴向在不同性别、年龄、前房深度、角膜屈光力、眼轴长度中的分布差异。结果143889例患者中女性84319例,男性59570例;年龄为72(65~78)岁;角膜散光度数为0.84(0.51~1.33)D,散光度数≥0.75 D者80895例(56.22%),散光度数≥1.00 D者57304例(39.83%)。女性角膜散光度数为0.87(0.53~1.37)D,男性为0.82(0.50~1.29)D(U=-14.891);女性顺规散光比例为33.26%(28046/84319),逆规散光比例为49.08%(41385/84319);男性顺规散光比例为34.26%(20408/59570),逆规散光比例为46.91%(27945/59570)(χ^(²)=70.913),差异均有统计学意义(均P<0.05)。随年龄增加,角膜散光度数先由0.94(0.57~1.48)D减少至0.75(0.46~1.18)D,后又增大至1.19(0.74~1.79)D,差异有统计学意义(H=1263.438,P<0.05),变化的转折在61~70岁。随着年龄的增大,顺规散光比例减小[由77.50%(396/511)减少至12.50%(3/24)],逆规散光比例增大[由11.15%(57/511)增大至79.07%(34/43)],斜向散光比例变化不大[17.02%(16/94)至19.92%(245/1230)],分布差异有统计学意义(χ^(²)=10174.496,P<0.05)。前房越浅,角膜散光度数越大,由0.82(0.51~1.31)D增大至1.05(0.61~1.56)D;逆规散光比例越大,由47.32%(60207/127227)增大至51.69%(184/356),差异均有统计学意义(H=409.961,χ²=120.995;均P<0.05)。平均角膜屈光力越大,角�Objective To analyze the distribution characteristics of the anterior corneal astigmatism in 140000 cataract patients from 18 hospitals in China.Methods Retrospective study.A total of 143889 patients(143889 right eyes)over the age of 40 years with age-related catarac were admitted to 18 Aier eye hospitals in China from July 2015 to October 2018.The average values of the three measurements of the magnitude of anterior corneal astigmatism,the meridian of corneal astigmatism,anterior chamber depth,corneal refractive power,and axial length measured by IOLMaster 500 were obtained.The data acquisition method of each sub-center was to collect and analyze the electronic case data in accordance with the inclusion and exclusion criteria,and to provide them for the sponsor Wuhan Aier Eye Hospital.Non-normal distribution data are presented as M(P25,P75).Mann-Whitney test,Kruskal-Wallis test,Chi-square test were used to analyze the distribution differences of the magnitude of corneal astigmatism and the meridian of corneal astigmatism in gender,age,anterior chamber depth,corneal refractive power and axial length.Results Among the 143889 patients,84319 were females and 59570 were males,the median age was 72(65,78)years old,the median corneal astigmatism was 0.84(0.51,1.33)D;the corneal astigmatism was≥0.75 D in 80895 patients(56.22%)and was≥1.00 D in 57304 patients(39.83%).The median corneal astigmatism was 0.87(0.53,1.37)D in women and 0.82(0.50,1.29)D in men;with statistical difference(U=-14.891;P<0.05).The proportion of with-the-rule(WTR)astigmatism was 33.26%(28046/84319)for women and 34.26%(20408/59570)for men;The proportion of against-the-rule(ATR)astigmatism was 49.08%(41385/84319)for women and 46.91%(27945/59570)for men,with statistical difference(χ^(²)=70.913;P<0.05).With the increase of age,the magnitude of corneal astigmatism first decreased from 0.94(0.57,1.48)D to 0.75(0.46,1.18)D,and then increased to 1.19(0.74,1.79)D,with statistical difference(H=1263.438;P<0.05),and the change was at 61 to 70 years old.Wi

关 键 词：白内障 散光 轴长度 眼 前房 年龄分布 性别分布 

分 类 号：R776.1[医药卫生—眼科]