前部缺血性视神经病变患者动态血压与视力损害关系的临床研究

Relationship between ambulatory blood pressure and visual impairment in patients with nonarteritic anterior ischemic optic neuropathy

目的探讨非动脉炎性前部缺血性视神经病变(NAION)患者动态血压参数与视力损害的关系。设计回顾性病例系列。研究对象63例确诊为NAION的患者,其中男性41例,女性22例。方法将研究对象分别按视力下降程度(0.3为界)分为低视力组(44例)和高视力组(19例);按就诊时发病眼别分为双眼发病组(20例)及单眼发病组(43例)。分别比较两组患者的一般情况、生化指标及动态血压参数。主要指标年龄、性别、体重指数、甘油三脂(TG)、总胆固醇(TC),24小时动态血压曲线形态及参数。结果双眼发病组患者的夜间舒张压(78.5±11.3 mm Hg)明显高于单眼发病组(72.2±10.8 mm Hg)(P=0.044)。低视力组患者发病年龄(57.1±10.3岁)较高视力组(47.6±9.7岁)大(P=0.001),低视力组中昼夜节律正常者比例(11.4%)明显低于高视力组(36.8%)(P=0.018)。结论 NAION患者中发病年龄大及血压24小时昼夜节律异常者视力损害更加严重。

Objectiwe To investigate the relationship between parameters of ambulatory blood pressure monitoring and the impair- ment of vision in patients with nonarteritic anterior ischemic optic neuropathy （NAION）. Design Retrospective case series. Participants sixty-three cases （41 males and 22 females） who were diagnosed as NAION were involved. Method All patients were divided into low visual group and better visual group according to the visual impairment; and divided into double eyes group and single eye group ac- cording to the affected eye in the current. General condition, biochemical indexes and parameters of ambulatory blood pressure were compared between the two groups respectively. Main Outcome Measures The age, gender, body mass index （BMI）, triglyceride （TG）, total cholesterol （TC）, the parameters and incidence of abnormal circadian rhythm of ambulatory blood pressure. Results The diastolic blood pressure at night in double eyes group （78.5±11.3 mm Hg） was significantly higher than in single eye group（72.2±10.8 mm Hg） （P=-0.044）. The age in low visual group （57.1±10.3 years） was significantly older than in better visual group （47.6±9.7 years） （P=0.001）. The incidence of normal circadian rhythm of 24-hour ambulatory blood pressure was significantly lower in low visual group （11.4%） than in better visual group（36.8%） （P=0.018）. Conclusion In terms of NAION, the patients with onset older and abnormal circadian rhythm of ambulatory blood pressure more likely to suffer poor visual acuity.