视网膜血管直径与高血压、白蛋白尿的关系探讨

Cross sectional study on the relationship of retinal vascular diameter with hypertension and albuminuria

目的视网膜血管是活体状态下唯一可通过无创方式观察到的血管,其病变可能会反映肾脏血管病变,而微循环系统的异常又可影响到体循环血压的变化。本文将针对这三者之间的关系进行研究。方法采用横断面研究,入组5 541人,测量尿白蛋白/尿肌酐、视网膜中央动脉直径、视网膜中央静脉直径及血压等指标;应用SPSS 17. 0计算相关性。结果视网膜动脉直径最小组白蛋白尿发生风险是最大组的1. 24倍(95%CI 1. 02～1. 51),视网膜静脉直径变化与白蛋白尿的发生无相关性。在经多因素调整后,高血压病人群整体发生白蛋白尿的风险较高,是对照组的1. 41倍(95%CI 1. 21～1. 64)。视网膜动脉狭窄合并高血压病时,发生白蛋白尿的风险最高,是对照组的1. 69倍(95%CI 1. 31～2. 19)。结论视网膜动脉狭窄与白蛋白尿发生独立相关,视网膜静脉直径变化与白蛋白尿发生无明显相关性。高血压病人群整体发生白蛋白尿的风险升高,且当合并视网膜动脉狭窄时,白蛋白尿发生率最高。提示视网膜血管检查与蛋白尿的检查及血压监测应结合起来,可能成为临床筛查慢性肾脏病的更有效方法。

Objective A cross-sectional study was carried out in this paper to test the hypothesis that retinal vessel diameter might be correlated with renal microvascular abnormalities. Methods A population-based cross-sectional study was conducted in this paper based on the data of Handan eye study( HES). 5 541 of the 7577 participants had complete information on retinal vessel diameter,albuminuria and blood pressure. Results It was found after adjusting age,gender and other confounders,the narrowest retinal arterial diameter was correlated with an increased risk of albuminuria( multivariable OR: 1. 24,95% CI: 1. 02 ~ 1. 51). Exposure to both hypertension and retinal arterial narrowing would obviously increase the risk of albuminuria( multivariable OR: 1. 69,95% CI: 1. 31 ~ 2. 19). Conclusions It is concluded in this research that retinal arterial diameter is independently associated with albuminuria. Individuals with both hypertension and retinal arterial narrowing are more likely to develop albuminuria.