目的：分析玻璃体积血的病因及临床特点，为其临床诊治及预防提供一定科学依据。

方法：收集2013-03/2019-11于我院以玻璃体积血首诊且行玻璃体切除(PPV)手术治疗的患者1 413例1 437眼的病历资料进行回顾性分析。

结果：纳入患者1 437眼中，玻璃体积血致病原因前三位分别为增殖型糖尿病性视网膜病变(PDR)(37.72%)、视网膜静脉阻塞(RVO)(27.00%)及眼外伤(13.15%)。青年(≤44岁)患者308眼，玻璃体积血致病原因主要为眼外伤(35.06%)、PDR(22.73%)及Ealse病(11.69%)； 中年(45～59岁)患者590眼，玻璃体积血致病原因主要为PDR(45.08%)、RVO(28.98%)及眼外伤(10.00%)； 老年(≥60岁)患者539眼，玻璃体积血致病原因主要为PDR(38.22%)、RVO(34.69%)及视网膜裂孔和视网膜脱离(RT/RD)(7.05%)，不同年龄患者病因构成具有差异性(P=0.003)。男性患者859眼中，玻璃体积血致病原因前三位依次为PDR(36.32%)、RVO(21.65%)及眼外伤(18.98%)； 女性患者578眼中，玻璃体积血致病原因前三位依次为PDR(39.79%)、RVO(34.95%)及RT/RD(6.92%)，不同性别患者病因构成具有差异性(P<0.001)。

结论：PDR、RVO和眼外伤分别为玻璃体积血的前三位病因，不同年龄、不同性别患者导致玻璃体积血的病因有所不同，PDR、RVO为中老年患者的主要病因； 眼外伤为青年男性患者的首要病因； PDR为青年女性患者的首要病因。

METHODS: We has collected and investigate 1 413 cases(1 437 eyes)from March 2013 to November 2019 in the Second Hospital of Lanzhou University, which had treated with vitreous hemorrhage as initial diagnosis and under-went pars plana vitrectomy(PPV)treatment.

RESULTS: Among 1 437 eyes with vitreous hemorrhage, the major causes of vitreous hemorrhage were proliferative diabetic retinopathy(PDR)(37.72%), retinal vein occlusion(RVO)(27.00%), and ocular trauma(13.15%). Analysis of the etiology of the age group, among 308 eyes in the youth group, the main causes were ocular trauma(35.06%), PDR(22.73%)and Ealse disease(11.69%); 590 eyes in the middle-aged group. Based on the affected eyes, the main causes were PDR(45.08%), RVO(28.98%)and ocular trauma(10.00%); From 539 eyes in the elderly group, the main cause was PDR(38.22%)and RVO(34.69%)and retinal tears and retinal detachment(RT/RD)(7.05%). There were significant differences in the etiology of each age group(P=0.003). Gender etiology analysis showed that among 859 males with vitreous hemorrhage, the top 3 pathogenic factors were PDR(36.32%), RVO(21.65%)and ocular trauma(18.98%); among 578 female eyes, the main causes were respectively for PDR(39.79%), RVO(34.95%)and RT/RD(6.92%), there was a significant difference in etiology between males and females(P<0.001).

CONCLUSION: PDR, RVO and ocular trauma were the main causes of vitreous hemorrhage in our study. Different age groups and genders caused different causes of vitreous hemorrhage. PDR and RVO were the primary causes of vitreous hemorrhage in middle-aged and elderly men and women; Ocular trauma was the primary cause of young male patients; PDR was the primary cause of young female patients.