POAG患者血管内皮功能和血液流变学指标变化及其危险因素分析

目的：探讨原发性开角型青光眼(primary open angle glaucoma，POAG)患者血管内皮功能及血液流变学指标变化及危险因素分析。

方法：POAG患者86例作为研究对象(观察组)，依据视野缺损程度分为轻度组(n=27)、中度组(n=29)和重度组(n=30)，另选取正常健康体检者30例作为对照组，分析POAG的危险因素及各组间血管内皮功能及血液流变学水平。

结果：单因素分析结果指出，对照组与观察组间患者性别比例、平均年龄、酗酒史及心血管病史比较，差异无统计学意义(P>0.05)，吸烟史、高血压史、糖尿病史及家族史比较，差异均具有统计学意义(P<0.05)； 观察组一氧化氮(nitric oxide，NO)水平显著低于对照组，且重度组水平显著低于中度组，重度组及中度组NO水平均显著低于轻度组，差异均有统计学意义(P<0.05)； 与对照组水平相比，观察组内皮素-1(endothelin-1，ET-1)、血浆粘度(plasma viscosity，PV)、红细胞压积(hematocrit，HCT)及纤维蛋白原(fibrinogen，FIB)水平均显著升高，且重度组ET-1、HCT水平显著高于中度组，重度组及中度组ET-1、HCT水平均显著高于轻度组，重度组PV及FIB水平显著高于轻度组，差异均有统计学意义(P<0.05)； Logistic回归分析结果表明，吸烟史、高血压史、糖尿病史、家族史、ET-1、PV、HCT及FIB是原发性青光眼的危险因素，NO是保护因素(P<0.05)。

结论：POAG患者存在血管内皮功能损伤及血液流变学异常，吸烟史、高血压史、糖尿病史、家族史均与POAG的发生有关。

Vascular endothelial function and hemorheological indexes in patients with POAG and its risk factors

AIM: To investigate the changes of vascular endothelial function and hemorheological indexes in patients with primary open angle glaucoma(POAG)and to analyze the risk factors of POAG.

METHODS: A total of 86 cases of POAG patients were selected as the research object(observation group), and they were divided into mild group(n=27), moderate group(n=29)and severe group(n=30)according to the visual field defect, another 30 cases normal healthy volunteers were selected as the control group. The levels of vascular endothelial function and blood hemorheology between the groups were compared, and to analysis the risk factors of the disease.

RESULTS: The results of single factor analysis showed that there was no significant difference in the sex ratio, average age, history of alcoholism and cardiovascular disease between the control group and the observation group(P>0.05); the smoking history, hypertension history, diabetes history, and family history were statistically significant(P<0.05). The level of NO in the observation group was significantly lower than that in the control group, and the level of the severe group was significantly lower than that in the moderate group, which was significantly lower than that of the mild group, and the difference was statistically significant(P<0.05). Compared with the control group, the levels of endothelin-1(ET-1), plasma viscosity(PV), hematocrit(HCT)and fibrinogen(FIB)in the observation group were significantly increased, and the ET-1 and HCT levels in the severe group were significantly higher than those in the moderate group, which were significantly higher than those in the mild group(P<0.05); and the levels of PV and FIB in the severe group were significantly higher than those in the mild group, the difference was statistically significant(P<0.05). Logistic regression analysis showed that smoking history, hypertension history, diabetes history, family history, ET-1, PV, HCT and FIB were risk factors for primary glaucoma, and NO was a protective factor(P<0.05).

CONCLUSION: There are endothelial dysfunction and hemorrheology abnormality in patients with POAG. Smoking history, hypertension history, diabetes history, family history are related to the occurrence of POAG.