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中国中老年人白内障手术发生率及影响因素的前瞻性队列研究

金鑫 梁晨 郭帅 郑晓瑛

金鑫, 梁晨, 郭帅, 郑晓瑛. 中国中老年人白内障手术发生率及影响因素的前瞻性队列研究[J]. 中华疾病控制杂志, 2024, 28(3): 303-309. doi: 10.16462/j.cnki.zhjbkz.2024.03.009
引用本文: 金鑫, 梁晨, 郭帅, 郑晓瑛. 中国中老年人白内障手术发生率及影响因素的前瞻性队列研究[J]. 中华疾病控制杂志, 2024, 28(3): 303-309. doi: 10.16462/j.cnki.zhjbkz.2024.03.009
JIN Xin, LIANG chen, GUO Shuai, ZHENG Xiaoying. Cataract surgery incidence and influencing factors in middle-aged and elderly Chinese: a prospective cohort study[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2024, 28(3): 303-309. doi: 10.16462/j.cnki.zhjbkz.2024.03.009
Citation: JIN Xin, LIANG chen, GUO Shuai, ZHENG Xiaoying. Cataract surgery incidence and influencing factors in middle-aged and elderly Chinese: a prospective cohort study[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2024, 28(3): 303-309. doi: 10.16462/j.cnki.zhjbkz.2024.03.009

中国中老年人白内障手术发生率及影响因素的前瞻性队列研究

doi: 10.16462/j.cnki.zhjbkz.2024.03.009
基金项目: 

国家社会科学基金重大项目 21ZD107

国家科技重大专项 SQ2022YFC3600291

详细信息
    通讯作者:

    郑晓瑛,E-mail:zhengxiaoying@sph.pumc.edu.cn

  • 中图分类号: R181.2

Cataract surgery incidence and influencing factors in middle-aged and elderly Chinese: a prospective cohort study

Funds: 

Major Project of the National Social Science Fund of China 21ZD107

The National Key Research and Development Program SQ2022YFC3600291

More Information
  • 摘要:   目的  探讨我国中老年人(≥45岁)白内障手术发生率及影响因素。  方法  采用前瞻性队列研究设计,利用2011―2018年中国健康与养老追踪调查数据,跟踪12 522名中老年人队列白内障手术发生状况,采用logistic回归分析模型分析白内障手术发生率及其影响因素。  结果  共计12 522名中老年人参加2011―2018年的连续4轮随访,7年期间白内障手术发生率为2.89%,其中≥60岁老年人7年期间白内障手术发生率为5.34%,呈上升趋势。Logistic回归分析模型显示,年龄较大、女性、远视力或近视力较差、患有糖尿病、教育程度较低、家庭人均周支出较低均与白内障手术发生的增加显著关联(OR=1.072,95% CI: 1.071~1.074,P < 0.001;OR=1.141,95% CI: 1.108~1.176,P=0.030;OR=1.587,95% CI: 1.531~1.646,P < 0.001;OR=1.445,95% CI: 1.394~1.499,P < 0.001;OR=1.474,95% CI: 1.417~1.533,P < 0.001;OR=0.867,95% CI: 0.840~0.895,P=0.002;OR=0.982,95% CI: 0.966~0.997,P=0.019),对风险人群如≥60岁和远视力状况较差的老年人分析中有相似的结果,但社会经济因素已不再是白内障手术发生的主要影响因素。  结论  个体的人口特征和慢性病患病情况明显影响白内障手术发生率,相关部门推广的眼保健项目有助于减少社会经济因素对接受白内障手术的影响提高老年人白内障手术可及性综合考虑健康状况和眼健康服务对白内障手术促进计划至关重要。
  • 图  1  样本筛选流程图

    Figure  1.  Flow chart of sample screening

    表  1  队列研究对象基本特征

    Table  1.   Characteristics of the study cohort

    变量名称Variable 白内障手术 Cataract surgery t/χ2值value P值value
    是Yes(n=363) 否No(n=12 159)
    年龄/岁Age /years 64.72±8.53 57.51±8.60 -15.752 < 0.001
    远视力状况Distance vision status 45.421 < 0.001
      一般/不好Poor or fair 283(77.96) 7 350(60.45)
      极好/很好/好Excellent, very good and good 80(22.04) 4 809(39.55)
    近视力状况Near vision status 25.823 < 0.001
      一般/不好Poor or fair 287(79.06) 8 062(66.30)
      极好/很好/好Excellent, very good and good 76(20.94) 4 097(33.70)
    高血压Hypertension 5.711 < 0.001
      有Yes 182(50.14) 5 328(43.82)
      无No 181(49.86) 6 831(56.18)
    糖尿病Diabetes 8.252 < 0.001
      有Yes 55(15.15) 1 270(10.44)
      无No 308(84.85) 10 889(89.56)
    性别Gender 4.737 0.030
      男性Male 153(42.15) 5 829(47.94)
      女性Female 210(57.85) 6 330(52.06)
    文化状况Literacy 35.532 < 0.001
      非文盲Literate 218(60.06) 9 003(74.04)
      文盲Illiterate 145(39.94) 3 156(25.96)
    抑郁得分Depression score 9.14±6.30 8.27±6.28 -2.524 0.012
    户口类型Hukou 1.184 0.553
      农业户口Rural 302(83.20) 9 845(80.98)
      其他户口类型Non-rural 61(16.80) 2 312(19.02)
    家庭人均周支出的对数Log household per capita expenditure 4.57±0.97 4.70±0.87 2.352 0.019
    医疗保险Health insurance 0.983 0.912
      仅有公立保险Public insurance 334(93.04) 11 035(91.97)
      仅有私立保险Private insurance 2(0.56) 89(0.74)
      既有公立保险又有私立保险Both public and private insurance 4(1.11) 195(1.62)
      既没有公立保险又没有私立保险Neither public nor private Insurance 19(5.29) 680(5.67)
    地区特征Geographical location 0.701 0.704
      东部地区Eastern region 132(36.36) 4 165(34.25)
      中部地区Central region 117(32.23) 4 029(33.14)
      西部地区Western region 114(31.41) 3 965(32.61)
    婚姻状态Marital status 3.709 0.054
      已婚与同居Married and cohabiting 296(81.54) 10 906(89.69)
      其他Not married 67(18.46) 1 253(10.31)
    注:①以人数(占比/%)或x±s表示。
    Note: ① Number of people (proportion/%) or x±s.
    下载: 导出CSV

