原发性开角型青光眼患者40岁以上一级亲属青光眼患病情况研究

doi:10.12114/j.issn.1007-9572.2019.07.017

摘要/Abstract

摘要： 背景　原发性开角型青光眼（POAG）是青光眼中最为常见的类型，流行病学资料显示，POAG的发病过程中遗传因素起了重要作用，POAG患者的发病具有明显的家族遗传聚集性倾向。目的　探讨湖北省宜昌市POAG患者40岁以上一级亲属原发性青光眼的患病情况，探讨家族史在POAG发病中的作用，为青光眼的早期防治提供参考。方法　选取2015—2017年在三峡大学附属仁和医院眼科确诊的100例POAG患者作为病例先证组，纳入其40岁以上一级亲属（包括父母、兄弟姐妹和子女）共289例作为病例组；以同期收治的100例白内障手术（排除POAG）患者作为对照先证组，纳入其40岁以上一级亲属共295例作为对照组。分别对病例组和对照组进行青光眼筛查和问卷调查，采用Logistic回归分析探讨POAG发生的影响因素。结果　295例对照组中，检出POAG患者5例（1.7%）；289例病例组中，检出POAG患者34例（11.8%）。病例组POAG患病率明显高于对照组（P<0.05）。病例组不论男性还是女性其POAG的患病率均高于对照组（P<0.05）；在50~59、60~69、≥70岁3个亚组中，病例组POAG的患病率高于对照组（P<0.05）。Logistic回归分析结果显示，40岁以上一级亲属是否患POAG以及患POAG的一级亲属类别，均是其患POAG的影响因素（P<0.05）。结论　POAG患者40岁以上一级亲属的POAG发生率高于非POAG患者，对POAG患者的一级亲属进行青光眼筛查是一项经济、高效的筛查方法。

关键词: 青光眼, 开角型；一级亲属；筛查；患病率；病例对照研究

Abstract: Background　Primary open angle glaucoma（POAG） is the most common type of glaucoma.Epidemiological data show that genetic factors play an important role in the pathogenesis of POAG.The incidence of POAG has an obvious tendency of familial aggregation due to genetic factors.Objective　To study the prevalence of primary glaucoma in first-degree relatives over 40 years of age of POAG patients，to identify the role of family history in the pathogenesis of POAG，providing a reference for early prevention and treatment of glaucoma.Methods　This study was carried out following a case-control design.From Department of Ophthalmology，Affiliated Renhe Hospital of China Three Gorges University，100 patients receiving a definite diagnosis of POAG（case proband group） and 100 receiving surgical treatment for cataract and without POAG（control proband group） were recruited during 2015 to 2017.First-degree relatives（parents，siblings and children） over 40 years of age of the case and control proband groups were included，named as case group（n=289）and control group（n=295），respectively.A glaucoma screening and a questionnaire survey were conducted in both case group and control group.Logistic regression analysis was performed to identify the factors associated with POAG.Results　The prevalence of POAG was much higher in the case group than that of the control group〔11.8%（34/289） vs 1.7%（5/295）〕（P<0.05）．Sex-specific subgroup analyses found that the prevalence of POAG was obviously higher either in males or females in case group compared with the control group（P<0.05）.Age-specific subgroup analyses revealed that the prevalence of POAG was obviously higher in individuals 50-59，60-69 and ≥70 years of age in case group compared with the control group（P<0.05）.Logistic regression analyses found that first-degree relatives（over 40 years of age）of the POAG patients were associated with increased risk of POAG compared with those of non-POAG patients（P<0.05）.And POAG patients' parents and children were independently associated with increased risk of POAG compared with their siblings（P<0.05）.Conclusion　First-degree relatives over 40 years of age of POAG patients had higher prevalence of POAG compared with those of non-POAG patients.So，glaucoma screening targeted at first-degree relatives of POAG patients is highly effective，yet inexpensive.

Key words: Glaucoma, open angle；First-degree relatives；Screening；Prevalence；Case-control studies

韩玉灿,谭容,王平,等. 原发性开角型青光眼患者40岁以上一级亲属青光眼患病情况研究[J]. 中国全科医学, 2019, 22(7): 834-838. DOI: 10.12114/j.issn.1007-9572.2019.07.017.
HAN Yucan,TAN Rong,WANG Ping, et al. Prevalence of Glaucoma in First-degree Relatives of Patients over 40 Years Old with Primary Open Angle Glaucoma　[J]. Chinese General Practice, 2019, 22(7): 834-838. DOI: 10.12114/j.issn.1007-9572.2019.07.017.

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