视网膜动脉硬化Ⅱ级以上高血压患者眼底病变与颈动脉血流参数、斑块情况的相关性

Correlation between fundus lesions and carotid blood flow parameters,plaque condition in patients with grade Ⅱ or above hypertension

目的探讨视网膜动脉硬化Ⅱ级以上原发性高血压(高血压)患者眼底改变与颈动脉血流参数、斑块情况的相关性。方法通过TOPCON眼底照相机筛选2016年3月至2019年5月于辽宁中医药大学附属二院确诊的282例视网膜动脉硬化Ⅱ级以上的高血压患者。收集患者双眼彩色眼底图像,并进行视网膜动脉硬化及眼底改变临床分级。采集患者的颈动脉彩色多普勒超声资料[颈动脉内膜-中层厚度(intima-media thick⁃ness,IMT)、收缩峰值流速(systolic peak blood flow velocity,PSV)、舒张末期流速(end diastolic blood flow veloc⁃ity,EDV)、阻力指数(resistance index,RI)]。分析视网膜动脉硬化及眼底改变分级与颈动脉血流参数、斑块情况的相关性。结果视网膜动脉硬化分级与年龄、病程、收缩压、脉压差分布呈正相关(均P<0.05)。高血压视网膜病变分级及视网膜动脉硬化分级与颈动脉硬化程度间均存在正相关的线性关系(两者Linearby-Linear Association P与Spearman均P<0.05);高血压视网膜病变患者视网膜动脉硬化分级与颈动脉PSV、EDV呈负相关(均P<0.05)。结论视网膜动脉硬化Ⅱ级以上的高血压患者眼底病变分级与颈动脉硬化情况具有高度的相关性,能够为高血压视网膜病变患者动脉硬化程度提供一定的参考依据。

Objectives To explore the relationship of carotid blood flow parameters,plaque condition and fundus lesions in patients with gradeⅡor above hypertensive retinopathy(HR).Methods Totally 282 cases of the gradeⅡor above HR patients from March 2016 to May 2019 in The Second Affiliated Hospital of Liaoning University of Traditional Chinese Medicine were selected by TOPCON fundus camera.Clinical classifications of retinal arteriosclerosis and fundus changes were performed according to binocular color fundus image.Carotid artery intima-media thickness(IMT),systolic peak blood flow velocity(PSV),end diastolic blood flow velocity(EDV),resistance index(RI)were measured by carotid color ultrasound examination.Correlations between fundus lesions,retinal arteriosclerosis and carotid blood flow parame⁃ters,plaque condition were analyzed.Results Classification of retinal arteriosclerosis in patients with gradeⅡor above HR positively correlated with age,course of disease,systolic blood pressure and pulse pressure difference(P<0.05).There were positive linear relationships between classification of HR,classification of retinal arteriosclerosis and degree of carotid atherosclerosis(Linear-by-Linear Association P<0.05 and Spearman P<0.05).Retinal arteriosclerosis class ification in patients with HR negatively correlated with carotid PSV and EDV(P<0.05).Conclusions Classification of ocular fundus lesions and carotid atherosclerosis has a high degree of correlation in patients with gardeⅡand above HR,which can provide a certain reference basis for the degree of arteriosclerosis in patients with HR.