中国中老年人白内障手术发生率及影响因素的前瞻性队列研究  

Cataract surgery incidence and influencing factors in middle-aged and elderly Chinese: a prospective cohort study

作　　者：金鑫 梁晨[2] 郭帅 郑晓瑛[3,4] JIN Xin;LIANG chen;GUO Shuai;ZHENG Xiaoying(Institute of Population Research,Peking University,Beijing 100871,China;Department of Ophthalmology,Peking University Hospital,Beijing 100871,China;School of Population and Public Health,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100730,China;Peking University Asia Pacific Economic Cooperation Health Sciences Academy,Peking University,Beijing 100871,China)

机构地区：[1]北京大学人口研究所,北京100871 [2]北京大学医院眼科,北京100871 [3]中国医学科学院/北京协和医学院群医学及公共卫生学院,北京100730 [4]北京大学亚太经合组织健康科学研究院,北京100871

出　　处：《中华疾病控制杂志》2024年第3期303-309,共7页Chinese Journal of Disease Control & Prevention

基　　金：国家社会科学基金重大项目(21ZD107);国家科技重大专项(SQ2022YFC3600291)。

摘　　要：目的 探讨我国中老年人(≥45岁)白内障手术发生率及影响因素。方法 采用前瞻性队列研究设计,利用2011―2018年中国健康与养老追踪调查数据,跟踪12 522名中老年人队列白内障手术发生状况,采用logistic回归分析模型分析白内障手术发生率及其影响因素。结果 共计12 522名中老年人参加2011―2018年的连续4轮随访,7年期间白内障手术发生率为2.89%,其中≥60岁老年人7年期间白内障手术发生率为5.34%,呈上升趋势。Logistic回归分析模型显示,年龄较大、女性、远视力或近视力较差、患有糖尿病、教育程度较低、家庭人均周支出较低均与白内障手术发生的增加显著关联(OR=1.072,95%CI:1.071~1.074,P<0.001;OR=1.141,95%CI:1.108~1.176,P=0.030;OR=1.587,95%CI:1.531~1.646,P<0.001;OR=1.445,95%CI:1.394~1.499,P<0.001;OR=1.474,95%CI:1.417~1.533,P<0.001;OR=0.867,95%CI:0.840~0.895,P=0.002;OR=0.982,95%CI:0.966~0.997,P=0.019),对风险人群如≥60岁和远视力状况较差的老年人分析中有相似的结果,但社会经济因素已不再是白内障手术发生的主要影响因素。结论 个体的人口特征和慢性病患病情况明显影响白内障手术发生率,相关部门推广的眼保健项目有助于减少社会经济因素对接受白内障手术的影响提高老年人白内障手术可及性综合考虑健康状况和眼健康服务对白内障手术促进计划至关重要。Objective The study aimed to explore the pattern of cataract surgery incidence and influencing factors among middle-aged and older people in China.Methods The study adopted a prospective cohort design.It was based on the tracking studies data of cataract surgery incidence in a cohort of 12522 middle-aged and older people from the China Health and Retirement Longitudinal Study 2011-2018,and analysed the influencing factors of cataract surgery incidence using logistic regression.Results The 12522 middle-aged and elderly Chinese population participated in four consecutive rounds of survey from 2011 to 2018,and the 7-year incidence of cataract surgery was 2.89%.The 7-year incidence of cataract surgery in the elderly population aged 60 years and older was 5.34%,which showed an increasing trend along with older age.Logistic regression results showed that the following factors were significantly associated with the increase of the incidence of cataract surgery:older age,being female,having poorer distant or near vision,having diabetes,having a lower level of education,and having a lower per capita weekly expenditure per household(OR=1.072,95%CI:1.071-1.074,P<0.001;OR=1.141,95%CI:1.108-1.176,P=0.030;OR=1.587,95%CI:1.531-1.646,P<0.001;OR=1.445,95%CI:1.394-1.499,P<0.001;OR=1.474,95%CI:1.417-1.533,P<0.001;OR=0.867,95%CI:0.840-0.895,P=0.002;OR=0.982,95%CI:0.966-0.997,P=0.019).A similar result was found in the analyses on the risk groups such as the population aged 60 years and older and the elderly with poor distant vision.However,socioeconomic factors were no longer the main influence on the occurrence of cataract surgery.Conclusions Individual demographic characteristics and the prevalence of chronic conditions significantly influence the incidence of cataract surgery.Health promotion programs aimed at eye care,advocated by relevant authorities,are instrumental in mitigating the impact of socio-economic factors on the accessibility of cataract surgery for the elderly.A holistic approach that considers both health status an

关 键 词：中老年人 白内障手术发生率 影响因素 队列研究 

分 类 号：R181.2[医药卫生—流行病学]