中国中老年人青光眼发病情况及其风险因素的前瞻性队列分析  

Incidence and risk factors of glaucoma in middle-aged and elderly Chinese:a prospective cohort study

作　　者：金鑫 郭帅[2,3] Catherine Jan[4] 戴婉薇[5] 郑晓瑛 JIN Xin;GUO Shuai;Catherine JAN;DAI Wanwei;ZHENG Xiaoying(Institute of Population Research,Peking University,Beijing 100871,China;Asia Pacific Economic Cooperation Health Science Academy,Peking University,Beijing 100871,China;School of Population and Public Health,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100730,China;不详)

机构地区：[1]北京大学人口研究所,北京100871 [2]北京大学亚太经合组织健康科学研究院,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]Ophthalmology,Faculty of Medicine,The University of Melbourne,Victoria Australia [5]北京大学第三医院眼科

出　　处：《中国慢性病预防与控制》2024年第11期801-806,814,共7页Chinese Journal of Prevention and Control of Chronic Diseases

基　　金：国家重点研发计划(2022YFC3600800);中央高校基本科研业务费项目(7101503356);国家资助博士后研究人员计划(GZC20240155)。

摘　　要：目的 了解中老年人群青光眼的发病情况及影响因素,为制定有针对性的青光眼预防策略提供科学依据。方法 采用前瞻性队列研究设计,利用中国健康与养老追踪调查(CHARLS)2011年基线数据及2013年、2015年、2018年3次随访数据,采用分层多阶段随机抽样在全国28个省(自治区、直辖市)选取12 678名≥45岁中老年人作为研究对象,进行问卷调查、体格检查和实验室检测。采用Stata 18.0统计软件进行χ~2检验和多因素Cox回归分析青光眼发病的影响因素。结果 该研究中位随访时间为7年,其中新发青光眼患者355例,整体随访87 749.5人年。≥45岁中老年人的青光眼7年累计发病率为2.80%,≥60岁老年人的累计发病率为3.78%。其中,男性新发青光眼144人,累计发病率为2.39%;女性新发青光眼211人,累计发病率为3.18%。多因素Cox回归分析结果显示,调整混杂因素后,≥60岁(HR=1.33,95%CI:1.06~1.67)、文盲(HR=1.62,95%CI:1.29~2.04)、有白内障手术史(HR=2.04,95%CI:1.17~3.59)、远视力一般或差(HR=1.55,95%CI:1.20~2.00)、患有糖尿病(HR=1.59,95%CI:1.15~2.22)、患有其他2种及以上慢性病均会增加中老年人青光眼发病风险(P<0.01)。其中,其他慢性病的患病数量与青光眼发病风险存在显著的剂量反应关系(2种:HR=1.86,95%CI:1.37~2.52;3种:HR=2.00,95%CI:1.35~2.96;4种及以上:HR=2.34,95%CI:1.50~3.66)。结论 中国中老年人群青光眼的发病率较高,需要引导中老年人进行青光眼筛查和慢性病管理,特别是针对高风险群体,以降低青光眼的发病率和致盲风险。Objective To understand the incidence and risk factors of glaucoma among middle-aged and elderly population in China,and provide the scientific basis for targeted prevention strategies for glaucoma.Methods A prospective cohort study was conducted using baseline data from the China Health and Retirement Longitudinal Study(CHARLS)in 2011 and follow-up data in 2013,2015,and 2018.A multi-stage stratified probability sampling method was adopted to select 12678 middle-aged and elderly residents(≥45 years old)from 28 provinces(including autonomous regions and municipalities)in China as the subjects.The investigation was performed with questionnaires,physical examinations,and laboratory tests.The χ^(2) test and multivariate Cox investigation were conducted to analyze the risk factors of glaucoma.The used software was State 18.0.Results The median follow-up time was 7 years,355 new cases of glaucoma were identified.Total cases in follow-up were 87749.5 person-years.The seven-year cumulative incidence of glaucoma was 2.80%among middle-aged and elderly residents(≥45 years old),and 3.78%among elderly residents(≥60 years old).For newly identified cases,the cumulative incidence was 2.39%(144 cases)in males and 3.18%(211 cases)in females,respectively.Multivariate Cox regression analysis showed that after adjusting the confounding factors,age≥60 years(HR=1.33,95%CI:1.06-1.67),illiteracy(HR=1.62,95%CI:1.29-2.04),history of cataract surgery(HR=2.04,95%CI:1.17-3.59),poor distant vision(HR=1.55,95%CI:1.20-2.00),diabetes(HR=1.59,95%CI:1.15-2.22),and two or more other chronic diseases could significantly increase the risk of developing glaucoma in middle-aged and elderly residents(P<0.01).There was a significant dose-response relationship between the number of chronic diseases and the risk of developing glaucoma(two chronic diseases:HR=1.86,95%CI:1.37-2.52;three chronic diseases:HR=2.00,95%CI:1.35-2.96;four or more chronic diseases:HR=2.34,95%CI:1.50-3.66).Conclusion The incidence of glaucoma among middle-aged and elderly res

关 键 词：中老年人 青光眼 发病率 风险因素 队列研究 

分 类 号：R181.3[医药卫生—流行病学]