体检人群中高血压视网膜病变患病率及危险因素分析

Prevalence and risk factors of hypertensive retinopathy in a health-checkup population

目的调查体检人群中高血压视网膜病变(HRP)的患病率及危险因素。方法以2020年1至12月在北京同仁医院体检科参加健康体检的≥30岁非糖尿病人群为研究对象,进行眼底照相,收集病史,测量身高体重、收缩压、舒张压、血脂、血糖、肌酐清除率(CCR)、尿酸等指标。研究人群分为高血压组、单次血压高组、正常血压组,对比各组HRP患病率,并应用二项logistic回归分析各组HRP的危险因素。结果≥30岁非糖尿病人群HRP患病率为4.3%,校正年龄、性别、收缩压后,高血压组和单次血压高组的HRP患病率均高于血压正常组[OR值(95%CI)分别为3.11(2.25~4.30)和1.72(1.21,2.45)],以1~2级HRP为主占76.2%,3级HRP在三组间患病率比较差异无统计学意义。校正年龄、性别后,收缩压和CCR是高血压组[OR值(95%CI)分别为1.22(1.01~1.48)和1.66(1.12~2.46)]和单次血压高组[OR值(95%CI)分别为1.48(1.10~2.06)和1.95(1.03~3.46)]的独立危险因素,收缩压和舒张压是血压正常组的独立危险因素[OR值(95%CI)分别为1.68(1.07~2.63)和1.61(1.06~2.44)]。结论体检人群中有较高的HRP患病率,血压正常人群中仍有较高的3级HRP患病风险。

Objective To investigate the prevalence and risk factors of hypertensive retinopathy(HRP)in a non-diabetic population over 30 years old during routine health examinations.Methods This was a cross-sectional study of a non-diabetic population over 30 years of age.The study was conducted during routine health examinations at the Tongren Hospital,Beijing,from January to December 2020.Fundus photographs were taken,and data including medical history,height,weight,and blood pressure were collected.Routine laboratory examinations were performed.The study population was divided into hypertension,transient hypertension,and non-hypertension groups.The prevalence of HRP was compared among the three groups.OR and 95%CI of HRP risk factors was estimated by binary logistic regression,adjusted for age and gender.Results The prevalence of HRP was 4.3%in the non-diabetic population over 30 years old.Adjusted for age,gender,and systolic blood pressure,the prevalence of HRP in hypertension and transient hypertension groups,was both higher than in the non-hypertension group[OR(95%CI)of 3.11(2.25-4.30)and 1.72(1.21-2.45),respectively].The proportion of grade 1-2 HRP was higher(76.2%).There was no significant difference in the prevalence of grade 3 HRP among the three groups.Adjusted for age and gender,systolic blood pressure and creatinine clearance rate were independent risk factors for HRP in the hypertension group[OR(95%CI):1.22(1.01-1.48)and 1.66(1.12-2.46)]and transient hypertension group[OR(95%CI):1.48(1.10-2.06)and 1.95(1.03-3.46)].SBP and DBP were independent risk factors for HRP in the non-hypertension group[OR(95%CI):1.68(1.07-2.63)and 1.61(1.06-2.44)].Conclusions There was a high prevalence of HRP among the non-diabetic population over the age of 30 and there was still relatively high risk of grade 3 HRP among the normotensive population.