原发性高血压对视网膜血管直径影响的研究

Influence of primary hypertension on retinal vessel diameter

目的 研究原发性高血压对视网膜血管直径的影响.方法 选择2012年1月至2013年12月首都医科大学附属北京安贞医院体检者179例.根据体重指数分为体型正常组（85例,高血压患者31例,正常血压者54例）和体型偏胖组（94例,高血压患者61例,正常血压者33例）.比较2组高血压患者和正常血压者视网膜血管直径的差异.结果 体型正常组高血压患者颞下动脉直径、动静脉比例明显低于正常血压者[（107±13） μm比（118±17） μm、（0.69 ±0.09）比（0.76 ±0.09）,t=2.967、3.513,P＜0.05];而二者颞上动脉直径、颞上静脉直径、颞下静脉直径比较差异无统计学意义（t=1.526、-1.422、-0.690,P＞0.05）.体型偏胖组高血压患者颞上动脉直径、颞下动脉直径、动静脉比例明显低于正常血压者[（106±15） μm比（117 ±15）μm、（111±15） μm比（121±16） μm、（0.71±0.09）比（0.77 ±0.10）,t=3.261、3.021、3.075,P＜0.05];而二者颞上静脉直径、颞下静脉直径比较差异无统计学意义（t=0.847、-0.671,P＞0.05）.体型正常组中正常血压者平均动脉压与视网膜动静脉比例呈负相关（r=-0.381,P＜0.05）,高血压患者及体型偏胖组正常血压者与高血压患者平均动脉压与视网膜动静脉比例均无明显相关性（r=-0.056、-0.156、-0.056,P＞0.05）.结论 原发性高血压患者视网膜动脉直径变细,动静脉比例下降,但不影响视网膜静脉直径.

Objective To study the influence of primary hypertension on retinal vessel diameter.Methods Total 179 medical examination cases from January 2012 to December 2013 were analyzed and divided into normal-figure group （85 cases,30 of hypertension and 54 of normal blood pressure） and overweight group （94 cases,61 of hypertension and 33 of normal blood pressure according to the body mass index）.The retinal vessel diameters of hypertension and normal blood pressure patients were compared.Results In normal-figure group,the diameter of inferior temple arteriole （IA） and arteriole venule ratio （AVR） in hypertension patients was statistically lower than that in normal blood pressure patients[（107 ± 13） μm vs （118 ± 17） μm,（0.69 ±0.09） vs （0.76 ± 0.09）,t =2.967,3.513,P 〈 0.05];nostatistical differences in the diameter of superior temple arteriole （SA）,superior temple venule diameter （SV）,and inferior temple venule （Ⅳ） were found （t =1.526,-1.422,-0.690,P 〉 0.05）.In overweight group,the diameter of SA,IA and AVR were significantly lower in hypertension patients than those in normal blood pressure patients[（106 ± 15） μm vs （117 ± 15） μm,（111 ± 15） μm vs （121 ±16） μm,（0.71 ±0.09） vs （0.77 ±0.10）,t =3.261,3.021,3.075,P〈0.05];no statistical differences in diameter of SV and Ⅳ were found （t =0.847,-0.671,P 〉 0.05）.In figure-normal group,there was a negative correlation between mean artery blood pressure （MAP） and AVR in normal blood pressure patients （r =-0.381,P 〈0.05）;no correlation was found in hypertension patients in both figure-normal group and overweight group （r =-0.056,-0.156,-0.056,P 〉 0.05）.Conclusion The diameter of retinal arteriole and AVR decrease in patients with primary hypertension.