山东大学耳鼻喉眼学报 ›› 2020, Vol. 34 ›› Issue (4): 75-79.doi: 10.6040/j.issn.1673-3770.1.2020.043

• 眼缺血综合征多学科精准诊疗 临床研究 • 上一篇    下一篇

以医院为基础的中心性浆液性脉络膜视网膜病变流行病学调查及危险因素的研究

杨秀芬,尤冉,马秀梅,王康,王艳玲   

  1. 杨秀芬, 尤冉, 马秀梅, 王康, 王艳玲首都医科大附属北京友谊医院 眼科, 北京 100050
  • 收稿日期:2020-05-18 出版日期:2020-07-20 发布日期:2020-08-28
  • 基金资助:
    首都卫生发展科研专项资助(首发2018-1-2021);首都医科大学附属北京友谊医院科研启动基金(yyqdkt2018-18)

Prevalence and risk factors of central serous chorioretinopathy in a hospital-based population YANG Xiufen, YOU Ran, MA Xiumei, WANG Kang, WANG Yanling Department of Ophthalmology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, ChinaAbstract:Objective〓

To describe characteristics and risk factors associated with central serous chorioretinopathy(CSC)in a hospital-based outpatient sample population. MethodsIn this hospital-based cross-sectional study, CSC patients were recruited from the Beijing Friendship Hospital from 01/2019 to 12/2019. All participants underwent a standardized interview. Logistic regression models were used to assess the risk factors associated with CSC. ResultsA total of 23,878 outpatients were recorded during the period 01/2019-12/2019. Of these, 45 patients(0.19%)were diagnosed with CSC, divided in 37 male patients(82.22%)and 8 female patients(17.78%). The patients′ age ranged from 21 to 65(42.3±10.1)years. Three patients(6.67%)presented a bilateral involvement. Of all the patients, 39 were included in the present analysis. Control patients were matched for age and sex at a ratio of 1:1. The presence of CSC was associated with exposure to steroids(OR=5.04, 95% CI:1.11-22.89), sleep time(going to sleep after 12 pm)(OR=4.16, 95% CI:1.33-13.04)),and shift-work(OR=5.74, 95% CI:1.47-22.45).ConclusionsOur data showed that CSC prevalence in the analyzed outpatients was 0.19%. Exposure to steroids, sleep time, and shift-work were factors related with CSC in the observed population.   

  1. Key words: Central serous chorioretinopathy;
    Risk factors;
    Prevalence;
    Exposure to stroids;
    Sleep time;
    Shift-workers 中心性浆液性脉络膜视网膜病变(Central Serous Chorioretinopathy, CSC)是继年龄相关性黄斑变性、糖尿病视网膜病变以及视网膜静脉阻塞等疾病之后处于第四位的常见威胁视力的视网膜病变［1-2］。该病的特征是黄斑部位局限性浆液性的视网膜神经上皮层脱离, 伴或不伴有视网膜色素上皮层脱离。CSC确切病因及发病机制尚未明确。流行病学及临床资料显示该病好发于中青年, 男性多于女性;
    其他相关的危险因素有A型人格, 心理压力, 外源性或者内源性激素水平增加、吸烟等［2-6］;
    也有报道［2, 6-7］该病发生与其他全身病相关, 例如高血压、过敏性呼吸道疾病、冠心病、消化道溃疡等与其发生有关。此外, 近几年来也有研究显示工作性质(是否为轮班工作)［8-10］以及睡眠障碍等［9, 11-12］因素与CSC的发病相关。
  • Received:2020-05-18 Online:2020-07-20 Published:2020-08-28

PDF (PC)

