原發(fā)性開角型青光眼危險(xiǎn)因素及生存質(zhì)量研究
發(fā)布時(shí)間：2019-04-24 00:45
【摘要】：目的：探討女性原發(fā)性開角型青光眼(POAG)發(fā)病的危險(xiǎn)因素,進(jìn)行原發(fā)性開角型青光眼患者生存質(zhì)量的研究,并研究影響原發(fā)性開角型青光眼患者生存質(zhì)量的相關(guān)影響因素,為探索提高原發(fā)性開角型青光眼患者生存質(zhì)量的對(duì)策措施,綜合評(píng)價(jià)原發(fā)性開角型青光眼患者的治療和護(hù)理效果提供參考依據(jù)。 方法：采用病例對(duì)照研究的方法,收集2009-2010年間女性POAG患者128例,同期非POAG患者142例,調(diào)查兩組對(duì)象的既往青光眼家族史、高血壓、糖尿病、初潮年齡、絕經(jīng)年齡、妊娠次數(shù)、口服避孕藥的使用情況,以及激素替代療法的使用情況,并采用多因素分析的方法,分析影響POAG發(fā)病的主要因素。采用方便抽樣的方法,對(duì)2010-2011年在復(fù)旦大學(xué)附屬華山醫(yī)院眼科門診就診的原發(fā)性開角型青光眼患者進(jìn)行抽樣,共抽取符合條件的研究對(duì)象186例。以問卷和臨床檢查相結(jié)合的方式對(duì)明確診斷的原發(fā)性開角型青光眼患者進(jìn)行生存質(zhì)量及其影響因素的調(diào)查。調(diào)查內(nèi)容包括視功能損害眼病患者生存質(zhì)量、視功能檢查及生存質(zhì)量影響因素調(diào)查。 結(jié)果：女性POAG發(fā)病危險(xiǎn)因素調(diào)查的Logistic回歸分析顯示,POAG家族史(OR=48.05,4.63-410.90)、高血壓(OR=6.51,2.76-15.31)、初潮年齡晚(OR=1.42,1.04-1.95)是女性PoAG發(fā)病的危險(xiǎn)因素；絕經(jīng)年齡晚(OR=0.62,0.39-0.99)、激素替代療法(OR=0.26,0.07-0.96)是女性POAG的保護(hù)因素。 原發(fā)性開角型青光眼生存質(zhì)量及影響因素調(diào)查顯示,POAG患者生存質(zhì)量總得分(YT)為127.06+40.67,其中精神心理(YP)的得分最低,為20.37±11.85。多因素分析顯示：雙眼綜合視野(回歸系數(shù)β=-20.791,t=-7.010,P0.001)和綜合視力(回歸系數(shù)β=12.193,t=5.913,P0.001)與生存質(zhì)量得分顯著相關(guān),雙眼綜合視野缺損越輕、綜合視力級(jí)別越高的患者生存質(zhì)量總得分及各部分得分越高；有青光眼藥物副作用的患者生存質(zhì)量得分低于沒有藥物副作用的患者(回歸系數(shù)β=-13.469,t=-3.425,P=0.001)；年齡大的患者生存質(zhì)量總得分比年齡小的患者高(回歸系數(shù)β=0.579,t=4.089,P0.001),主要體現(xiàn)在社會(huì)活動(dòng)(YS)和精神心理(YP)這兩部分；文化程度高的患者生存質(zhì)量得分比文化程度低的患者高(回歸系數(shù)β=6.636,t=3.081,P=0.002)。 結(jié)論：POAG家族史和高血壓是女性POAG的發(fā)病的危險(xiǎn)因素,女性性激素可能是女性POAG的保護(hù)因素。原發(fā)性開角型青光眼患者生存質(zhì)量普遍下降,其中精神心理(YP)的得分最低,需要關(guān)注POAG患者的生存質(zhì)量,尤其應(yīng)給予必要的心理疏導(dǎo)；雙眼綜合視野缺損越輕、綜合視力級(jí)別越高的患者生存質(zhì)量相對(duì)較好；青光眼藥物的副作用可以影響患者的生存質(zhì)量,治療中除了考慮藥物療效還應(yīng)注意藥物的副作用；年齡大的POAG患者生存質(zhì)量比年齡小的患者好,要注重年輕POAG患者的心理疏導(dǎo)；文化程度高的POAG患者生存質(zhì)量相對(duì)比文化程度低的好。
[Abstract]:Objective: to investigate the risk factors of (POAG) in female patients with primary open-angle glaucoma, and to study the quality of life in patients with primary open-angle glaucoma and the related factors affecting the quality of life in patients with primary open-angle glaucoma. To explore the countermeasures to improve the quality of life of patients with primary open-angle glaucoma and to evaluate the treatment and nursing effect of patients with primary open-angle glaucoma. Methods: a case-control study was conducted to investigate the family history of glaucoma, hypertension, diabetes mellitus, menarche age and menopause age of 128 female POAG patients and 142 non-POAG patients from 2009 to 2010, and to investigate the family history of glaucoma, hypertension, diabetes mellitus, menarche age and menopause age between the two groups. The frequency of pregnancy, the use of oral contraceptive and the use of hormone replacement therapy (HRT) were analyzed. The main factors affecting the incidence of HRT were analyzed by multivariate analysis. A convenient sampling method was used to sample 186 patients with primary open angle glaucoma from 2010 to 2011 in the ophthalmology clinic of Huashan Hospital affiliated to Fudan University. The quality