本文關鍵詞：身體測量值與年齡相關性白內障的關系　出處：《遼寧醫(yī)學院》2012年碩士論文　論文類型：學位論文

  更多相關文章： 年齡相關性白內障 視力損傷 腰圍 體質指數(shù) 腰臀比 高血壓

【摘要】：目的 調查中老年人群臨床術后年齡相關性白內障（ARC）及其所引起的視覺損害的流行病學現(xiàn)狀，探討社會人口學特征、生活方式因素、身體測量值、體力活動、膳食因素以及個體疾病既往史等與ARC發(fā)生發(fā)展的關系。 方法 采用以醫(yī)院為基礎的病例對照研究方法，病例為2010年4月~2011年10月，在錦州的三級甲等醫(yī)院眼科病房住院，臨床診斷為ARC，施行手術治療，術后病理檢驗證實為ARC的360例患者，年齡為45~85歲。對照為因各種急性、非腫瘤性及非代謝性疾病同期入住相同醫(yī)院的360例非白內障的患者。采用自行設計的調查表對所有研究對象進行調查，內容包括人口學特征、生活方式因素、個體疾病既往史等因素。同時對身體測量值指標身高、體重、腰圍及臀圍進行測量，并計算體質指數(shù)（BMI）和腰臀比（WHR）。采用SPSS13.0統(tǒng)計分析軟件，對調查資料進行分析，比較各組間均值和率的差異。應用Logistic回歸模型估計腰圍（WC）、體質指數(shù)（BMI）、腰臀比（WHR）與ARC關聯(lián)的比值比（OR）及其相應的95%可信區(qū)間（CI）。 結果 1、共收集有效臨床ARC病例和對照各360例，年齡45~85歲，病例年齡45~85歲，平均（69.20±10.39）歲；對照年齡45~85歲，平均（69.62±10.93）歲。人口統(tǒng)計學特征分析結果顯示，2組研究對象的年齡、性別、民族、居住地、文化程度、職業(yè)、以及經(jīng)濟收入均無顯著性差異（P0.05）。 2、BMI增高與發(fā)生ARC的危險性呈正相關。超重和肥胖者（24.00~27.99和≥28.00）發(fā)生ARC的危險性約是正常BMI（18.50~24.99）者的1.6倍（OR=1.587，95%CI：1.135~2.218，P=0.007）和2.3倍（OR=2.315，95%CI：1.369~3.914，P=0.002）。與BMI最低四分位數(shù)(16.96~21.16)的對照組相比較，病例組最高四分位數(shù)（25.11~32.18）者ARC的發(fā)病危險性明顯增加（OR=2.645，95%CI：1.887~3.656，P=0.003）。 3、WHR增高與ARC發(fā)病危險性的增加有關。向心性肥胖者發(fā)生ARC的危險性顯著增高，與正常體型者（男性WHR 0.9；女性WHR 0.88）相比，WHR≥0.9男性和WHR≥0.88女性發(fā)生ARC的危險性分別增加了69%（OR=1.689，95%CI：1.496~2.538，P=0.006）和53%（OR=1.534，95%CI：1.183~2.345，P=0.019）。 4、高血壓與ARC呈顯著正相關（OR=1.573，95%CI：1.145~2.161，P=0.005）。隨著收縮壓的升高，ARC的發(fā)生率明顯增加。與收縮壓140mmHg者相比，收縮壓≥180mmHg者發(fā)病的危險性增加（OR=2.812，95%CI：1.450~5.455，P=0.002）。 不同BMI的研究對象高血壓狀況與ARC的關系不同，，BMI正常（18.50~23.99）者的血壓升高與發(fā)生ARC無關（OR=1.333，95%CI：0.819~2.170，P=0.246）。然而，超重者罹患高血壓可使發(fā)生ARC的危性顯著增加（OR=1.991，95%CI：1.160~3.419，P=0.012），BMI≥28.00者的血壓升高與ARC發(fā)病危險性呈顯著正相關（OR=2.000，95%CI：1.747~5.355，P=0.008）。 結論 1、結果提示，肥胖是發(fā)生ARC的重要危險因素，維持正常WHR或BMI是ARC發(fā)病的保護因素。 2、超重和肥胖者罹患高血壓與發(fā)生ARC的危險性顯著升高有關，維持正常血壓對ARC有益。 3、收縮壓升高及高血壓病程可使ARC的發(fā)病危險性增加；而體力活動、騎自行車則與發(fā)生ARC的危險性降低有關。 通過改善飲食習慣和生活方式，維持正常的BMI和WHR，可有效地預防ARC的發(fā)生。
[Abstract]:objective
Survey of elderly population in clinical postoperative cataract (ARC) epidemiological status and causes of visual impairment, to explore the social demographic characteristics, lifestyle factors, body measurements, physical activity, the relationship between dietary factors and individual disease history and ARC development.
Method
A hospital-based case-control study, cases for the April 2010 ~2011 year in October, in the ophthalmology ward of three hospitals in Jinzhou, the clinical diagnosis of ARC, surgical treatment, postoperative pathological examination confirmed 360 cases of ARC patients, aged 45~85 years old. The control for various acute, non neoplastic and non metabolic diseases during the same period in the same hospital 360 cases of cataract patients. Using a self-designed questionnaire survey was conducted on all subjects, including demographic characteristics, lifestyle factors, individual disease history and other factors. At the same time value to the body height, body weight measurement, waist and hip circumference were measured and calculated. Body mass index (BMI) and waist to hip ratio (WHR). Using SPSS13.0 statistical analysis software, analysis of survey data, the differences between groups were compared and the mean rate. The application of Logistic regression model to estimate the waist circumference (WC), Body mass index (BMI), the ratio of waist to hip ratio (WHR) to ARC (OR) and its corresponding 95% confidence interval (CI).
