视网膜血管直径与家族性高胆固醇血症的相关性研究

Retinal vascular caliber and the risk of familial hypercholesterolemia

目的探讨视网膜血管直径与家族性高胆固醇血症（FH）的相关性。方法选取2008年6月至2014年2月于首都医科大学附属北京安贞医院确诊为FH的21例患者为FH组，另外选取38例年龄、性别、血压和血糖相匹配的非FH正常者为对照组。通过彩色眼底照相及计算机辅助软件对视网膜动脉直径（CRAE）、视网膜静脉直径（CRVE）和视网膜动、静脉直径比值（AVR）分别进行测量。比较2组患者视网膜血管直径的测量值，并采用多元线性回归分析视网膜血管直径与FH的相关性。结果2组患者性别、收缩压、舒张压、空腹血糖比较，差异无统计学意义（P＞0.05）。与对照组比较，FH组CRAE和AVR数值均明显降低[CRAE：（147±6）μm比（150±4）μm，AVR：（0.65±0.05）比（0.69±0.08）]，差异有统计学意义（P＜0.05）。2组患者的CRVE比较，差异无统计学意义（P=0.90）。校正年龄及性别后，AVR减小与FH相关（P=0.03），FH越明显，AVR越小。结论FH患者的AVR较正常人群减小，视网膜血管直径改变对FH具有一定提示作用。

ObjectiveTo examine the relation between retinal vascular caliber and familial hypercholesterolemia （FH）. MethodsWe prospectively recruited 21 cases of FH and 38 control cases with matched age, gender, blood pressure and blood sugar from June 2008 to February 2014. Central retinal artery equivalent （CRAE）, central retinal vein equivalent （CRVE） and arteriovenous ratio （AVR） were assessed from baseline retinal photographs using IVAN software. CRAE, CRVE and AVR were compared with the student t test between FH group and controls. Multiple linear regression analysis was performed to evaluate the correlation between retinal vascular caliber and FH. ResultsCRAE and AVR were decreased in FH group compared with controls[CRAE：（147±6）μm vs （150±4）μm,AVR：（0.65±0.05） vs （0.69±0.08）]. The difference between the two groups was significant （P〈0.05）. Decreased AVR was associated with FH （P=0.03） after controlling age and sex. ConclusionsAVR is effective for patients with FH. The variation of retinal vascular caliber may be useful in the prediction of FH.