目的 分析一般人群中视力损伤和抑郁症及其交互作用对全因死亡率的影响.方法 以美国国家健康和营养检查调查(National Health and Nutrition Examination Survey,NHANES)数据库中2005～2008年招募的成年人为研究对象,并随访至2019年12月31日.采用多变量COX回归风险模型及Kaplan-Meier方法来探索视力损伤、抑郁症及其交互作用与全因死亡风险的关联.结果 研究共纳入8455例成年人,随访时间为11.71(11.20,13.48)年,最终有1473例参与者死亡.在矫正社会人口统计学和生活方式后,视力损伤(HR=1.68,95％CI:1.48～1.92)和抑郁症(HR=1.30,95％CI:1.08～1.57)与全因死亡风险增加呈独立正相关.同时,视力损伤和抑郁症之间存在相乘交互作用以增加全因死亡风险.罹患抑郁症和视力损伤的参与者发生全因死亡的风险是无抑郁症和无视力损伤参与者的2.76倍(HR=2.76,95％CI:1.90～4.00,P交互=0.013).结论 视力损伤与抑郁症是患者死亡的危险因素,且二者存在相乘交互作用.
Association of Visual Impairment,Depression,and their Interaction effects with All～Cause Mortality
Objective To analyze the effects of visual impairment,depression,and their interaction effects on all-cause mortality in the general population.Methods The study included adults recruited from the National Health and Nutrition Examination Surveys da-tabase 2005-2008,and followed up until December 31,2019.Associations of visual impairment,depression and their interaction with all-cause mortality risk were estimated using Kaplan-Meier method and multivariate COX regression risk model.Results A total of 8455 adults were included in the study.After a followed for 11.71(11.20,13.48)years,and 1473 participants died.Visual impairment(HR=1.68,95％CI:1.48-1.92)and depression(HR=1.30,95％CI:1.08-1.57)were independently associated with increased risk of all-cause mortality after adjusted for sociodemographic and lifestyle factors.Meanwhile,there was a multiplicative interaction be-tween visual impairment and depression to increase the risk of all-cause mortality.Participants with depression and visual impairment had a 2.76 fold higher risk of all-cause mortality than participants without depression and visual impairment(HR=2.76,95％CI:1.90-4.00,Pinteraction=0.013).Conclusion Vision impairment and depression are risk factors for patient death,and there is a multiplicative interaction between them.
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