非动脉炎性前部缺血性视神经病变全身危险因素分析

目的 探讨诱发非动脉炎性前部缺血性视神经病变（non-arteritic anterior ischemic optic neuropathy， NA-AION）全身危险因素。 方法 回顾性收集2007年1月-2015年12月首都医科大学附属北京同仁医院神经内科收治的符合NAAION 诊断标准患者的病例资料，记录患者全身危险因素，包括高血压、糖尿病或糖耐量异常、高脂血 症、睡眠呼吸暂停、夜间低血压等。对不同性别的临床因素及辅助检查结果进行对比分析。 结果 共收集357例NA-AION患者的资料，其中男性240例，女性117例，平均发病年龄（50.9±9.5）岁。 单眼受累252例（70.6%），男性162例，女性90例。男性较女性双眼受累（32.5% vs 23.1%，P =0.004）、 高血压（66.3% vs 53.8%，P =0.003）、颈动脉动脉粥样硬化斑块（51.3% vs 38.5%，P =0.018）及其 他动脉粥样硬化斑块（10.0% vs 2.6%，P =0.021）比例增多，差异有统计学意义。女性心脏疾病发病 率（10.3% vs 4.6%，P =0.039）高于男性，但其中冠状动脉粥样硬化性心脏病男性多于女性（45.5% vs 8.3%，P =0.046），差异均有统计学意义。确诊为阻塞性睡眠呼吸暂停综合征（obstructive sleep apnea syndrome，OSAS）的患者108例，占所有监测患者的48.0%。夜间低氧血症患者127例，占所监测 患者的56.4%。这两种因素在男性中的发生率均高于女性（OSAS：57.1% vs 32.9%，P＜0.001；夜间低 氧血症：70.0% vs 34.1%，P＜0.001），差异有统计学意义。 结论 N A-AION男性患者多双眼受累。高血压、糖尿病、高脂血症为NA-AION的主要全身危险因素， OSAS、夜间低氧、夜间低血压亦是常见的危险因素。男性较女性全身危险因素更为突出。

General Risk Factors Analysis of Non-arteritic Anterior Ischemic Optic Neuropathy

Objective To explore the general risk factors of non-arteritic anterior ischemic optic neuropathy
(NA-AION).
Methods The clinical data of 357 NA-AION patients admitted in Beijing Tongren hospital of
Capital Medical University from January 2007 to December 2015 were collected retrospectively.
The general risk factors included hypertension, diabetes and impaired glucose tolerance,
hyperlipidemia, obstructive sleep apnea syndrome (OSAS), nocturnal hypotension, and so on.
The clinical factors and the results of auxiliary examination of different sex were compared and
analyzed.
Results There were 357 NA-AION cases in our study, including 240 male patients and 117 female
patients. The mean age of onset was (50.9±9.5) years old. About 252 cases (70.6%) were monocular
involvement, including 162 male patients and 90 female patients. The male cases were significantly
more in binocular involvement (32.5% vs 23.1%, P =0.004), hypertension (66.3% vs 53.8%, P =0.003),
carotid atherosclerotic plaque (51.3% vs 38.5%, P =0.018) and other atherosclerotic plaques (10.0% vs
2.6%, P =0.021). The female incidence (10.3%) was more than male (4.6%) of heart disease (P =0.039),
while coronary atherosclerotic heart disease cases were more in male than in female (45.5% vs 8.3%,P =0.046). OSAS was diagnosed in 108 cases (48.0%), and nocturnal hypoxemia was found in 127
patients (56.4%), and the incidence of the two risk factors were much more in male than female (OSAS:
57.1% vs 32.9%, P <0.001; hypoxemia: 70.0% vs 34.1%, P <0.001).
Conclusion Male patients are susceptible to both eyes in NA-AION. Hypertension, diabetes and
hyperlipidemia are more important general risk factors of NA-AION. OSAS, hypoxemia and
hypotension at night are common risk factors. The general risk factors are more prominent in male
NA-AION patients than in female.