176

摘要： 目的 探讨医院人群中心性浆液性脉络膜视网膜病变(CSC)的患病情况及相关危险因素。 方法 以医院人群为基础的回顾性横断面研究。以2019年1~12月期间就诊患者为研究对象,对符合纳入标准的CSC及同时期对照,进行电话通知并进行随访,填写调查问卷。采用SPSS软件进行统计分析。 结果 2019年1~12月期间共有23 878人次就诊于医院通州院区门诊。其中45例确诊为CSC(0.19%);男37例(82.22%),女8例(17.78%);21~65岁,平均(42.3±10.1)岁;双眼患病者3例(6.67%)。45例中39例患者接受调查,选择同期年龄、性别匹配的门诊就诊患者39例为对照,进行危险因素分析。使用logistic回归分析结果显示,与CSC患病呈独立相关的因素有外源性激素使用(OR=5.04,95%CI:1.11-22.89)、睡眠时间(24:00后)(OR=4.16, 95%CI:1.33-13.04)、轮班工作(OR=5.74, 95%CI:1.47-22.45)。 结论 在医院就诊人群中CSC的患病率0.19%,与其相关的独立因素有轮班工作、睡眠时间(24:00后)和外源性激素使用。

关键词: 中心性浆液性脉络膜视网膜病变, 危险因素, 患病率, 外源性激素, 睡眠时间, 轮班工作

Abstract: Objective To describe characteristics and risk factors associated with central serous chorioretinopathy(CSC)in a hospital-based outpatient sample population. Methods In this hospital-based cross-sectional study, CSC patients were recruited from the Beijing Friendship Hospital from 01/2019 to 12/2019. All participants underwent a standardized interview. Logistic regression models were used to assess the risk factors associated with CSC. Results A total of 23,878 outpatients were recorded during the period 01/2019-12/2019. Of these, 45 patients(0.19%)were diagnosed with CSC, divided in 37 male patients(82.22%)and 8 female patients(17.78%). The patients' age ranged from 21 to 65(42.3±10.1)years. Three patients(6.67%)presented a bilateral involvement. Of all the patients, 39 were included in the present analysis. Control patients were matched for age and sex at a ratio of 1:1. The presence of CSC was associated with exposure to steroids(OR=5.04, 95% CI:1.11-22.89), sleep time(going to sleep after 12 pm)(OR=4.16, 95% CI:1.33-13.04)),and shift-work(OR=5.74, 95% CI:1.47-22.45).Conclusions Our data showed that CSC prevalence in the analyzed outpatients was 0.19%. Exposure to steroids, sleep time, and shift-work were factors related with CSC in the observed population.

Key words: Central serous chorioretinopathy, Risk factors, Prevalence, Exposure to stroids, Sleep time, Shift-workers

中图分类号: 

