高血压人群微量蛋白尿与眼底血管直径的关系

 目的 探讨福建省沿海地区高血压人群尿微量白蛋白肌酐比值（UACR）与眼底血管直径的相关性。方法 免散瞳眼底照相测得视网膜中央动/静脉直径（CRAE/CRVE），并测定尿微量白蛋白及尿肌酐。结果 (1)正常对照组、高血压非蛋白尿组、高血压蛋白尿组间CRAE差异有统计学意义［（135.68±10.10)μm、(129.79±10.48)μm、(125.29±11.17）μm，P＜0.01］；(2)CRAE与UACR呈负相关（r=-0.29，P＜0.01）；(3)线性回归分析显示高血压人群UACR与CRAE相关（β=-5.0，P＜0.01）；(4)logistic回归分析显示收缩压为CRAE异常的危险因素（β=1.08，P=0.02），正常对照、高血压非蛋白尿、高血压伴蛋白尿三者CRAE异常率依次增高（P＜0.01）。结论 视网膜中央动脉直径的缩小与高血压肾损害存在相关性，UACR和CRAE可共同评估高血压微小血管病变，成为评价高血压靶器官损害的指标。   

The relationship between association of microalbuminuria and retinal vessel diameter in population with essential hypertension

Objective To investigate the association of urinary albumin-to-creatinine ratio (UACR) and the diameter of retinal vessel in population with essential hypertension in Fujian coastal area.MethodsCentral retinal artery and vein equivalents (CRAE and CRVE) were measured from the avoiding mydriatic digitized photographs and semi-automatic fundus analysis software, as well as albumin and urine creatinine.Results There were significant differences in CRAE levels among the normal control group, normoalbuminuria with essential hypertension group and microalbuminuria with essential hypertension group ［(135.68±10.10)μm, (129.79±10.48)μm, (125.29±11.17)μm, all P values＜0.01］. The CRAE levels were significantly negative correlated with UACR (r=－0.29, P＜0.01). Linear regression analysis showed CRAE was associated with UACR in the patients with hypertension(β=－5.0, P＜0.01). Logistic regression analysis showed, systolic blood pressure (β=1.08, P=0.02) was risk factor for CRAE abnormality. The CRAE abnormality was increased in turn in the normal control group, normoalbuminuria with the essential hypertension group and microalbuminuria with essential hypertension group (P＜0.01).Conclusion The reduction of central retinal artery diameter are associated with the hypertensive renal damage. UACR and CRAE could be used to evaluate the microvascular lesions and be used as an indicator to assess the target organs damage in essential hypertension patients.