高血压与视盘周视网膜神经纤维层厚度的相关性分析

Correlation between hypertension and peripapillary retinal nerve fiber layer thickness

目的:探讨高血压与视盘周视网膜神经纤维层厚度(pRNFL)的相关性。方法:选取2021-2022年在郴州市第一人民医院健康管理中心体检的高血压患者46例,选取同期体检的健康志愿者39例为对照组,所有受检者均完善体质量指数、血糖、血脂等检查,应用OCT测量pRNFL平均值及各象限厚度。采用Spearman秩相关对pRNFL厚度与血压相关性进行分析,采用多元线性回归探讨各象限pRNFL厚度的影响因素。结果:高血压组pRNFL平均厚度、上方、下方、颞侧pRNFL厚度薄于健康组,差异有统计学意义(P<0.05);年龄与pRNFL平均厚度呈负相关(P<0.05);高血压病史、收缩压、舒张压与pRNFL平均厚度、上方、下方和颞侧pRNFL厚度呈负相关(P<0.05);体质量指数与pRNFL平均值、下方和颞侧pRNFL厚度呈负相关(P<0.05);高血压病史是pRNFL平均厚度、上方、下方、颞侧pRNFL厚度的独立影响因素;体质量指数是颞侧pRNFL厚度的独立影响因素。结论:高血压病可使pRNFL厚度变薄,使用OCT测量pRNFL厚度分析青光眼视神经病变进展时,应同时考虑高血压对pRNFL的影响。

Objective To investigate the correlation between hypertension and the thickness of peripapillary retina nerve fiber layer(pRNFL).Methods 46 hypertensive patients and 39 health control cases were recruited from 2021 to 2022 in theHealthManagement CenterChenzhoufirstPeople'sHospital,all the participants underwent medical examinations include lipids,blood pressure,glucose and body mass index(BMI)and so on,pRNFL were measured by OCT.The correlation between pRNFL thickness and blood pressure were analyzed by Spearman rank correlation.Multiple stepwise regression was used to explore the influencing factors of pRNFL thickness in each quadrants.Results The average pRNFL,superior pRNFL,inferior pRNFL and temporal pRNFL thickness in the hypertensive group were thinner than those in the healthy group,and the difference was statistically significant(P<0.05),Age was negatively correlated with average pRNFL thickness.History of hypertension,systolic blood pressure and diastolic blood pressure were significantly negatively correlated with average pRNFL,superior pRNFL,inferior pRNFL and temporal pRNFL thickness.BMI was negatively correlated with average pRNFL,inferior pRNFL and temporal pRNFL thickness.The history of hypertension was an independent influencing factor of average pRNFL,superior RNFL,inferior pRNFL thickness and temporal pRNFL.BMI was an independent influencing factor of temporal pRNFL thickness.Conclusions Hypertension can make the thickness of pRNFL thinner.When using OCT to measure the thickness of pRNFL to analyze glaucoma optic neuropathy progression,the influence of hypertension on pRNFL should be considered.