of life (QOL) and its influencing factors were investigated in patients with primary open-angle glaucoma diagnosed by questionnaire and clinical examination. The investigation included quality of life (QOL), visual function examination and influencing factors of QOL in patients with visual impairment. Results: Logistic regression analysis showed that the family history of POAG (OR=48.05,4.63-410.90), hypertension (OR=6.51,2.76-15.31), and hypertension (POAG) were analyzed by Logistic regression analysis. Late menarche age (OR=1.42,1.04-1.95) was the risk factor of PoAG in women. Late menopause (OR=0.62,0.39-0.99), hormone replacement therapy (OR=0.26,0.07-0.96) is the protective factor of POAG in women. A survey on the quality of life and its influencing factors in primary open angle glaucoma showed that the total quality of life score (YT) of POAG patients was 127.06 40.67, and the score of psycho-psychological (YP) was the lowest (20.37 鹵11.85). Multivariate analysis showed that Binocular comprehensive visual field (regression coefficient 尾 =-20.791, t = 7.010, P0.001) and comprehensive visual acuity (regression coefficient 尾 = 12.193, t = 5.913, P0.001) were significantly correlated with quality of life score (QOL). The lighter the comprehensive visual field defect, the higher the total score of quality of life and the score of each part of the patients with higher comprehensive visual acuity. The scores of QOL in patients with glaucoma drug side effects were lower than those without drug side effects (regression coefficient 尾 =-13.469, t = 3.425, P < 0.001). The total quality of life score of older patients was higher than that of younger patients (regression coefficient 尾 = 0.579, t = 4.089, P0.001), which was mainly reflected in social activity (YS) and psycho-psychological (YP). The quality of life score of patients with higher education level was higher than that of patients with low education level (regression coefficient 尾 = 6.636, t = 3.881, P = 0.002). Conclusion: the family history of POAG and hypertension are the risk factors of POAG in women. The female sex hormone may be the protective factor of POAG in women. The quality of life of patients with primary open-angle glaucoma is generally decreased, and the score of psycho-psychological (YP) is the lowest. It is necessary to pay attention to the quality of life of POAG patients, especially to give necessary psychological guidance. The lighter the binocular comprehensive visual field defect, the better the quality of life of the patients with higher comprehensive visual acuity, and the side effects of glaucoma drugs can affect the quality of life of the patients, in addition to considering the efficacy of drugs, attention should be paid to the side effects of drugs. The quality of life of the older POAG patients is better than that of the younger ones, so we should pay attention to the psychological guidance of the young POAG patients, and the POAG patients with high education level have better quality of life than those with the lower education level.