  • R774.5
[1] Wang M, Munch IC, Hasler PW, et al. Central serous chorioretinopathy[J]. Acta Ophthalmol, 2008, 86(2): 126-145. doi:10.1111/j.1600-0420.2007.00889.x.
[2] Liew G, Quin G, Gillies M, et al. Central serous chorioretinopathy: a review of epidemiology and pathophysiology[J]. Clin Experiment Ophthalmol, 2013, 41(2): 201-214. doi:10.1111/j.1442-9071.2012.02848.x.
[3] 徐昌标,孙祖华,黄颖林,等. 中心性浆液性脉络膜视网膜病变患者外源性糖皮质激素使用情况调查[J]. 中华眼底病杂志, 2019, 35(4): 387-389. doi:10.3760/cma.j.issn.1005-1015.2019.04.015
[4] Daruich A, Matet A, Dirani A, et al. Central serous chorioretinopathy: Recent findings and new physiopathology hypothesis[J]. Prog Retin Eye Res, 2015, 48: 82-118. doi:10.1016/j.preteyeres.2015.05.003.
[5] Sahin A, Bez Y, Kaya MC, et al. Psychological distress and poor quality of life in patients with central serous chorioretinopathy[J]. Semin Ophthalmol, 2014, 29(2): 73-76. doi:10.3109/08820538.2013.793728.
[6] Liu B, Deng T, Zhang JJ. RISK FACTORS FOR CENTRAL SEROUS CHORIORETINOPATHY: a systematic review and meta-analysis[J]. Retina(Philadelphia, Pa), 2016, 36(1): 9-19. doi:10.1097/IAE.0000000000000837.
[7] Chen SN, Chen YC, Lian I. Increased risk of coronary heart disease in male patients with central serous chorioretinopathy: results of a population-based cohort study[J]. Br J Ophthalmol, 2014, 98(1): 110-114. doi:10.1136/bjophthalmol-2013-303945.
[8] Matet A, Daruich A, Zola M, et al. Risk factors for recurrences of central serous chorioretinopathy[J]. Retina(Philadelphia, Pa), 2018, 38(7): 1403-1414. doi:10.1097/IAE.0000000000001729.
[9] Bousquet E, Dhundass M, Lehmann M, et al. Shift work: a risk factor for central serous chorioretinopathy[J]. Am J Ophthalmol, 2016, 165: 23-28. doi:10.1016/j.ajo.2016.02.012.
[10] Sahoo NK, Singh SR, Kammari P, et al. Prevalence and profile of central serous chorioretinopathy in an Indian cohort[J]. Nepal J Ophthalmol, 2019, 11(21): 5-10. doi:10.3126/nepjoph.v11i1.25410.
[11] Ji YY, Li ML, Zhang XZ, et al. Poor sleep quality is the risk factor for central serous chorioretinopathy[J]. J Ophthalmol, 2018, 2018: 9450297. doi:10.1155/2018/9450297.
[12] Yu J, Xu GZ, Chang Q, et al. Risk factors for persistent or recurrent central serous chorioretinopathy[J]. J Ophthalmol, 2019, 2019: 1-6. doi:10.1155/2019/5970659.
[13] Kitzmann AS, Pulido JS, Diehl NN, et al. The incidence of central serous chorioretinopathy in Olmsted County, Minnesota, 1980-2002[J]. Ophthalmology, 2008, 115(1): 169-173. doi:10.1016/j.ophtha.2007.02.032.
[14] Li Y, You QS, Wei WB, et al. Prevalence and associations of central serous chorioretinopathy in elderly Chinese. The Beijing Eye Study 2011[J]. Acta Ophthalmol, 2016, 94(4): 386-390. doi:10.1111/aos.12891.
