老年性白内障危险因素病例对照研究

目的 探讨可能引起老年性白内障的危险因素。为制定预防白内障提供依据。方法 采用1：1病例对照研究方法对合肥市及定远县50对老年性白内障及对照进行多变量多指标测量,研究因素采条件Logistic回归单因素和多因素分析。结果 单因素分析结果发现居住在农村及小城市高中及中专文化程度（OR=13.33,95%CI=1.78-40.86)、吸烟（OR=1.23,95%CI=1.03-2.29)、饮酒（OR=1.65,95%CI=1.04-4.33)、高血压（OR=1.25,95%CI=1.11-1.46)、胆固醇（OR=1.37,95%CI=1.05-1.79)及紫外线（OR=2.06,95%CI=1.84-4.34)、腹泻引起营养不良（OR=2.87,95%CI=1.80-5.31)及类固醇等药（OR=1.51,95%CI=1.16-2.04)可能是白内障发病的危险因素,维生素（OR=0.66,95%CI=0.45-0.94),阿斯匹林（OR=0.93,95%CI=0.74-1.16)及谷光甘肽（OR=0.58,95%CI=0.38-0.85)可能是保护因子,条件Logistic回归逐步法进行分析显示高血压年限,降压药种类、腹泻引起营养不良、维生素、谷光甘肽和胆固醇等6个因素进入方程。结论 老年性白内障的发病与多种因素有关。合肥市和定远县两地白内障发病的危险因素基本具有其它地区人群共同的特点外,还有有别与其它地区人种的自身特点。     

Cytological study of senile cataract

Summary Cortical cataracts are essentially characterized by a cellular deterioration of the lens epithelium with hypertrophy of the vacuolar system, cytolysis and cell proliferation, as well as by an intercellular storage of foamy material and the presence of intracellular deposits.Author's address: Ophthalmological Clinic University of Ghent Ghent, Belgium.     

老年性白内障的現代中醫研究

老年性白内障的發病率、致盲率均是常今世界上最高的眼病之一,尽管現代白内障颞微外科手術能使白内障盲人復明,但越來越多的白内障病人屬于早期發展或等待手術或不能手術的範畴,雖然迄今爲止尚無療效碓切的藥物,然而現代中醫中藥的研究在老年性白内障的防治方面,已經廣泛的受到國内外導家、學者的重視舆關注,本文現就常前中醫中藥在老年性白内障的防治方面的病因病機研究、治則治法研究、辯證論治研究以及專病專方、針炙治瘵、穴位注射、敷貼、埋臟、結扎、冷凍、外用眼藥等臨床舆實験研究綜述如下,以供參考.     

老年性白内障的现代中医研究

老年性白内障的发病率,致盲率均是当今世界上最高的眼病之一,尽管现代白内障显微外科手术能使白内障盲人复明,但越来越多的白内障病人属于早期发展或等待手术或不能手术的范畴,虽然迄今为止尚无疗效确切的药物,然而现代中医中药的研究在老年性白内障的防治方面,已经广泛的受到国内外专家、学者的重视与关注,本文现就当前中医中药在老年性白内障的防治方面的病因病机研究、治则治法研究、辩证论治研究以及专病专方、针炙治疗、穴位注射、敷贴、埋藏、结扎、冷冻、外用眼药等临床与实验研究综述如下,以供参考。     

A population based case-control study of cataract and inhaled corticosteroids

BACKGROUND/AIMS: Exposure to systemic corticosteroid use is known to be associated with a risk of cataract. Whether low doses of inhaled corticosteroids are associated with an increased risk of cataract is not known. This study was undertaken to quantify the risk of cataract associated with the use of inhaled corticosteroids and assess whether there is a dose-response relation. METHODS: A population based case-control study based on the General Practice Research Database in the United Kingdom. 15 479 people with cataract and 15 479 controls were matched for age, sex, practice, and observation period. RESULTS: The crude odds ratio for the association between any recorded exposure to inhaled corticosteroids and cataract was 1.58 (95% CI 1.46 to 1.71), reduced to 1.10 (95% CI 1.00 to 1.20) after adjustment for systemic corticosteroid exposure and consultation rate. There was a dose-response relation, the adjusted odds ratio rising from 0.99 (95% CI 0.87 to 1.13) at daily doses up to 400 micro g to 1.69 (95% CI 1.17 to 2.43) for daily doses greater than 1600 micro g. The association was also stronger with increasing duration of use. CONCLUSION: Higher doses and longer duration of exposure to inhaled corticosteroids are associated with an increased risk of cataract. The lowest doses compatible with good control of airways disease should be used. The risk of cataract associated with high doses of inhaled corticosteroids needs to be more widely appreciated.     

