知识与财富的链接
目的：了解成都地区原发性开角型青光眼（POAG）患者≥40 岁的一级亲属青光眼患病情况,研究家族史这一危险因素在POAG发病中的作用。方法：病例对照研究。选取2014 年2 月至2015 年10 月期间在华西医院确诊的99 例POAG患者为先证者,其≥40 岁的一级亲属290 例作为病例组。同期来院行白内障手术（无其他合并眼部疾病）的105 例患者,其≥40 岁的一级亲属355 例作为对照组。分别进行问卷调查和青光眼筛查。采用t 检验、卡方检验,多元Logistic回归等进行统计学分析。结果：①病例组总患病率高于对照组（10.7% vs . 1.4%,χ2=26.090,P ＜0.001）。②病例组女性青光眼患病率高于对照组女性青光眼患病率（11.7% vs . 1.6%,χ2=15.203,P ＜0.001）,病例组男性青光眼患病率也高于对照组男性青光眼患病率（9.8% vs . 1.2%,χ2=11.098,P ＜0.001）。③按年龄（＜50 岁、50～59岁、60～69岁、≥70岁）分层,在＜50岁、50～59岁、≥70岁这3个年龄亚组,病例组青光眼患病率均明显高于对照组（χ2=14.328、4.919、6.959,P ＜0.05）。④在调整年龄和性别的影响后,病例组患病风险是对照组的8.45倍（95%CI：3.24～22.06）,其中病例组中子女患病风险为对照组的11.53倍（95%CI：2.45～54.26）。⑤92.1%的POAG患者一级亲属无青光眼筛查意识。结论：POAG患者≥40岁以上的一级亲属患病风险明显高于其他人群,绝大多数POAG患者一级亲属缺乏进行青光眼筛查的意识。
Objectives:To study the prevalence of glaucoma in first-generation relatives (FGRs) of patients with primary open angle glaucoma (POAG),and to identify the likelihood of family history as a risk factor for the presence of POAG.Methods:In this case control study,290 FGRs of 99 patients who were diagnosed with POAG in West China Hospital from February 2012 to October 2013 were enrolled (POAG-related group).FGRs (n=355) of 105 cataract patients were also enrolled (control group).Both groups were matched for sex and age (40 years or older).All participants were asked to complete a questionnaireand undergo a comprehensive eye examination.A chi-square test,t-test,and multiple logistic regression analysis were used to analyze the data.Results:The FGRs of patients with POAG had a greater prevalence of glaucoma than the controls (10.7％ vs.1.4％,x2=26.090,P＜0.001).There was a greater prevalence of glaucoma in females (11.7％ vs.1.6％,x2=15.203,P＜0.001) and in males (9.8％ vs.1.2％,x2=11.098,P＜0.001) in the FGRs of patients with POAG compared with the controls.For three different age groups,＜50,50-59,and ≥ 70 years of age,the FGRs of patients with POAG had a greater prevalence of glaucoma than did the controls (x2=14.328,4.919,6.959,P＜0.05).The calculated odds ratio (OR) for the characteristics associated with glaucoma were strong when adjusted for age and gender [OR=8.45 (95％ confidence interval:3.24-22.06)],and offspring [OR=1 1.53 (95％ confidence interval:2.45-54.26)] had an obvious association with POAG.Most of the FGRs of patients with POAG,92.1％,had no awareness of the need for glaucoma screening.Conclusions:Our study shows that the FGRs of patients with POAG are at high risk for having POAG,and a family history of glaucoma is associated with the presence of glaucoma.The FGRs of patients with POAG should be made more aware of the need for glaucoma screening.