[15] Tsai DC, Chen SJ, Huang CC, et al. Epidemiology of idiopathic central serous chorioretinopathy in Taiwan, 2001-2006: a population-based study[J]. PLoS One, 2013, 8(6): e66858. doi:10.1371/journal.pone.0066858.
[16] Yang XF, Deng Y, Gu H, et al. Relationship of retinal vascular calibre and diabetic retinopathy in Chinese patients with type 2 diabetes mellitus: the Desheng Diabetic Eye Study[J]. Br J Ophthalmol, 2016, 100(10): 1359-1365. doi:10.1136/bjophthalmol-2014-306078.
[17] Meerlo P, Sgoifo A, Suchecki D. Restricted and disrupted sleep: effects on autonomic function, neuroendocrine stress systems and stress responsivity[J]. Sleep Med Rev, 2008, 12(3): 197-210. doi:10.1016/j.smrv.2007.07.007.
[18] Smolensky MH, Hermida RC, Reinberg A, et al. Circadian disruption: New clinical perspective of disease pathology and basis for chronotherapeutic intervention[J]. Chronobiol Int, 2016, 33(8): 1101-1119. doi:10.1080/07420528.2016.1184678.
[19] Zhao M, Célérier I, Bousquet E, et al. Mineralocorticoid receptor is involved in rat and human ocular chorioretinopathy[J]. J Clin Invest, 2012, 122(7): 2672-2679. doi:10.1172/JCI61427.
[20] Araki T, Ishikawa H, Iwahashi C, et al. Central serous chorioretinopathy with and without steroids: a multicenter survey[J]. PLoS One, 2019, 14(2): e0213110. doi:10.1371/journal.pone.0213110.
[1] 陈东,余红,李洋,黄强,方敏. 功能性鼻内窥镜鼻窦手术粘连的潜在危险因素及其预测价值[J]. 山东大学耳鼻喉眼学报, 2020, 34(4): 87-91.
[2] 郝文培, 翟华蕾, 孙晓彤, 张雅妮, 朱艳辉, 孔倩倩, 程钧, 张婷. 角膜再移植原因与植片失活的危险因素分析[J]. 山东大学耳鼻喉眼学报, 2020, 34(3): 134-140.
[3] 黄河,欧阳晖. 下咽癌共病食管癌的高危因素及预后分析[J]. 山东大学耳鼻喉眼学报, 2019, 33(4): 82-86.
[4] 郎永耀,杨云,刘晴,徐林弟,林子萍. 咽喉反流性疾病的影响因素及治疗效果分析[J]. 山东大学耳鼻喉眼学报, 2019, 33(3): 119-123.
[5] 姜秀颖,李元彬. 后房型人工晶体脱位的临床分析[J]. 山东大学耳鼻喉眼学报, 2019, 33(2): 105-110.
[6] 刘传合. 我国儿童哮喘患病与诊治现状[J]. 山东大学耳鼻喉眼学报, 2019, 33(1): 28-32.
[7] 崔乐,关凯,李丽莎,李俊达,王子熹,徐迎阳,王良录,尹佳. 蜜蜂研究人群中蜂毒过敏患病率及相关危险因素分析[J]. 山东大学耳鼻喉眼学报, 2019, 33(1): 63-66.
[8] 沈翎,林宗通,林兴,杨中婕. 儿童阻塞性睡眠呼吸暂停低通气综合征危险因素的[J]. 山东大学耳鼻喉眼学报, 2018, 32(2): 25-29.
[9] 王国强, 赵春红, 霍红, 龚志云, 宋伟伟, 严丽霞, 李雪华, 王伟丽. 早产儿听力筛查结果及其听力障碍危险因素[J]. 山东大学耳鼻喉眼学报, 2015, 29(4): 7-10.
[10] 刘志高, 颜世龙, 胡尊霞, 孙同鑫, 杨明, 王玉. 济南市农村白内障患者糖尿病及糖尿病视网膜眼底病变患病率调查分析[J]. 山东大学耳鼻喉眼学报, 2015, 29(1): 38-39.
[11] 葛星, 吕玲双, 潘铭, 时巧梅, 许建峰, 林友结, 孙雅慧, 神平. 打鼾相关流行病学现状及其影响因素调查研究——以徐州地区为例[J]. 山东大学耳鼻喉眼学报, 2014, 28(5): 10-13.
[12] 李学忠, 刘洪英, 李心沁, 蔡晓岚. 睡眠呼吸紊乱成人患者健康相关危险因素调查[J]. 山东大学耳鼻喉眼学报, 2014, 28(4): 6-10.
[13] 赵源庆1，郭家亮1综述张峰2审校. OSAHS与心血管疾病研究进展[J]. 山东大学耳鼻喉眼学报, 2014, 28(2): 33-37.
[14] 梅芳，陈志钧. 超低和极低出生体质量儿早产儿视网膜病变及其影响因素[J]. 山东大学耳鼻喉眼学报, 2013, 27(4): 76-78.
[15] 高荣莉1，丁见2，臧延伟3，闫舒1，刘婷婷1，刘赞刚4，宫相贵5，周晓彬6，李娜1，张念凯1. 青岛地区变应性鼻炎流行病学调查研究[J]. 山东大学耳鼻喉眼学报, 2012, 26(2): 55-60.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
No Suggested Reading articles found!
网站版权所有 © 2018 《山东大学耳鼻喉眼学报》编辑部　
地址：山东省济南市山大南路27号（250100）电话：+86-0531-88366912 E-mail: ebhxb@sdu.edu.cn
本系统由北京玛格泰克科技发展有限公司设计开发