无锡市50岁及以上人群白内障患病率和手术情况调查

背景 白内障是主要的致盲眼病,中国白内障患者逐年增加,由此带来的社会问题日益严重.目的 调查无锡市50岁及以上人群白内障患病率、白内障患者手术覆盖率及白内障患者的社会负担率.方法 采用整群随机抽样的方法.收集2010年1-12月无锡市滨湖区28个调查点50岁及以上人群共6722名居民,进行详细的病史采集和眼部检查,统计该人群中白内障的患病率及手术覆盖率,评估白内障患者的视功能.本研究遵循医学伦理学准则,经江苏省卫生厅批准,受检者在检查前均签署知情同意书.结果 受检者共6 150例,应答率91.5％.受检者中诊断为白内障者1 564例,白内障的患病率为25.43％.高龄、女性、文盲、有高血压病、糖尿病病史、吸烟史、饮酒史的人群白内障患病率明显增高,差异均有统计学意义（x2=927.835、18.508、303.968、11.934、17.956、32.091、35.290,P＜0.01）.以双眼最佳矫正视力＜0.05作为盲的标准,已行手术的白内障盲者与未手术的白内障盲者的总优势比值为3.15（85/27）,白内障盲者总手术覆盖率为75.89％（85/112）,白内障盲者社会总负担率为1.82％（112/6 150）.随着年龄的增长和受教育程度的降低,白内障盲的手术覆盖率逐渐降低,这种趋势差异无统计学意义（P＞0.05）,而白内障盲者的社会负担率逐渐增加的趋势差异有统计学意义（P＜0.01）.结论 高龄、女性和文盲的白内障是无锡地区比较严重的问题,白内障盲者的社会负担率仍然比较高,白内障仍然是防盲、治盲的工作重点.

Survey of the cataract prevalence and surgical coverage rate among 50 or above in Wuxi City

Background Cataract is the main blinding eye disease with an increasing prevalence in China.Objective Purpose of this study was to survey the prevalence of cataract and surgical coverage rate in 50 years old or above population in Wuxi City.Methods Cluster randomized sampling was used to organize the 6 722 residents aged 50 or above in 28 communities in Binhu District of Wuxi from January to December 2010 under the informed consent.Visual acuity was tested and ocular examination were performed.The incidence rate of cataract and surgical coverage rate of cataract were calculated.Results Total 6 150 individuals were collected in this survey with the response rate 91.5%.Lens opacification was examined in 1 564 subjects,with the prevalence of cataract 25.43% （1 504/6 150）.The prevalence of cataract was higher in the population with advanced age,female,illiterate,hypertension,diabetes,alcohol,smoking （χ2 =927.835,18.508,303.968,11.934,17.956,32.091,35.290,all at P〈 0.01）.When the bilateral presenting vision〈0.05 was defined as the criterion,the odds ratio of cataractous blindness between with and without surgery was 3.15 （85/27）.Cataract surgical coverage rate was 75.89% （85/112）,and the bilateral cataract-blindness burden was 1.82% （112/6 150） in this region.The cataract surgical coverage rate was parallel to aging and lower education level,and there were statistically significant differences among the subjects with different ages or education levels （P〉0.01）.However,the social burden rate of cataract-blindness was much higher in aged and lower education level population （P〈0.01）.Conclusions The prevalence of cataract remains a high level in women,illiterates and elder individuals in Wuxi.The social burden shows an increasing trend in the bilateral cataract-blindness population with elder age and lower schooling.The prevention and treatment of cataract blindness still faces with a challenge. Keywords：Cataract; Prevalence; Cataract surgical coverage rate; Blindness; Social and economical burden