年龄相关性黄斑变性流行病学研究进展.doc

年龄相关性黄斑变性流行病学研究进展 武明星1，郑政1，周希瑗2 【摘要】年龄相关性黄斑变性(age—related mascular degeneration，AMD)是一种与年龄相关的致盲性退行性眼底病变，全球约有3000万老年黄斑变性患者，每年约有50 万人因此致盲 ADDIN EN.CITE ADDIN EN.CITE.DATA [ HYPERLINK \l _ENREF_1 \o Bloch, 2012 #46 1]。随着我国经济发展及人口老龄化的加剧，AMD在我国发病率呈逐年上升的趋势，现已跃居我国第三大致盲原因。目前，AMD的发病机制尚不完全明确，可能与氧化应激，炎症免疫反应，VEGF形成及遗传调控密切相关。临床上主要有光动力疗法、药物治疗、放射治疗、激光光凝、黄斑下手术、经瞳孔温热治疗、中医药治疗以及玻璃体腔注射VEGF拮抗剂如雷珠单抗、康柏西普等方法。本文主要就AMD有关的流行病学因素做一系统阐述，并重点就遗传调控方面取得的进展进行综述。 【关键词】年龄相关性黄斑变性；流行病学；遗传调控 New progresss on the research of epidemiology for age-related macular degeneration Wu Mingxing1,Zheng zheng1,Zhou xiyuan2 【Abstract】Age-related macular degeneration (AMD) is a kind of age-related blinding degenerative fundus lesions, toally about 30 million patients suffer from AMD all over the world, with about 500000 people blind for it yearly ADDIN EN.CITE ADDIN EN.CITE.DATA [ HYPERLINK \l _ENREF_1 \o Bloch, 2012 #46 1].As the development of economy and the aging of the population intensified, incidence of AMD indicates a trend of rising year by year, with being the third major cause of blindness in our country. At present, the pathogenesis of AMD is not fully clear, as reported it may be related to oxidative stress, inflammation, immune response, VEGF and genetic manipulation. Clinical treatment mainly include photodynamic therapy, drug therapy, radiation therapy, laser photocoagulation, operation, the pupil warm treatment, Chinese medicine and intravitreous injection VEGF antagonists such as ranibizumab,conbercept and so on.This issue mainly expounds on the progress in the epidemiological studies of AMD , especially elaborate the progress made on genetic manipulation in recent years. 【Key words】age-related macular degeneration, epidemiology, genetic manipulation 年龄相关性黄斑变性(age—related macular degeneration，AMD)是中央区视网膜慢性进展性疾病，临床上主要分为萎缩型与渗出型两大类：萎缩型AMD常表现为双眼视力进行性下降，可见黄斑区色素紊乱，脉络膜毛细血管萎缩和玻璃膜疣的形成。渗出型多为一眼先发病，主要特点是有脉络膜新生血管(choroidal neovascularization，CNV)的形成，以及所引起的渗出、出血、机化、瘢痕等一系列病理改变。近来年，关于AMD病因及治疗方面的研究取得了较大进展，但在世界范围