老年人眼底微血管病变与急性冠脉事件发生的关系

Retinal microvascular disease and acute coronary event risk in aged Chinese cohort

目的探讨老年人眼底微血管病变与急性冠脉事件(ACE)发生的关系。方法采用前瞻性社区研究方法,对济宁市兴隆庄煤矿社区年龄≥60岁的居民(排除ACE病史)进行问卷调查、体格检查和实验室检查,并进行眼底照相。按照统一的随访方案和诊断标准对心脑血管病事件及死亡事件的发生情况进行随访登记。应用Cox比例风险模型对眼底微血管病变与ACE发病危险进行多因素分析。结果对1 370例调查对象随访3 a,随访结束时发生终点事件256例,主要终点事件101例,ACE的发病率为292.5/万人年。其中眼底血管正常、轻度异常、中重度异常者的ACE发病率分别为242.8/万人年、293.2/万人年、640.8/万人年。多因素Cox回归分析显示,年龄、吸烟、眼底微血管病变、高血压是ACE发生的独立危险因素。结论眼底微血管病变是ACE发生的独立危险因素;眼底微血管病变病情越重,ACE发病率越高。

Objective To evaluate the association between retinal microvascular disease and acute coronary event in aged. Methods A 3-year prospective study was conducted among aged people who were taken physical examination, reti- nal vasography and a baseline examination by study physicians. Cox multivariate proportional hazards regressionl was ap- plied to explore various factors to ACE. Results During the 3 years follow-up, there were 256 incidences of endpoint e- vent and 101 incidences of major endpoint event observed. The morbidity of ACE were 292.5/10 000 person-years. In reti- nal microvascnlar normal group, mildly abnormal group and moderate-severe group, the morbidity of ACE were 242.8, 293.2, 640.8/10 000 person-years. The Cox multivariate proportional hazards regression showed smoking, retinal micro- vascular disease, hypertension and age were found to be the influencing factors for the occur of ACE. Conclusions In the aged Chinese cohort, retinal microvascular disease are the independent risk factor for ACE, retinal microvascular lesion condition is heavier, the higher the incidence of ACE.