福建沿海人群视网膜中央血管直径与心血管危险因素的关系

The relationships between central retinal vascular caliber and cardiovascular risk factors in a Fujian coastal population

目的探讨福建沿海人群视网膜中央血管直径与心血管危险因素的关系。方法通过横断面调查方法，纳入福建省沿海人群2169人（男812人，女1357人），年龄30．O～90．0（51．9土11．9）岁。均行心血管危险因素及眼底照片采集，应用半自动软件定量分析视网膜中央血管直径。采用单因素方差分析、协方差分析及Logistic回归分析心血管危险因素与视网膜中央血管直径的相关性。结果研究对象视网膜中央动脉直径（CRAE）平均为（134．1±11．1）μm，视网膜中央静脉直径（CRVE）为（184．0±16．6）μm；趋势检验随着平均动脉压（MABP）的增大CRAE逐渐减小，随着脉压的增大CRVE逐渐减小；Logistic逐步回归示，MABP升高是CRAE减小的危险因素，吸烟、女性与CRAE减小呈负相关（分别β=-0．307、-0．427，均P〈0．05）。年龄、MABP增加是CRVE减小的危险因素，吸烟、糖化血红蛋白（HbAlc）升高与CRVE减小呈负相关（分别β=-0．428、-0．226，P〈O．05）。结论视网膜中央动脉狭窄与血压升高相关。视网膜血管直径能反映心血管危险因素对微血管的作用。

Objective To examine the relationships between central retinal vascular caliber and cardiovascular risk factors in a Fujian coastal population. Methods It was a cross-section study involving 2169 subjects （812 male and 1357 female）, aged from 30.0 to 90.0 years old （average 51.9±11.9）. A series of surveys were conducted to ac- cess subjects cardiovascular risk factors and to have their fundus photographs taken. Semi-automatic software was used to quantitatively analyze central retinal vascular caliber and one-way analysis of variance, analysis of covariance and Logistic regression analysis to analyze the relationships between central retinal vascular caliber and blood pres- sure level; as well as other cardiovascular risk factors. Results The mean central retinal arteriolar equivalent （CRAE） was （134.1±11.1）μm, and the mean central retinal venular equivalent （CRVE） was （184.0±16.6）μm. Trend test showed that smaller CRAE was related to higher mean arterial pressure （MABP） ; smaller CRVE to lar- ger pulse pressure （PP）. The Logistic stepwise regression analysis showed that increasing MABP was a risk factor for the narrowing of central retinal artery, and the decreasing CRAE had negative correlations with both smoking and female gender （respectively β=-0. 307, -0. 427, all P〈0.05）. The increases in age and MABP were risk fac- tors for the decreasing of CRVE, and the decreasing CRVE had negative correlations with both smoking and the rise of hemoglobin Alc （HbAlc）（respectively β=-0. 428, -0. 226, all P〈0.05）. Conclusions The central retinal artery narrowing was associated with higher blood pressure level. Retinal vascular caliber may reflect the effects of cardiovascular risk factors on capillaries.