视网膜中央静脉阻塞发病因素的病例对照观察

目的 观察视网膜中央静脉阻塞(CRVO)患者与主要的全身性疾病、眼局部疾病以及相关危险因素的关系。 方法 病例对照研究。患者组：76例病程在3个月内、经荧光素眼底血管造影(FFA)检查确诊、未进行过药物治疗的CRVO患者；对照组：76例非CRVO患者，既往无眼底血管性疾病史，以年龄和性别与患者组一对一相匹配。患者组按年龄分为≤45岁（25例，占32.9%）和＞45岁（51例，占67.1%）两个亚组；按FFA检查结果分为非缺血型（40例，占52.6%）和缺血型（36例，占47.4%）两个亚组。检测血脂、血压和空腹血糖等。各组之间分别进行全身性和眼局部性疾病以及相关危险因素的统计学比较。 结果 患者组高血压和高脂血症患病率明显高于对照组（P＜0.001，P=0.001），而心、脑血管疾病、开角型青光眼的发病率、以及吸烟和饮酒生活习性上差异无统计学意义（P＞0.05）。年龄≤45岁组中，患者组各项指标与对照组差异无统计学意义（P＞0.05）。缺血型CRVO组，除高血压和高脂血症外, 糖尿病发病率明显高于对照组（P＜0.001，P=0.031，P=0.024）。 结论 高血压和高脂血症为CRVO发病的全身性因素。此外，糖尿病与缺血型CRVO发病也相关。及时诊断和治疗全身性疾患对于CRVO的防治具有重要指导意义。 (中华眼底病杂志，2007，23：159-162)

A case-control observation on risk factors in central retinal vein occlusion

Objective To investigate the relationship among central retinal vein occlusion (CRVO), major systemic diseases, ocular local diseases and related risk factors in Chinese population. Methods Seventeen-six patients with CRVO diagnosed by fundus fluorescein angiography (FFA) without any medical treatment were in CRVO group. Another 76 patients without CRVO or any vascular diseases of ocular fundus were in the control group who were matched with the ones in CRVO group to a one-to-one partnership according to the age and gender. The 2 groups were subdivided into ≤45 years old (25 patients, 32.9%) and >45 years old (51 patients, 67.1%) subgroups according to the age, and 2 ischemia and non-ischema subgroups according to the results of FFA, respectively. The blood lipid, blood pressure, and fasting blood glucose were measured. The systematic diseases, ocular local diseases and the related risk factors were statistically analyzed and compared. Results The incidence of hypertension and hyperlipemia in CRVO group were significantly higher than that in the control group (P<0.001,P=0.001). There was no significant difference of cardiovascular diseases, cerebrovascular diseases, open-angle glaucoma, and smoking and drinking between the two groups(P>0.05). In ≤45 years old subgroups, there was no significant difference of each examination target between CRVO and control group(P>0.05). In ischemia subgroups, except for the hypertension and hyperlipemia, the incidence of diabetes mellitus was obviously higher in CRVO group than that in the control group (hyperlipidemia:P=0.031; diabetes mellitus:P=0.024; diabetes mellitus: P<0.001). Conclusion Hypertension and hyperlipidemia are the systematic factors in Chinese population with occurrence of CRVO. In addition, diabetes mellitus is associated with ischemic CRVO. Timely diagnosis and treatment of the systematic diseases is important to the prevention and treatment for CRVO. (Chin J Ocul Fundus Dis, 2007, 23:159-162)