揉眼和睡姿与圆锥角膜发病的相关性分析  

Correlation analysis of eye rubbing and sleeping posture with keratoconus

作　　者：刘晓宇 郭星涵 刘小雪 鲍庆东 陈彤 高华 LIU Xiaoyu;GUO Xinghan;LIU Xiaoxue;BAO Qingdong;CHEN Tong;GAO Hua(Shandong First Medical University,Jinan 250021,Shandong Province,China;Institute of Ophthalmology,Affiliated to Shandong First Medical University,Jinan 250117,Shandong Province,China;School of Ophthalmology,Shandong First Medical University,Jinan 271016,Shandong Province,China;Eye Hospital,Affiliated to Shandong First Medical University(Shandong Eye Hospital),Jinan 250014,Shandong Province,China)

机构地区：[1]山东第一医科大学,山东省济南市250021 [2]山东第一医科大学附属眼科研究所,山东省济南市250117 [3]山东第一医科大学眼科学院,山东省济南市271016 [4]山东第一医科大学附属眼科医院(山东省眼科医院),山东省济南市250014

出　　处：《眼科新进展》2024年第11期868-871,共4页Recent Advances in Ophthalmology

基　　金：国家自然科学基金面上项目(编号:82371032);山东省自然科学基金重大基础研究项目(编号:ZR2023ZD60);山东省自然科学基金青年项目(编号:ZR2023QH466)。

摘　　要：目的通过调查圆锥角膜(KC)患者的揉眼和睡姿习惯,分析KC发病与揉眼及睡姿的相关性,并进一步分析KC严重程度与揉眼、睡姿的相关性。方法回顾性病例对照研究。收集2018年1月到2022年6月在山东第一医科大学附属眼科医院诊疗的KC患者作为KC组,同时收集2022年2月至6月在同医院招募的年龄、性别相匹配的近视患者作为对照组。对所有患者进行问卷调查并就揉眼和睡姿及相关习惯详细情况进行记录;按照病情严重程度(角膜曲率大小)对KC患者进行分期,比较不同分期KC患者的揉眼和睡姿情况。结果本研究共收集了406例KC患者和394例近视患者。KC组患者中揉眼占比67.98%,对照组患者揉眼占比24.87%,二者差异具有统计学意义(P<0.001);KC患者睡觉时有侧卧或俯卧习惯的占比45.32%,近视患者此项占比24.87%,二者差异具有统计学意义(P<0.001)。多因素二元Logistic回归分析结果显示以下变量存在显著差异:病情分期更严重眼(以下简称即更陡眼)揉眼率更高(OR=3.547,95%CI:2.02~6.24,P<0.001)、侧卧或俯卧位睡姿(OR=10.725,95%CI:5.77~19.94,P<0.001)、睡觉时头偏向更陡眼(OR=12.171,95%CI:7.23~20.49,P<0.001)。统计学分析结果显示,病情分期更严重的Ⅳ期KC患者中喜欢揉更陡眼及睡觉时头偏向更陡眼的比例明显高于前三期患者(均为P<0.001)。结论揉眼和侧卧或俯卧位睡姿是KC发病的危险因素,并与疾病严重程度相关。Objective To investigate the habits of eye rubbing and sleeping posture of patients with keratoconus(KC)and analyze the correlation of the onset and severity of KC with eye rubbing and sleeping posture.Methods In this retrospective case-control study,KC patients who received diagnosis and treatment in the Eye Hospital of Shandong First Medical University from January 2018 to June 2022 were collected as the KC group,and myopia patients with matching ages and sexes who visited our hospital from February to June 2022 were recruited as the control group.All patients were investigated by questionnaire and the details of eye rubbing,sleeping posture and related habits were recorded.According to the severity of the disease(corneal curvature),KC patients were divided into different stages,and the eye rubbing and sleeping posture of KC patients in different stages were compared.Results In this study,406 KC patients and 394 myopia patients were included.It was found that 67.98%of KC patients and 24.87%of myopia patients rubbed their eyes,with a significant difference(P<0.001);45.32%of KC patients and 24.87%of myopia patients were accustomed to sleeping on their side or stomach,with a significant difference(P<0.001).The multivariate binary logistic regression analysis indicated that the following variables showed significant differences:patients with eyes at the later stages(steeper eyes)were more likely to rub eyes[odds ratio(OR)=3.547,95%CI:2.02-6.24,P<0.001],sleep on side or stomach(OR=10.725,95%CI:5.77-19.94,P<0.001),and turn head to the steeper eye when sleeping(OR=12.171,95%CI:7.23-20.49,P<0.001).The statistical analysis demonstrated that the proportion of KC patients at the IV stage who were habituated to rub their steeper eyes and turn their heads to the steeper eyes when sleeping was significantly higher than that of patients at stages I to III(all P<0.001).Conclusion Eye rubbing and sleeping on the side or stomach are risk factors for the onset of KC and are related to the severity of the disease.

关 键 词：圆锥角膜 揉眼 睡姿 危险因素 

分 类 号：R772.23[医药卫生—眼科]