维持性血液透析患者眼底病变相关因素分析

Related factors analysis of eyeground pathological changes in maintenance hemodialysis patients

目的 观察维持性血液透析患者眼底病变状况,分析其发生率高的可能相关因素。方法 随机选择健康体检人群30例为正常对照组;选择原发性高血压患者33例为高血压组;选择维持性血液透析患者36例(剔除糖尿病患者)为血液透析组。测量三组人员血压,检查眼底,检测血清胆固醇(TC)、甘油三脂(TG)、低密度脂蛋白胆固醇(LDL-ch)、高密度脂蛋白胆固醇(HDL-ch)含量。结果 三组人员中高血压组平均收缩压及舒张压最高。P<0.001,有显著统计学意义。血液透析组与正常组对照P<0.01。眼底检查中血液透析组病变发生率最高且重,占三组人员眼底病变的63.3％,占血液透析组检查病例数的94.4％。血脂检测中,血液透析组甘油三脂与低密度脂蛋白胆固醇明显增高,属高脂血症Ⅳ型,高密度脂蛋白胆固醇则较低。结论 维持性血液透析患者眼底病变显著。除继发性高血压之外,代谢产物的堆积,脂质代谢紊乱,动脉血管硬化等都是其变化的因素,尤其是脂质代谢紊乱应给予适当的治疗。

Objective To observe the eyeground pathological changes in maintenance hemodialysis patients, and to analyse the possible related factors of its high incidence. Methods We choosed 30 cases who took health examination as normal controlls randomly, 33 hypertension patients as hypertension group, and 36 maintenance patients hemodialysis (no Diabetes patients ) as hemodialysis group. We checked the three groups' people's blood pressure and examined their eyeground. We also checked serum cholesterol, triglyceride, low density lipoprotein, and high density lipoprotein. Results The mean systolic pressure and diastolic pressure in hypertension group is higher than the other two groups significantly . (P < 0.001). There were on significant diffevence between the other two groups, (P < 0.01). The incidence of eyeground pathological changes in hemodialysis group is higher and more severe than the other two groups, accounting for 63.3% of the all three groups, and 94.4% of all examined cases hemodialysis. In hemodialysis group the level of triglyceride and low density lipoprotein rised significantly, which is classified into the type Ⅳ hyperlipidemia. The of high density lipoprotein level was lower. Conclusion The maintenance patients hemodialysis had a higher eyeground disease incidence. Except for secondary hypertension, the accumulation of metabolic products, lipid metabolic disorder, and arterial sclerosis etc. are all factors related to these pathological changes, dyslipidemia should be given adequate treatment especially.