非动脉炎性前部缺血性视神经病危险因素研究

Risk factors study of nonarteritic anterior ischemic optic neuropathy in a population of China

目的探讨非动脉炎性前部缺血性视神经病（NAION）的危险因素，为临床决策提供理论依据。方法通过与脑梗塞组和正常对照者进行比较，分析临床诊断为NAION患者的危险因素。纳入观察的NAION患者38例，脑梗塞患者40例，健康对照者41名。记录NAION和脑梗塞患者年龄、性别、既往史等临床资料，检查血生物化学、头颅MRI、颈部血管超声多谱勒、十二导联心电图等检测结果；测量所有研究对象杯盘比。采用SPSS11．5统计软件包对纳入分析资料进行比较分析。结果NAION组平均年龄低于脑梗塞组（P〈0．01）；高血压、糖尿病、脂代谢异常等血管病危险因素均可见与两组患者，其中糖尿病、脂代谢异常在NAION和脑梗塞组差异无统计学意义（P〉0．05）；而高血压、临床和临床下缺血性心、脑血管病以及颈动脉狭窄显著在NAION组较脑梗塞组少见（P〈0．01，0．05）。小视盘或小杯盘比在NAION组较脑梗塞和正常对照组常见且差异有统计学（P〈0．01）。结论糖代谢异常和脂代谢异常是NAION更为重要的危险因素；小杯盘比在NAION的发病中具有重要作用。

Objectives To evaluate the risk factors of nonarteritie anterior isehemie optic neuropathy（NAION）in a population of China and to provide theory basis for clinical decision. Methods Demographic features and clinical data of NAION were recorded. Cerebral infarction （CI） patients were also collected as control group. Systemic evaluations including whole blood chemical test, brain MRI, carotid artery ultrasound and fundus photography were performed in NAION and CI patients. The fundus photography and cup/disk ratio were also acquired in a healthy control group with matched age and gender. Statistical analysis was done by SPSS11. 5 software. Results Thirty-eight NAION patients and 40 CI patients with intact data were included. Fundus photography and cup/disk ratio were acquired in 41 healthy individuals. No statistically significant difference regard to incidences of diabetes, male gender and lipid metabolic abnormalities was found between NAION and CI patients （P〉 0. 05）. Hypertension, clinical and sub-clinical cerebral vascular disease and carotid artery stenosis were statistically more common in CI patients than in NAION patients （P〈 0. 01, 0. 05）. Cup/disk ratio was statistically significant smaller in NAION than in CI patients while no statistical difference （P〉0. 05） was found between the CI group and healthy individuals. Conclusions NAION shared similar risk factors with cerebral infarction, but exposure of these risk factors was different between NAION and cerebral infarction. Hypertension, cerebral vascular disease and carotid artery stenosis were more common in cerebral infarction while diabetes, male gender and lipid metabolic abnormalities were similar. Small cup/disk ratio was an independent and the most important risk factor for NAION.