Result
1, the total number of valid clinical ARC cases and controls 360 cases, aged 45~85 years, were 45~85 years old, the average (69.20 + 10.39) years; in the age 45~85 years old, average (69.62 + 10.93) years old. Demographic analysis showed that 2 groups of subjects of age, gender, nationality, place of residence. Education, occupation, there were no significant differences in income and economy (P0.05).
2, BMI is associated with an increased risk of positive ARC. Overweight and obesity (24.00~27.99 = 28) the incidence of ARC is about 1.6 times the normal BMI (18.50~24.99) of the (OR=1.587,95%CI:1.135~2.218, P=0.007) and 2.3 times (OR=2.315,95%CI:1.369~3.914, P=0.002) and BMI. The lowest four percentile (16.96~21.16) control compared to the group, four cases were the highest quantile (25.11~32.18) risk of a significant increase in ARC (OR=2.645,95%CI:1.887~3.656, P=0.003).
3, WHR increased with the increase of ARC risk. The risk of obesity ARC increased significantly, and the normal person (male 0.9 female 0.88 WHR; WHR) compared to WHR risk more than 0.9 men and women aged 0.88 WHR ARC were increased by 69% (OR=1.689,95%, CI:1.496~2.538, P=0.006) and 53% (OR=1.534,95%CI:1.183~2.345, P=0.019).
4, hypertension was positively correlated with ARC (OR=1.573,95%CI:1.145~2.161, P=0.005). With the increase of systolic blood pressure, the incidence of ARC increased significantly. Compared with the 140mmHg systolic blood pressure, systolic blood pressure greater than 180mmHg increase the risk of onset (OR=2.812,95%CI:1.450~5.455, P=0.002).
The relationship between hypertension status and ARC study of different BMI different, BMI normal (18.50~23.99) of the blood pressure and the occurrence of ARC. (OR=1.333,95%CI:0.819~2.170, P=0.246). However, overweight hypertension can make the risk of ARC was significantly increased (OR=1.991,95%CI: 1.160~3.419, P=0.012, BMI = 28) increased the blood pressure and the risk ARC was significantly positively correlated (OR=2.000,95%CI:1.747~5.355, P=0.008).
conclusion
1, the results suggest that obesity is an important risk factor for the occurrence of ARC, and the maintenance of normal WHR or BMI is a protective factor for the pathogenesis of ARC.
2, high blood pressure in overweight and obese people is associated with a significant increase in the risk of ARC, and maintaining normal blood pressure is beneficial to ARC.
3, the increase in systolic pressure and the course of hypertension can increase the risk of ARC, while physical activity and cycling are associated with the risk of ARC.
The maintenance of normal BMI and WHR can effectively prevent the occurrence of ARC by improving the eating habits and lifestyle.

【學位授予單位】：遼寧醫(yī)學院
【學位級別】：碩士
【學位授予年份】：2012
【分類號】：R776.1

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