目的:评估原发性获得性鼻泪管阻塞(PANDO)患者炎症状况的发生率和危险因素。
方法:对2001年至2022年以色列ClalitHealthServices(CHS)的患者进行了回顾性病例对照研究。对于每种情况,根据出生年份在所有CHS患者中匹配三个对照,性别,和种族。人口特征的差异,眼表,眼睑,上呼吸道,并评估了组间的系统性疾病,并计算比值比(OR)。
结果:共纳入60,726例诊断为PANDO的患者。PANDO患者的平均年龄为63±18岁,63%是女性。发现PANDO与各种眼表和眼睑状况之间存在显着关联,包括慢性结膜炎(OR2.96,95%CI[2.73-3.20]),春季角膜结膜炎(OR2.89,95%CI[2.45-3.29]),眼睑炎(OR2.75,95%CI[2.68-2.83])。与各种上呼吸道疾病有显著关联,包括鼻炎(OR1.62,95%CI[1.58-1.66]),慢性鼻窦炎(OR1.71,95%CI[1.62-1.80]),鼻中隔偏曲(OR1.76,95%CI[1.69-1.84])。还观察到与系统条件的关联,包括哮喘(OR1.34,95%CI[1.27-1.41])和特应性皮炎(OR1.36,95%CI[1.32-1.41])。
结论:眼表,眼睑,上呼吸道,发现全身性炎症相关疾病与PANDO有关,支持炎症在PANDO的病理生理学中具有突出作用的理论。
OBJECTIVE: To evaluate the incidence and risk factors for inflammatory conditions among patients with primary acquired nasolacrimal duct obstruction (PANDO).
METHODS: A retrospective case-control study was conducted among patients of Clalit Health Services (CHS) in Israel from 2001 to 2022. For each case, three controls were matched among all CHS patients according to year of birth, sex, and ethnicity. Differences in demographic characteristics, ocular surface, eyelid, upper airway, and systemic diseases were assessed between the groups, and odds ratios (OR) were calculated.
RESULTS: A total of 60,726 patients diagnosed with PANDO were included. The average age of PANDO patients was 63 ± 18 years, 63% were female. Significant associations were found between PANDO and various ocular surface and eyelid conditions, including chronic conjunctivitis (OR 2.96, 95% CI [2.73-3.20]), vernal keratoconjunctivitis (OR 2.89, 95% CI [2.45-3.29]), and blepharitis (OR 2.75, 95% CI [2.68-2.83]). There was a significant association with various upper airway conditions, including rhinitis (OR 1.62, 95% CI [1.58-1.66]), chronic sinusitis (OR 1.71, 95% CI [1.62-1.80]), and deviated nasal septum (OR 1.76, 95% CI [1.69-1.84]). Association was also observed with systemic conditions, including asthma (OR 1.34, 95% CI [1.27-1.41]) and atopic dermatitis (OR 1.36, 95% CI [1.32-1.41]).
CONCLUSIONS: Ocular surface, eyelid, upper airway, and systemic inflammatory-related diseases were found to be associated with PANDO, supporting the theory that inflammation has a prominent role in the pathophysiology of PANDO.