摘要
目的调查山东省农村50岁及以上人群盲和中、重度视力损伤的患病率。方法采用以人群为基础的随机整群抽样方法。2008年4-7月在山东省3个不同经济发展水平的县（市）中各选择1个县（市）作为调查地[乳山市（人均国内生产总值高）、滕州市（人均国内生产总值中等）、鄄城县（人均国内生产总值低）]，另外选择1个人均国内生产总值中等城市市区的郊区农村作为调查地（山东大学槐荫区）。各调查地按照单纯随机抽样方法在编号排序的基本抽样单位中抽取调查点（村）。受检者在当地设置的检查站进行视力检查和眼科检查，对一只眼日常生活视力（PVA）≤0．5者检查其最佳矫正视力（BCVA）。不同组之间盲和中、重度视力损伤患病率的比较采用X^2检验。年龄、性别、受教育程度、地区差异对视力的影响采用多分类logstie回归分析，各地调查结果的比较采用调整的疾病优势比。结果4个调查地共检录350岁样本人数19583人，实际受检人数17816人，总受检率为90．98％。以PVA为标准，较好眼中、重度视力损伤（0．05≤视力〈0．3）患病率为7．01％（6．63％-7．39％，年龄标化率为6．56％）；盲（视力〈0．05）患病率为1．58％（1．39％-1．76％，年龄标化率为1．48％）。以BCVA为标准，较好眼中、重度视力损伤患病率为3．66％（3．38％～3．94％，年龄标化率为3．38％）；盲患病率为1．33％（1．16％～1．50％，年龄标化率为1．24％）。应用PVA标准的中、重度视力损伤患病率高于应用BCVA标准的中、重度视力损伤患病率（x^2=201．262，P=0．000）；应用两种标准的盲患病率的差异无统计学意义（x^2=0．117，P=0．732）。以PVA为标准，中、重度视力损伤和盲患病率与高龄、女性、受教育程度低和调查地区经济水平低均有相关性（P≤0．05）。以BCVA为标准，中、重度视力损伤患病率与高龄、女性、文化水平低和调查地区经济水平低有相关性（P≤0．05）；盲患病率与高龄、受教育程度低和调查地区经济水平有相关性，与性别无相关性。结论在山东省农村50岁及以上人群中，盲和中、重度视力损伤仍然是重要的公共卫生问题；未矫正的屈光不正是中、重度视力损伤的主要原因之一。
Objective To describe the prevalence of visual impairment/blindness among older adults aged 〉150 years in rural populations in Shandong Province, China. Methods Population-based, cross- sectional study was designed in this survey. Three counties and one suburbs representative of the different levels of socioeconomic development were selected as the study areas within the province from April to July 2008. Geographically defined cluster sampling was used in randomly selecting a cross-section of residents aged ≥50 years from each county. Eligible persons were invited to local examination sites for visual acuity （VA） testing and eye examination. Those presenting with VA ≤0. 5 in either eye were refracted to achieve best-corrected VA. x^2-test was used to compare the prevalence of blindness and visual impairment in the different groups. Multiple logistic regressions were used to investigate the association of age, gender, education, and county with presenting and best-corrected visual impairment and blindness. Adjusted odds ratio was used to compare the prevalence of blindness and visual impairment in the different counties. Results Of 19 583 enumerated eligible persons, 17 816 （90. 98% ） were examined and tested for VA. The prevalence of presenting visual impairment （0. 05- 〈 0. 3） in the better-seeing eye was 7.01% （the age-standardized rate was 6. 56% ） and presenting blindness （ 〈 0. 05 ） was 1.58% （ the age-standardized rate was 1.48% ）. Across the 4 counties, presenting visual impairment ranged from 4. 51% to 8. 65% , and presenting blindness from 1.35% to 1.77%. With best-corrected VA,the prevalence of visual impairment was 3.66% （the age- standardized rate was 3.38% ）, and 1.33% for blindness （ the age-standardized rate was 1.24% ）. The ranges across the 4 counties were 2. 63% to d. 38% for visual impairment and 1.06%-1.54% for blindness. The prevalence of visual impairment with presenting VA was higher than that with best-corrected VA（ ~2 = 201. 262,P = 0. 000）. There was no significant difference between the prevalence of blindness with presenting VA and that with best-corrected VA（ X2 = 0. 117,P = 0. 732）. Based on both presenting and best- corrected VA, visual impairment and blindness were associated with older age, female gender, lack of education, and county （P 〈 0. 05 ）. Conclusions Visual impairment and blindness are important public health problems in rural older adults aged 〉150 years in Shandong Province. Un-corrected refractive error is one of the main causes of visual impairment.
出处
《中华眼科杂志》
CAS
CSCD
北大核心
2012年第3期226-233,共8页
Chinese Journal of Ophthalmology
基金
山东省科学技术发展计划（2008GG10002051）
山东省医药卫生科技发展计划（2005HW101）
志谢赵家良教授为本调查提供《卫生部全国九省市50岁及以上人群眼病流行病学调查方案》并给予指导和支持,山东省卫生厅帮助组织和协调本调查,受检地乳山市、滕州市、鄄城县、山东大学槐荫区卫生局对本调查给予支持和帮助,特此感谢
关键词
盲
视觉障碍
患病率
中年人
老年人
Blindness
Visual impairment
Prevalence
Middle aged
Aged
