摘要目的 探讨上海市曹杨新村街道≥60岁人群结膜松弛症的患病情况及其相关因素.方法 采用以社区为基础的横断面调查方法.于2008年9月至10月间采用整群随机抽样方法在上海市曹杨新村街道抽取调查点5个,对其中≥60岁2225名老年人进行调查,询问病史,采用裂隙灯显微镜进行眼部检查,并确立结膜松弛症的诊断.正式调查前先进行预试验,并进行保证调查质量的重复性检验.应用SPSS 10.0软件建立数据库,采用卡方检验完成调查数据统计分析.结果 应调查2225人,实际调查2110人,受检率为94.85%,其中确诊为结膜松弛症930例(1762只眼),人群患病率占44.08%.随着年龄增大,结膜松弛症患病率逐渐增高(χ2=10.44,P<0.01).结膜松弛症Ⅰ级556例943只眼占患眼53.52%,Ⅱ级246例647只眼占患眼36.72%,Ⅲ级120例162只眼占患眼9.19%,Ⅳ级8例10只眼占患眼0.57%.患眼组视物模糊、视疲劳、疼痛症状发生比例分别为43.02%、10.73%、9.02%,明显高于非患病组37.02%、6.79%、5.49%,差异有统计学意义(χ2值分别为15.44、20.54和19.74,P值均<0.01).松弛结膜堆积于下眼睑部位最多见于鼻侧和颞侧(944只眼,占患眼53.58%).患病眼的下睑缘位置最多见为角膜缘上型(2589只眼,占61.35%),下睑缘张力分类多为内翻型、内倾型(分别占7.04%和6.63%).患病眼泪河异常的比例(87.23%)明显高于非患病眼(24.49%)(χ2=1615.81,P<0.01).结论 结膜松弛症是年龄相关性眼病,伴有明显的眼表损伤症状、体征和泪液异常.在社区人群中,结膜松弛症多为轻度的Ⅰ级和Ⅱ级,下睑缘的位置和张力是影响结膜松弛症患病的重要因素.

abstractsObjective To investigate the prevalence and relative factors of conjunctivochalasis among people over 60 years old in Canyangxincun community of Shanghai. Methods A cross-sectional study based on local residents in this community was carried out from September 2008 to October 2008. Cluster sampling was used in randomly selecting individuals aged ≥60 years. Slit-lamp ophthalmoscope was used for eye examination and diagnosis. The survey was preceded by a pilot study where operational methods were refined and quality assurance evaluation was carried out. A database was set using SPSS 10. 0 software, Chi-square test was used for data analysis. Results 2110 residents took part in this study, with the response rate 94. 85%. 930 cases (1762 eyes) were confirmed as conjunctivochalasis, so the prevalence rate is 44.08%. The prevalence of conjunctivochalasis was increasing with age (χ2= 10. 44,P <0. 01 ). 556 cases (943 eyes) were confirmed as degree Ⅰ, 246 cases (647 eyes) as degree Ⅱ, 120 cases ( 162 eyes) as degree Ⅲ and the test 8 cases ( 10 eyes) as degree Ⅳ. Several symptoms, such as blurred vision, asthenopia and eye pain were more frequent in patient group than in the normal onos(χ2 value was 15.44, 20. 54 and 19. 74, respectively, P <0. 01 ). In the disease eyes, the conjunctiva usually piled up on the nasal and temporal side (944 eyes, 53.58% ), the location of inferior lid margin was usually above corneal limbus (2589 eyes, 61.35% ) and inferior lid margin entropion and introversion were always found (7.04% and 6. 63% ). Abnormal lacrimal river was found in 87. 23% of the diseased eyes, more than the non-conjunctivochalasis eyes (χ2 = 1615. 81, P < 0. 01 ). Conclusions Conjunctivochalasis is a common eye disease in aged population, with obvious signs and symptoms of ocular surface and lacrimal river impairment. In the local residents, most patients were classified as minimal or moderate degree. The location of inferior lid margin and the tension of inferior lid may be related factor of conjunctivochalasis.