目的：探讨中国北部地区严重玻璃体积血的病因及其影响因素。

方法：对2011-01/2014-01在中国人民解放军火箭军总医院、北京市健宫医院及西安市第四医院因玻璃体积血(玻血)行玻璃体切割手术的患者进行回顾性分析。

结果：1275例患者(1335眼)被纳入此研究。其中糖尿病视网膜病变(PDR)、视网膜静脉阻塞(RVO)、视网膜脱离/视网膜裂孔(RD/RH)、外伤、Eales病、老年性黄斑变性或息肉样脉络膜血管病变(AMD/PCV)所致玻璃体积血的总占比高达90%以上。年轻患者最常见玻璃体积血原因为外伤(40%)、PDR(19.5%)和Eales病(19.1%)； 中年患者最常见玻璃体积血原因为PDR(34.4%)、RVO(30.8%)及RD/RH(12.2%)； RVO(35.7%)、PDR(26.6%)、RD/RH(14.6%)及AMD/PCV(8%)则是老年患者玻璃体积血的主要原因。

结论：糖尿病视网膜病变、静脉阻塞及外伤是玻璃体积血最常见原因。不同年龄段中导致玻璃体积血发生的原因各有不同。PDR及RVO易出现复发性玻璃体积血，再次手术可能性大。

METHODS: Files on patients presenting with VH treated with vitrectomy between January 2011 and January 2014 were retrieved from medical records.

RESULTS:A total of 1 335 eyes of 1 275 patients(735 males, 540 females)presenting with VH were included in this study. Proliferative diabetic retinopathy(PDR), retinal vein occlusion(RVO), either retinal detachment or retinal hole(RD/RH), ocular trauma, Eales disease, and either age-related macular degeneration or polypoidal choroidal vasculopathy(AMD/PCV)constituted the etiology of VH in more than 90% of the patients. The most common causes of VH were ocular trauma(40%), PDR(19.5%), and Eales disease(19.1%)in the youth group, PDR(34.4%), RVO(30.8%), and RD/RH(12.2%)in the middle-aged group, and RVO(35.7%), PDR(26.6%), RD/RH(14.6%), and AMD/PCV(8%)in the elder group.

CONCLUSION:PDR, RVO, and ocular trauma are usually the main causes of VH. Within each group, the most common causes of VH were ocular trauma and Eales disease in the youth group, PDR, RVO, and RD/RH in the middle-aged group, and RVO, PDR, RD/RH, and AMD/PCV in the elder group. In addition, we found that males with ocular trauma are at high risk for VH, PDR and Eales disease often present bilateral VHs, and PDR and RVO have a high risk of recurrence.