山梨医科大学雑誌　第14巻3号　091-097(1999)

＜原著＞ 人間ドックデータと緑内障性眼底変化との関連

雨宮哲士，関希和子，笹森典雄，塚原重雄

抄 録：対象，方法：対象は平成9 年に牧田総合病院人間ドックを受診した１，９５１名（男１，６７６名，女２７５名）。眼圧，年齢，収縮期及び拡張期血圧，糖負荷検査結果，身長，体重のデータを集計し，高血圧，糖尿病，肥満，それぞれの境界群と緑内障性眼底所見（乳頭陥凹の拡大の有無と神経線維
層欠損（ＮＦＬＤ）の有無，乳頭出血を別個に集計）との関連をロジスティック回帰分析により検討した。
結果：緑内障性の眼底変化は両眼とも眼圧の上昇と関係があった。眼底所見のうち両眼NFLD の発生は年齢と関係があり（ｐ＝０．０１８），１歳毎にオッズ比は１．１５（１．０２〜１．２８：９５％信頼区間）倍ずつ上昇した。また，高血圧症と診断された症例の少なくとも片眼の緑内障性眼底変化に対しては３．８８（１．３２〜１１．４３）倍（ｐ＝０．０１４）だった。また，多重分析より年齢や眼圧に関係なく高血圧症の症例は正常とくらべて３．４６ （１．１５〜１０．４５）倍（ｐ＝０．０２７）で眼底に緑内障性の変化を指摘されていた。
結論：加齢によりＮＦＬＤの頻度は増加し，高血圧症は緑内障のリスクファクターとなる。

キーワード：緑内障，高血圧，糖尿病，肥満，加齢



Relation Between Glaucomatous Fundus Change
and Systemic Data In our Health Planning Center

Tetsuji AMEMIYA, Kiwako SEKI, Norio SASAMORI and Shigeo TSUKAHARA

Abstract: Subjects and methods: 1,951 persons (1,676 males, 275 females) who were examined at Makita General Hospital Health Planning Center in 1997 were selected. Their disc photographs were examined by ophthalmologists.　Intraocular pressure (IOP), age, systolic and diastolic blood pressure, glucose tolerance test result, height and weight were statistically analyzed in relation with disc appearance. (Enlargement of disc cupping, nerve fiber layer defect (NFLD), and disc hemorrhage were analyzed respectively.)　Subjects were divided into the following groups based on the systemic data, hypertension, diabetes mellitus, obesity and their boundary group. Logistic regression between glaucomatous fundus appearance and the other parameters were calculated.
Result: Glaucomatous optic disc was significantly related to IOP in each eye.　Relation between the occurrence of NFLD and age was significant (p = 0.018) in both eyes.　The odds ratio (OR) was 1.15 (1.02-1.28 /95% confidence limits) times per 1 year of age increase.　OR of glaucomatous fundus change in hypertensive subjects was 3.88 (1.32-11.43) times that of normotensive subjects in right and/or left eye (p = 0.0138). 　Hypertensive subjects were 3.46 (1.15-10.45) times (p = 0.027) more likely to demonstrate glaucoma on fundus photograph ragardless of age and IOP (multivariate logistic regression analysis).
Conclusion: Incidence of NFLD was increased by aging. Hypertension is a risk factor for glaucoma.

Key words: glaucoma, hypertension, diabetic mellitus, obesity, aging



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