原发性闭角型青光眼合并白内障患者术前临床特征及其术后预测价值分析

doi:10.3969/j.issn.1006-6233.2025.12.023

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摘要 目的: 探讨原发性闭角型青光眼(PACG)合并白内障患者术前临床特征及其术后预测价值。方法: 选择2021年10月至2024年11月于本院行手术治疗的107例PACG合并白内障患者,根据术后3个月预后情况分为预后良好组及预后不良组。单因素分析两组术前临床特征,多因素Logistic回归分析各影响因素与PACG合并白内障患者术后预后不良的相关性,并使用ROC曲线评价其预测价值。结果: 与预后良好组相比,预后不良组术前房角完全关闭、高血压史、糖尿病史、高脂血症史、吸烟史、饮酒史占比增加,眼压波动较大(P<0.05);前房深度较浅,眼轴长度较短(P<0.05)。术前高脂血症史、前房深度浅、眼轴短、眼压波动大是PACG合并白内障患者术后预后不良的影响因素(P<0.05)。ROC曲线分析高脂血症史、前房深度、眼轴长度、眼压波动检测效能较高,且联合检测高于单项检测。结论: 术前高脂血症史、前房深度、眼轴长度、眼压波动与PACG合并白内障患者术后预后不良密切相关,且预测效能较高。

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关键词 ：原发性闭角型青光眼, 白内障, 术前临床特征, 预测价值

Abstract：Objective: To investigate the preoperative clinical features and postoperative predictive value of primary angle-closure glaucoma (PACG) patients with cataract. Methods: A total of 107 patients with PACG complicated with cataract who underwent surgical treatment in our hospital from October 2021 to November 2024 were selected. According to the prognosis at 3 months after surgery, they were divided into good prognosis group and poor prognosis group. Univariate analysis was used to analyze the preoperative clinical characteristics of the two groups. Multivariate logistic regression analysis was used to analyze the correlation between various influencing factors and poor postoperative prognosis in patients with PACG and cataract, and ROC curve was used to evaluate its predictive value. Results: The poor prognosis group had a higher percentage of complete closure of the anterior chamber angle, hypertension history, diabetes history, hyperlipidemia history, smoking history, and drinking history compared to the good prognosis group. Additionally, the intraocular pressure fluctuated significantly (P<0.05), the anterior chamber depth was shallower, and the axial length was shorter (P<0.05). Preoperative hyperlipidemia history, shallow anterior chamber depth, short axial length and large fluctuation of intraocular pressure were the influencing factors of poor prognosis in PACG patients with cataract (P<0.05). ROC curve analysis showed that the detection efficiency of hyperlipidemia history, anterior chamber depth, axial length and intraocular pressure fluctuation was higher, and the combined detection was higher than that of single detection. Conclusion: Preoperative hyperlipidemia history, anterior chamber depth, axial length and intraocular pressure fluctuation are closely related to the poor prognosis of PACG patients with cataract, and the prediction efficiency is high.

Key words： Primary angle-closure glaucoma Cataract Preoperative clinical characteristics Predictive value

基金资助:安徽省卫生健康科技计划项目,(编号:AH2021jk021)

引用本文:

董云云, 邓吉安, 杨洋. 原发性闭角型青光眼合并白内障患者术前临床特征及其术后预测价值分析[J]. 河北医学, 2025, 31(12): 2078-2084.
DONG Yunyun, DENG Ji'an, YANG Yang. Analysis of Preoperative Clinical Characteristics and Postoperative Predictive Value of Patients with Primary Angle-Closure Glaucoma Complicated with Cataract. HeBei Med, 2025, 31(12): 2078-2084.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2025.12.023 或 http://www.hbyxzzs.cn/CN/Y2025/V31/I12/2078

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