【學(xué)位授予單位】：復(fù)旦大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類號(hào)】：R775.2
本文編號(hào)：2463957
[Abstract]:Objective: to investigate the risk factors of (POAG) in female patients with primary open-angle glaucoma, and to study the quality of life in patients with primary open-angle glaucoma and the related factors affecting the quality of life in patients with primary open-angle glaucoma. To explore the countermeasures to improve the quality of life of patients with primary open-angle glaucoma and to evaluate the treatment and nursing effect of patients with primary open-angle glaucoma. Methods: a case-control study was conducted to investigate the family history of glaucoma, hypertension, diabetes mellitus, menarche age and menopause age of 128 female POAG patients and 142 non-POAG patients from 2009 to 2010, and to investigate the family history of glaucoma, hypertension, diabetes mellitus, menarche age and menopause age between the two groups. The frequency of pregnancy, the use of oral contraceptive and the use of hormone replacement therapy (HRT) were analyzed. The main factors affecting the incidence of HRT were analyzed by multivariate analysis. A convenient sampling method was used to sample 186 patients with primary open angle glaucoma from 2010 to 2011 in the ophthalmology clinic of Huashan Hospital affiliated to Fudan University. The quality of life (QOL) and its influencing factors were investigated in patients with primary open-angle glaucoma diagnosed by questionnaire and clinical examination. The investigation included quality of life (QOL), visual function examination and influencing factors of QOL in patients with visual impairment. Results: Logistic regression analysis showed that the family history of POAG (OR=48.05,4.63-410.90), hypertension (OR=6.51,2.76-15.31), and hypertension (POAG) were analyzed by Logistic regression analysis. Late menarche age (OR=1.42,1.04-1.95) was the risk factor of PoAG in women. Late menopause (OR=0.62,0.39-0.99), hormone replacement therapy (OR=0.26,0.07-0.96) is the protective factor of POAG in women. A survey on the quality of life and its influencing factors in primary open angle glaucoma showed that the total quality of life score (YT) of POAG patients was 127.06 40.67, and the score of psycho-psychological (YP) was the lowest (20.37 鹵11.85). Multivariate analysis showed that Binocular comprehensive visual field (regression coefficient 尾 =-20.791, t = 7.010, P0.001) and comprehensive visual acuity (regression coefficient 尾 = 12.193, t = 5.913, P0.001) were significantly correlated with quality of life score (QOL). The lighter the comprehensive visual field defect, the higher the total score of quality of life and the score of each part of the patients with higher comprehensive visual acuity. The scores of QOL in patients with glaucoma drug side effects were lower than those without drug side effects (regression coefficient 尾 =-13.469, t = 3.425, P < 0.001). The total quality of life score of older patients was higher than that of younger patients (regression coefficient 尾 = 0.579, t = 4.089, P0.001), which was mainly reflected in social activity (YS) and psycho-psychological (YP). The quality of life score of patients with higher education level was higher than that of patients with low education level (regression coefficient 尾 = 6.636, t = 3.881, P = 0.002). Conclusion: the family history of POAG and hypertension are the risk factors of POAG in women. The female sex hormone may be the protective factor of POAG in women. The quality of life of patients with primary open-angle glaucoma is generally decreased, and the score of psycho-psychological (YP) is the lowest. It is necessary to pay attention to the quality of life of POAG patients, especially to give necessary psychological guidance. The lighter the binocular comprehensive visual field defect, the better the quality of life of the patients with higher comprehensive visual acuity, and the side effects of glaucoma drugs can affect the quality of life of the patients, in addition to considering the efficacy of drugs, attention should be paid to the side effects of drugs. The quality of life of the older POAG patients is better than that of the younger ones, so we should pay attention to the psychological guidance of the young POAG patients, and the POAG patients with high education level have better quality of life than those with the lower education level.
【學(xué)位授予單位】：復(fù)旦大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類號(hào)】：R775.2
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