A case-control study of cataract in Oxfordshire: some risk factors.

Three hundred patients with cataract and 609 control subjects with the same age-sex distribution were interviewed in a study of cataract in Oxfordshire, England. The risks associated with severe diarrhoea, glaucoma, and work on a military base have been demonstrated. Population attributable risks were calculated for those and other risk factors.     

西藏地区影响老年性白内障术后视力改善因素分析

Objective To analyze impact factors for visual acuity improvement of senile cataract surgery in Tibet prospectively. Methods Of 278 cases were included. To study relations of visual acuity improvement between pre- and post-cataract surgery with patient age, nucleus classification, small incision cataract surgery (SICS) or Phacoemulsification (PHACO) and corneal edema. LogMAR chart was used in visual acuity analysis. Results 1. Univariate analysis: There was no significant difference between PHACO group and SICS group on visual acuity improvement (PHACO 0.92± 0.48, SICS 0.83± 0.46, P ＞0.05). Age group for 70- and 80- years-old had less improvement on visual acuity (P ＜0.05). Diffuse corneal edema had much more influence than central corneal edema on visual acuity improvement (0.52± 0.42, 0.70± 0.44, diffuse vs central, respectively). 2. Multivariate analysis: There were significant differences in age and location of corneal edema on visual acuity improvement (P ＜0.05). Conclusions There is no significant difference on visual acuity improvement between PHACO and SICS. Ophthalmologist can choose either PHACO or SICS for better rehabilitation of visual acuity, depending on area economics, his own experience and so on in Tibet. Visual acuity improvement in cataract surgery is significantly affected by the age of the patients. Since medication is deficient in Tebit, screening of cataract in Tibet is very important for detecting and treating cataract as early as possible. Diffuse corneal edema has much more influence than central edema on visual acuity improvement when corneal edema degrees are not different. It's important to avoid corneal endothelium damage in cataract surgery.     

西藏地区影响老年性白内障术后视力改善因素分析

目的 分析影响西藏地区老年性白内障术后视力改善的因素.方法 对西藏地区接受白内障手术的老年性白内障278例,分析年龄、核分级、术式(超声乳化术和小切口白内障囊外摘除术)、人工晶状体度数、角膜水肿部位等对术后视力改善的影响.视力采用LogMAR视力.统计方法分别采用单因素和多因素线性回归方法.结果 (1)单因素分析:术式:超声乳化术组术后较术前视力改善(平均视力差) 0.92±0.48,小切口白内障囊外摘除术组平均视力差0.83±0.46,两种手术方式对视力改善的影响,差异没有统计学意义(P＞0.05).年龄:70-、80-年龄组分别与40-、50-、60-年龄组差异有统计学意义(P＜0.05).角膜水肿部位:弥漫性水肿(平均视力差0.52±0.42)较中央部位水肿(平均视力差0.70±0.44))对视力改善影响更大,差异有统计学意义(P＜0.05).(2)多因素线性回归分析:年龄、角膜水肿部位均对视力改善有影响,差异有统计学意义(P＜0.05).结论 (1)超声乳化术和小切口白内障囊外摘除术两种手术方式对视力提高程度无明显差异,因此在西藏地区可以根据当地条件,包括经济状况和医师具备的手术水平,来选择术式,以使患者获得最佳有用视力.(2)年龄为白内障术后视力改善的影响因素之一,随年龄增加视力改善减少,而西藏地区就医条件有限,故在西藏地区更应重视白内障的普查,强调早期发现和早期手术.(3)在角膜水肿分级无明显差异的基础上,弥漫性水肿较中央部水肿对视力改善影响更大,因此在术中应谨慎操作,尽量避免角膜内皮广泛的损伤.