原发性高血压眼底改变相关因素分析

目的调查高血压病病人眼底改变的相关因素。方法用前置镜、直接和间接眼底镜观察52例原发性高血压病病人眼底,用等级相关分析评价高血压眼底分期及眼底动脉硬化分期与血压、年龄、总胆固醇、甘油三酯、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、空腹血糖、血尿素氮和血肌酐的关系。结果原发性高血压病52例,并发冠心病20例,糖尿病16例,脑梗死21例,肾功能不全15例。有程度不等的眼底视网膜动脉硬化51例,眼底出血1例,视网膜水肿2例,硬性渗出2例,合并出血和硬性渗出4例,合并出血、硬性渗出和棉絮样斑2例,合并水肿和硬性渗出1例,视网膜微动脉瘤1例,视网膜分支静脉阻塞1 例;等级相关分析发现高血压眼底分期和眼底动脉硬化分期与高血压危险因素分层呈正相关(r=0．278,P< 0．05),其他相关因素包括年龄和高密度脂蛋白胆固醇,但与收缩压、舒张压、总胆固醇、甘油三酯、低密度脂蛋白胆固醇、空腹血糖、血尿素氮和血肌酐无相关(P>0．05)。结论高血压眼底分期和眼底动脉硬化分期能提示高血压危险因素分层,定期检测高血压病病人眼底对预测心脑血管事件有重要意义。

Correlation factor analysis of retinal microvascular signs in essential hypertension

Objectives To investigate correlation factors of retinal microvascular signs in essential hypertension. Methods Using the indirect biomicroscopy lens, direct and the indirect ophthalmoscope,we observed retinal microvascular signs in 52 cases with essential hypertension to assess hypertensive retinopathy grade, retinal arteriosclerosis grade, and their relationship with blood pressure, age, total cholesterol, triglyceride, high density lipoprotein, low density lipoprotein, fasting blood glucose, blood urea nitrogen and creatinine with spearman method. Results Amount 52 cases of essential hypertension, 20 cases complicated with coronary heart disease, 16 cases with diabetes, 21 cases with stroke, 15 cases with kidney malfunction, 51 cases with varying extent retinal arteriosclerosis, 1 case with retinal haemorrhage, 2 cases with retinal edema, 2 cases with retinal hard exudation, 4 cases with retinal haemorrhage companied hard exudation, 2 cases with retinal haemorrhage companied both hard exudation and cotton wool spot, 1 case with retinal edema and hard exudation, 1 case with retinal microaneurysms, 1 case with retinal branch vein occlusion. The rank correlation analysis showed that either hypertensive retinopathy grade or retinal arteriosclerosis grade was correlated with hypertension dangerous factor lamination (r=0.278, P<0.05), other correlation factors included age and high density lipoprotein, but the systolic or diastolic blood pressure, total cholesterol, triglyceride, low density lipoprotein, fasting blood glucose, blood urea nitrogen and creatinine did not show any correlation (P>0.05). Conclusions Either hypertensive retinopathy grade or retinal arteriosclerosis grade indicated hypertension dangerous factor lamination. It suggests that the examination of the eye fundus of hypertensive patients would be great help to predict the incidence of cardiovascular event.