本文關(guān)鍵詞： 翼狀胬肉 患病率 漢族和藏族 危險因素　出處：《北京協(xié)和醫(yī)學(xué)院》2016年博士論文　論文類型：學(xué)位論文

【摘要】：背景翼狀胬肉是結(jié)膜向角膜生長的三角楔形纖維血管組織,可引起眼部刺激癥狀甚至影響視力。其具體發(fā)病機制尚不明確,針對不同人群的橫斷面研究所報道的患病率及危險因素存在差異。翼狀胬肉具有合并惡性腫瘤的風(fēng)險,且其手術(shù)治療復(fù)發(fā)率較高,因此預(yù)防就顯得尤為重要。對危險因素和保護因素越來越深入的了解使我們有望逐漸減少未來翼狀胬肉的發(fā)生。目的通過橫斷面研究分析青海省漢族和藏族翼狀胬肉的患病率及危險因素。方法本研究為2015年7月-8月進行的一項覆蓋青海省4個縣市的橫斷面研究,通過多階段分層抽樣法抽取一個能代表青海省人口的樣本,采集了人口學(xué)特征、生活方式、疾病史等信息,前節(jié)檢查在小瞳下采用手持裂隙燈進行。以logistic回歸模型分析潛在的獨立危險因素。結(jié)果4711名調(diào)查對象納入分析,漢族2594人(55.1%),藏族2117人(44.9%)。平均年齡44歲(8-83歲)。翼狀胬肉的總體患病率為8.3%(n=391),其中單眼受累者5.3%(n=248),雙眼受累者3.0%(n=143),30歲以上人群年齡性別調(diào)整患病率為8.7%。多因素分析顯示高齡(p＜0.001)、女性(p＜0.001)、出生于農(nóng)村(p=0.02)、室外工作(p=0.001)、高血壓病史(p=0.046)、遠視(p=0.049)為翼狀胬肉的危險因素,而高學(xué)歷(趨勢p=0.003)為獨立保護因素；僅高BMI(趨勢p=0.013)是雙眼翼狀胬肉的危險因素。男性中高齡(p＜0.001)、室外工作(p＜0.001)、高血壓病史(p=0.01)為翼狀胬肉的危險因素,目前吸煙(p=0.02)為保護因素,而吸煙指數(shù)與翼狀胬肉不相關(guān)(趨勢p=0.15)。女性中高齡(p＜0.001)、出生地為農(nóng)村(p＜0.001)為翼狀胬肉的危險因素,而高學(xué)歷(p=0.04)為保護因素。在農(nóng)村居住10年以內(nèi)的人群患翼狀胬肉的危險性和城鎮(zhèn)居民無統(tǒng)計學(xué)差異(p=0.072),而居住時間滿10年者患病風(fēng)險顯著增加,但其OR值并未隨農(nóng)村居住時間的延長而進一步上升。結(jié)論本研究分析了青海省藏族和漢族中翼狀胬肉的患病率和危險因素。高齡、女性、農(nóng)村、室外工作為翼狀胬肉的危險因素,高學(xué)歷為保護因素,而高血壓病史及遠視可能與翼狀胬肉相關(guān)。多因素分析未發(fā)現(xiàn)漢族和藏族間患病率具有統(tǒng)計學(xué)差異。男性中高齡、室外工作及高血壓病史為危險因素,而目前吸煙為保護因素；女性中發(fā)現(xiàn)高齡、農(nóng)村為危險因素,高學(xué)歷為保護因素。農(nóng)村居住時間滿10年者患翼狀胬肉的風(fēng)險增加,早期脫離危險因素可能更好地預(yù)防翼狀胬肉的發(fā)生。
[Abstract]:Background pterygium is a triangular wedge-shaped fibrous vascular tissue with conjunctival growth to cornea, which can cause ocular irritation and even affect visual acuity. The specific pathogenesis of pterygium is not clear. The prevalence and risk factors of pterygium were different in cross-sectional study of different population. Pterygium had the risk of complicated with malignant tumor, and the recurrence rate of surgical treatment was higher. Therefore, prevention is particularly important. More and more in-depth understanding of risk factors and protective factors will lead us to gradually reduce the occurrence of pterygium. Objective to analyze the pterygium of Han nationality and Tibetan nationality in Qinghai Province by cross-sectional study. The prevalence and risk factors of pterygium. Methods A cross-sectional study covering 4 counties and cities in Qinghai Province was conducted from July 2015 to August. A multi-stage stratified sampling method was used to select a sample representing the population of Qinghai Province, and the demographic characteristics, lifestyle, disease history and other information were collected. Logistic regression model was used to analyze the potential independent risk factors. Results 4711 subjects were included in the analysis. The average age was 44 years old and 8-83 years old. The overall prevalence rate of pterygium was 8.3%. Among them, the patients with monocular involvement were 5.3and the patients with binocular involvement were 3.0and 143respectively. The age and gender adjusted prevalence rate of the population over 30 years old was 8.7%. The multivariate analysis showed that the elderly patients (p < 0.001) and the females (P < 0.001) were born in rural areas (P < 0.02). The risk factors of pterygium were found in outdoor work, hypertension, hyperopia and hyperopia. Higher educational background (trend p0.003) was the independent protective factor. High BMI (trend p0.013) was the risk factor of pterygium in both eyes. The history of hypertension (p0.01) is the risk factor of pterygium, and smoking is the protective factor. However, the smoking index was not correlated with pterygium (trend p0. 15). The elderly women (P < 0. 001) and the place of birth in the countryside (p < 0. 001) were the risk factors of pterygium. The risk of pterygium in the population living in rural areas less than 10 years was not significantly different from that of urban residents. However, there was a significant increase in the risk of disease among those who lived for more than 10 years. Conclusion the prevalence and risk factors of pterygium in Tibetan and Han nationality in Qinghai Province were analyzed. Outdoor work was the risk factor of pterygium, and higher education was the protective factor. The history of hypertension and hyperopia may be related to pterygium. There was no significant difference in prevalence rate between Han and Tibetan by multivariate analysis. Elderly men, outdoor work and hypertension history were risk factors. At present, smoking is the protective factor. The risk factors of pterygium were higher than 10 years, and the risk of pterygium was increased in women who lived in rural areas for more than 10 years. The risk factors of early detachment may be better to prevent the occurrence of pterygium.
【學(xué)位授予單位】：北京協(xié)和醫(yī)學(xué)院
【學(xué)位級別】：博士
【學(xué)位授予年份】：2016
【分類號】：R777.33

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