原发性高血压患者眼底改变与动态血压关系的研究

Relationships between Retinal Arteriosclerosis and Essential Hypertension

为了探讨原发性高血压 (以下简称高血压 )患者血压与眼底改变的关系 ,分别观察 1 86例轻中度高血压患者的脉压、诊所舒张压、2 4h平均舒张压、血压负荷及夜间血压下降率与眼底小动脉改变的关系。结果 :1 86例患者中 ,眼底正常 46例 ( 2 4.7% ) ,Ⅰ级改变 1 1 6例 ( 62 .4% ) ,Ⅱ级改变 2 4例 ( 1 2 .9% )。眼底正常组左室肥厚 (LVH)的发生率为 1 0 .9% ( 5 /46) ,而眼底异常组的发生率为 89.3 % ( 1 2 5 /1 40 )。诊所舒张压≥ 1 3 .3kPa( 1 0 0mmHg)、2 4h舒张压≥ 1 2 .0kPa( 90mmHg)的高血压组与其对应组相比眼底改变有显著性差异 (P分别 <0 .0 5、<0 .0 1 ) ;舒张期血压负荷超过 40 %组与对应组比较眼底改变有显著性差异 (P <0 .0 5 ) ,而收缩压负荷、杓型与非杓型血压及不同脉压差组的眼底变化组间比较无显著性差异 (P >0 .0 5 )。提示 :无合并症的轻中度高血压患者早期眼底改变大多为Ⅰ级 ,受舒张压的影响较明显 ,视网膜动脉硬化的程度也提示高血压的时限及病情。

The aim of the present study was to assess the risk of retinal arteriosclerosis at different ambulatory blood pressures (ABP) in essential hypertensive patients. Subjects were males and females, aged between 14 and 73 years, suffering from mild to moderate essential hypertension. BP data was obtained by using Spacelabs monitors for a full 24 h. The retinal artery were examined using fundscope. The results showed significant differences in the degree of retinal arteriosclerosis between groups with different clinical diastolic blood pressure (DBP) and different DBPL ( P <0.05). No similar finding was between retinal artery and the difference of pulse pressure and night BP decreasing rate. The proportion of first grade retinal arteriosclerosis in hypertensives patient was 62.4%. It is suggested that retinal arteriosclerosis(gradeⅠ) was more closely related with DBP in most of the subjects suffering from mild to moderate essential hypertension, coexisted with LVH.