高血压患者视网膜病变与血清脂蛋白相关磷脂酶A_2的相关性研究

Correlation Between Retinopathy and Serum Lipoprotein-Associated Phospholipase A2 in Patients with Hypertension

目的:探讨高血压视网膜病变(HRP)与脂蛋白相关磷脂酶A_2(Lp-PLA_2)的相关性。方法:回顾性分析2021年7月—2022年3月深圳市福田区5个社区康复中心收治的高血压患者400例病历资料,根据疾病类型分为HRP组(n=240)与单纯高血压组(n=160);另选取同期健康体检者100例为对照组。所有入选者接受常规血压检查、谱域光学相干断层扫描检查及血清Lp-PLA_2检查。比较三组及不同血压水平高血压患者血清Lp-PLA_2水平、黄斑区中心凹血流密度、视网膜厚度及中心凹无血管区(FAZ)面积,分析HRP患者血清Lp-PLA_2水平与FAZ面积、收缩压(SBP)、最佳矫正视力(BCVA)、舒张压(DBP)等的相关性。结果:HRP组血清Lp-PLA_2水平高于单纯高血压组、对照组,黄斑区中心凹血流密度、FAZ面积均大于单纯高血压组、对照组,视网膜厚度小于单纯高血压组、对照组,差异有统计学意义(P<0.05);SBP/DBP>140/90 mmHg高血压患者血清Lp-PLA_2水平高于SBP/DBP<120/80 mmHg患者、120/80~140/90 mmHg患者,黄斑区中心凹血流密度、FAZ面积大于SBP/DBP<120/80 mmHg患者、120/80~140/90 mmHg患者,视网膜厚度小于SBP/DBP<120/80 mmHg患者、120/80~140/90 mmHg患者;Pearson分析显示,HRP患者的血清Lp-PLA_2水平与SBP、DBP、Keith-Wagener分级呈正相关(P<0.05),与BCVA呈负相关(P<0.05)。结论:HRP与血清Lp-PLA_2有关,血清Lp-PLA_2水平升高会增加患者HRP风险,通过血清Lp-PLA_2检查能够为HRP的早期筛查与预后评估提供参考。

Objective:To investigate the correlation between hypertensive retinopathy(HRP)and lipoprotein-associated phospholipase A2(Lp-PLA2).Methods:The medical record data of 400 patients with hypertension from July 2021 to March 2022 in five community health centers in Futian District of Shenzhen City were analyzed retrospectively.They were divided into HRP group(n=240)and simple hypertension group(n=160)according to the disease type;In addition,100 health examinees in the same period were collected as the control group.All participants underwent routine blood pressure examination,spectral optical coherence tomography,and serum Lp-PLA2 examination.The serum Lp-PLA2 level,foveal blood flow density,retinal thickness and foveal avascular zone(FAZ)area in the three groups and in hypertensive patients with difference blood pressure levels were compared.The correlation between the serum Lp-PLA2 level of HRP patients and FAZ area,systolic pressure(SBP),best corrected vision acuity(BCVA),diastolic pressure(DBP)was analyzed.Results:The serum Lp-PLA2 level in the HRP group was higher than that in the simple hypertension group and the control group,the foveal blood flow density and FAZ area in the HRP group were higher than those in the simple hypertension group and the control group,and the retinal thickness in the HRP group was lower than that in the simple hypertension group and the control group,and the difference was statistically significant(P<0.05).The hypertensive patients with SBP/DBP>140/90 mmHg had a higher serum Lp-PLA2 level than those with SBP/DBP<120/80 mmHg and 120/80-140/90 mmHg,a higher foveal blood flow density and FAZ area than those with SBP/DBP<120/80 mmHg and 120/80-140/90 mmHg,and a lower retinal thickness than those with SBP/DBP<120/80 mmHg and 120/80-140/90 mmHg;Pearson analysis showed that,serum Lp-PLA2 levels in HRP patients were positively correlated with SBP,DBP,Keith-Wagener grades(P<0.05)and negatively correlated with BCVA(P<0.05).Conclusion:HRP is associated with serum Lp-PLA2,and elevation of serum Lp-PLA2 level may increase the risk of HRP in patients.Serum Lp-PLA2 test can provide a reference for early screening and prognosis assessment of HRP.