    表  2  2011―2018年中国中老年人(≥45岁)白内障手术发生影响因素logistic回归分析

    Table  2.   Logistic regression analysis of factors influencing the occurrence of cataract surgery among middle-aged and elderly people(≥45 years) in China, 2011-2018

    基线特征Baseline characteristic 单变量模型Univariate model 多变量模型Multivariate model
    β值value OR值value (95% CI) P值value β值value OR值value (95% CI) P值value
    年龄/岁Age/years 0.082 1.086(1.074~1.098) <0.001 0.070 1.072(1.071~1.074) <0.001
    远视力状况Distance vision status <0.001 <0.001
      一般/不好Poor or fair 1.000 1.000
      极好/很好/好Excellent, very good and good 0.839 2.315(1.801~2.974) 0.462 1.587(1.531~1.646)
    近视力状况Near vision status <0.001 <0.001
      一般/不好Poor or fair 1.000 1.000
      极好/很好/好Excellent, very good and good 0.652 1.919(1.486~2.478) 0.368 1.445(1.394~1.499)
    性别Gender 0.030 0.030
      男性Male 1.000 1.000
      女性Female 0.234 1.264(1.023~1.561) 0.132 1.141(1.108~1.176)
    高血压Hypertension <0.001 0.010
      否No 1.000 1.000
      是Yes 0.235 1.264(1.231~1.297) -0.037 0.937(0.937~0.991)
    糖尿病Diabetes <0.001 <0.001
      否No 1.000 1.000
      是Yes 0.396 1.486(1.432~1.542) 0.388 1.474(1.417~1.533)
    文化状况Literacy <0.001 0.002
      文盲Illiterate 1.000 1.000
      非文盲Literate -0.640 0.527(0.426~0.653) -0.143 0.867(0.840~0.895)
    抑郁量表平均得分Mean depression score 0.020 1.020(1.018~1.022) <0.001 -0.001 0.999(0.997~1.002) 0.858
    平均家庭人均支出对数Log household per capita expenditure -0.206 0.814(0.723~0.916) <0.001 -0.019 0.982(0.966~0.997) 0.019
    注:高血压、是否患糖尿病和抑郁量表平均得分均根据年龄结构进行了调整。
    Note: Hypertension, diabetes status, and the average depression score were adjusted for age structure.
    下载: 导出CSV

    表  3  2011―2018年中国老年人(≥60岁且基线自报远视力一般/差)白内障手术发生影响因素logistic回归分析

    Table  3.   Logistic regression analysis of factors influencing the occurrence of cataract surgery in elderly (≥60 years and baseline self-reported fair/poor distance vision) in China, 2011-2018

    基线特征Baseline characteristic 单变量模型Univariate model 多变量模型Multivariate model
    β值value OR值value(95% CI) P值value β值value OR值value(95% CI) P值value
    年龄/岁 Age/years 0.058 1.058(1.036~1.082) <0.001 0.054 1.056(1.053~1.059) <0.001
    近视力状况Near vision status 0.350
      一般/不好Poor or fair 1.000
      极好/很好/好Excellent, very good and good 0.190 1.210(0.881~1.904)
    性别Gender 0.055 <0.001
      男性Male 1.000 1.000
      女性Female 0.286 1.331(0.994~1.783) 0.236 1.266(1.218~1.315)
    高血压Hypertension <0.001 <0.001
      否No 1.000 1.000
      是Yes 0.083 1.087(1.050~1.125) 0.219 1.245(1.202~1.290)
    糖尿病Diabetes <0.001 <0.001
      否No 1.000 1.000
      是Yes 0.346 1.414(1.347~1.484) 0.452 1.571(1.496~1.651)
    文化状况Literacy 0.013 <0.001
      文盲Illiterate 1.000 1.000
      非文盲Literate -0.365 0.694(0.520~0.926) -0.125 0.883(0.849~0.918)
    抑郁量表平均得分Mean depression score 0.001 1.000(0.998~1.004) 0.474
    平均家庭人均支出对数Log household per capita expenditure -0.022 0.978(0.832~1.150) 0.790
    注:高血压、是否患糖尿病和抑郁量表平均得分均根据年龄结构进行了调整。
    Note: Hypertension, diabetes status, and the average depression score were adjusted for age structure.
    下载: 导出CSV
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  • 收稿日期:  2023-05-19
  • 修回日期:  2024-01-09
  • 网络出版日期:  2024-04-08
  • 刊出日期:  2024-03-10

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