目的:探讨玻璃体积血的原因及构成特点。方法:对以玻璃体积血为首诊的193例218眼患者的病历资料进行回顾性的原因分析。结果:在所有患者中,增生性糖尿病性视网膜病变(prolif-erative diabetic retinopathy,PDR)致玻璃体积血者最多,为72例(37.3%);其次为眼外伤47例(24.4%),再次视网膜静脉阻塞(retinal vein occlusion,RVO)36例(18.7%);孔源性视网膜脱离10例(5.2%)和视网膜静脉周围炎9例(4.7%)。汉族与少数民族玻璃体积血原因分布无明显差异(χ2=15.648,P=0.239)。各年龄组病因构成存在统计学差异(χ2=115.154,P<0.01)。年龄<45岁的青年组中,眼外伤导致玻璃体积血的最多,为37例(55.2%),其次为PDR12例(17.9%),再次为视网膜静脉周围炎9例(13.4%)。45~59岁中年组,PDR致玻璃体积血的最多,为28例(50.0%),其次为RVO14例(25.0%),再次为眼外伤7例(12.5%)。≥60岁老年组,PDR致玻璃体积血的最多,为32例(45.7%),其次为RVO21例(30.0%),再次为渗出型老年性黄斑变性5例(7.1%)。男女病因构成存在统计学差异(χ2=36.095,P<0.01)。124例男性患者的主要致病原因依次为眼外伤、PDR,RVO,视网膜静脉周围炎,分别占总男性患者人数的34.7%,32.3%,13.7%,5.7%。69例女性患者中,PDR,RVO,眼外伤、孔源性视网膜脱离为导致玻璃体积血的主要原因,分别占46.4%,27.5%,5.8%,4.4%。结论:眼外伤,PDR和视网膜静脉周围炎是青年患者玻璃体积血的主要原因,PDR,RVO及眼外伤是中年患者主要原因,PDR,RVO和渗出型老年性黄斑变性是老年患者玻璃体积血的主要原因。眼外伤、PDR,RVO,视网膜静脉周围炎是男性患者玻璃体积血的主要原因,而女性PDR,RVO,眼外伤、孔源性视网膜脱离为导致玻璃体积血的主要原因。PDR及视网膜静脉周围炎是双眼玻璃体积血的常见原因。视网膜新生血管破裂及出血和牵拉性视网膜脱离是导致多数玻璃体积血的根本原因。

·AIM:To investigate the cause of vitreous hemorrhage and constitutional characteristics.·METHODS:The clinical data of 218 eyes of 193 patients with vitreous hemorrhage were studied for the causal analysis from August 2002 to February 2007.·RESULTS:Of all the causes,proliferative diabetic retinopathy(PDR)was the principal cause(72 patients,37.3%),the second was ocular trauma(47 patients,24.4%),the third was retinal vein occlusion(RVO,36 patients,18.7%),followed by rhegmatogenous retinal detachment(10 patients,5.2%)and Eales’s disease(9 patients,4.7%).Compared to the distribution of minority,nationality and Han nation,there were no statistical differences between them(χ2=15.648,P=0.239).67 cases in youth group(<45 years old),the principal cause was ocular trauma(37 patients,55.2%),the second was PDR(12 patients,17.9%),the third was Eales’s disease(9 patients,13.4%).56 cases in middle-aged group(45-59 years old),PDR was the principal cause(28 patients,50.0%),the second was RVO(14 patients,25.0%),followed by ocular trauma(7 patients,12.5%).70 cases in old group(≥60 years old),the principal cause was PDR(32 patients,45.7%),the second was RVO(21 patients,30.0%),followed by exudative age related macular degeneration(5 patients,7.1%).There was statistically significant difference among them(χ2=115.154,P<0.01).The major causes of 124 males were ocular trauma,PDR,RVO and Eales’s disease,accounted for 34.7%,32.3%,13.7%,5.7%,respectively.The principal causes of 69 females were PDR,RVO,ocular trauma and rhegmatogen-ous retinal detachment,accounted for 46.4%,27.5%,5.8%,4.4%,respectively.There was statistically signifi-cant difference between them(χ2=36.095,P<0.01).·CONCLUSION:Ocular trauma、PDR and Eales’s disease are the main causes of the vitreous hemorrhage in youth group.PDR,RVO,ocular trauma are the main causes of the vitreous hemorrhage in middle-aged group.PDR,RVO and exudative age related macular degeneration are the main causes in old group.The major causes of males are ocular trauma,PDR,RVO and Eales’s disease.The principal causes of females are PDR,RVO,ocular trauma and rhegmatogenous retinal detachment,PDR and Eales’s disease are the major causes of bilateral vitreous hemorrh-age.The fundus neovascular cracking and bleeding and traction retinal detachment are the inherent causes.·

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