高血压性眼底病变的血液学指标分析

Hematological index in patients with hypertensive fundus lesions

目的分析高血压性眼底病变患者的血液学指标。方法选取眼科收治的高血压性眼底病患者96例作为研究对象,进行眼底检查并通过K-W分级标准进行分级。抽取患者空腹血测定内皮素(ET)、降钙素、血管内皮生长因子(VEGF)、纤维蛋白原、D-二聚体、空腹血糖(FBG)、TG和TC,监测舒张压(SBP)和收缩压(DBP),比较不同分级高血压性眼底病变患者的血清生化指标、相关细胞因子以及血液流变学参数。结果 96例高血压性眼底病患者中Ⅰ级33例、Ⅱ级30例、Ⅲ级21例、Ⅳ级12例。Ⅳ级患者SBP、DBP、TG、TC和FBG均显著高于Ⅰ级和Ⅱ级患者(均P<0.05)。Ⅳ级患者血清中ET、CGRP、VEGF和D-二聚体水平均显著高于Ⅰ级和Ⅱ级患者(均P<0.05)。Ⅳ级患者全血高切、全血中切、全血低切、血液黏度、血沉以及纤维蛋白原含量与Ⅰ级和Ⅱ级相比差异均有统计学意义(均P<0.05)。结论高血压患者眼底病变的分级与患者血清脂质指标、相关细胞因子以及血液流变学参数等有一定的关系。血液学指标对评估高血压靶器官损伤及病情预后的有一定的指导意义。

gObjective To evaluate the hematological indexes in patients with different stages of hypertensive fundus lesion.Methods Ninety six patients with hypertensive fundus disease were enrolled in the study. The patients were examined and graded by K-W classification. The fasting blood endothelin（ET）, calcitonin（CGRP）, vascular endothelial growth factor（VEGF）, fibrinogen, D-dimer, blood glucose（BG）, triglycerides（TG） and total cholesterol（TC） were measured; the diastolic blood pressure（DBP） and systolic blood pressure（SBP） were determined. The serum biochemical indexes, the related cytokines levels and hemorheologic parameters were compared among hypertension patients with different grades of fundus lesions. Results In 96 patients with hypertensive eye disease, there were 33 cases in stage I, 30 cases in stage Ⅱ, 21 in Ⅲ and 12 in IV. The SBP, DBP, TG, TC and BG in stage IV patients were significantly higher than those in stage I and stage Ⅱ. The levels of ET, CGRP, VEGF and d-dimer in patients with stage IV were significantly higher than those in stage I and stage Ⅱ（P0.05）.There were significant differences in hemorheological parameters of patients with different K-W classification. There were significant differences in high,medium and low whole blood viscosity, plasma viscosity and fibrinogen levels between patients with stage IV and those with phase I and Ⅱ（P0.05）. Conclusion The classification of fundus lesions in hypertensive patients is correlated with serum lipid index, cytokines levels and hemorheological parameters. Hematological indicators are important for evaluating the damage and prognosis of hypertension target organs.