Nucci Carlo, Cedrone Claudio, Culasso Franco, Cesareo Massimo, Regine Federico, Cerulli Luciano
Department of Biopathology and Diagnostic Imaging, University of Rome "Tor Vergata", Via Montpellier 1, 00133, Rome, Italy.
Graefes Arch Clin Exp Ophthalmol. 2004 Apr;242(4):289-94. doi: 10.1007/s00417-003-0837-z. Epub 2004 Jan 22.
Lens opacities are associated with a higher risk of death, although there are some discrepancies regarding the specific types of cataract representing risk. The purpose of the present study was to further investigate the relationships between different types of lens opacity and patient survival.
In 1987, 860 residents of Priverno, Italy, aged 45-69 years underwent an ophthalmologic examination. Based on patient histories and the findings of the slit-lamp examination, each of the 860 patients was classified according to the type of opacity (pure cortical, pure nuclear, pure posterior subcapsular, mixed, and surgical aphakia). The survivors of the original cohort were re-examined in 1994. Death and survival rates were computed by the Kaplan-Meier method. Associations between mortality and significant factors were included in a stepwise Cox proportional-hazards regression model.
Forty-four members of the original cohort had died during the 7-year follow-up. Age-adjusted survival curves based on Kaplan-Meier estimates showed significantly lower survival in those whose baseline examinations had revealed pure nuclear opacity (log rank test: P=0.020) and aphakia (log rank test: P<0.001). When adjusted for other mortality risk factors (age, sex, diabetes, cardiovascular diseases), the hazard ratio was 4.32 for pure nuclear opacity (95% CI 1.13-16.4) and 18.3 for aphakia (95% CI 3.21-104.0).
The analysis of the Priverno data seems to confirm an association between lower survival and cataracts, particularly those confined to the lens nucleus and those that had already prompted surgery.
晶状体混浊与较高的死亡风险相关，尽管在代表风险的特定白内障类型方面存在一些差异。本研究的目的是进一步调查不同类型的晶状体混浊与患者生存率之间的关系。
1987年，意大利普里韦尔诺的860名年龄在45 - 69岁的居民接受了眼科检查。根据患者病史和裂隙灯检查结果，860名患者中的每一位都按照混浊类型（单纯皮质性、单纯核性、单纯后囊下性、混合性和手术性无晶状体）进行了分类。原队列的幸存者在1994年接受了再次检查。采用Kaplan-Meier方法计算死亡率和生存率。死亡率与重要因素之间的关联被纳入逐步Cox比例风险回归模型。
在7年的随访期间，原队列中有44名成员死亡。基于Kaplan-Meier估计的年龄调整生存曲线显示，那些基线检查显示为单纯核性混浊（对数秩检验：P = 0.020）和无晶状体（对数秩检验：P < 0.001）的患者生存率显著较低。在对其他死亡风险因素（年龄、性别、糖尿病、心血管疾病）进行调整后，单纯核性混浊的风险比为4.32（95%可信区间1.13 - 16.4），无晶状体的风险比为18.3（95%可信区间3.21 - 104.0）。
对普里韦尔诺数据的分析似乎证实了较低的生存率与白内障之间的关联，特别是那些局限于晶状体核的白内障以及那些已经促使进行手术的白内障。
