基于SD-OCT分析高血压类型与视网膜血管管径的关系

doi:10.6040/j.issn.1673-3770.1.2020.052

山东大学耳鼻喉眼学报 ›› 2020, Vol. 34 ›› Issue (4): 64-68.doi: 10.6040/j.issn.1673-3770.1.2020.052

• 眼缺血综合征多学科精准诊疗临床研究 • 上一篇下一篇

基于SD-OCT分析高血压类型与视网膜血管管径的关系

冯雪¹,王海伟²,李闻思¹,杨新同¹,孙存¹,赵媛¹,赵朋波¹,张建强¹

冯雪¹, 王海伟², 李闻思¹, 杨新同¹, 孙存¹, 赵媛¹, 赵朋波¹, 张建强¹1.北京市回民医院眼科, 北京 100054;
2.首都医科大学附属复兴医院眼科, 北京 100038

收稿日期:2020-05-22 出版日期:2020-07-20 发布日期:2020-08-28
基金资助:
北京市西城区财政科技专项项目(XCSTS-SD2018-11)

Association between the classification of blood pressure and retinal vessel diameter measured by SD-OCTFENG Xue¹, WANG Haiwei², LI Wensi¹, YANG Xintong¹, SUN Cun¹, ZHAO Yuan¹, ZHAO Pengbo¹, ZHANG Jianqiang¹ 1. Department of Ophthalmology, Beijing Moslem People's Hospital, Beijing 100054, China; 2. Department of Ophthalmology, Fuxing Hospital, Capital Medical University, Beijing 100038, ChinaAbstract:

ObjectiveTo analyze the association between the classification of blood pressure and retinal vessel diameter measured by spectral-domain optical coherence tomography(SD-OCT). MethodsThis was a cross-sectional study that included 103 patients(103 eyes)with hypertension. Based on the classification of hypertension, the subjects were divided into three groups: the isolated systolic hypertension(ISH)(34 eyes), isolated diastolic hypertension(IDH)(34 eyes), and systolic combined with diastolic hypertension(SDH)(35 eyes)groups. Retinal vessel diameters were measured by SD-OCT. The differences among the central retinal arteriolar equivalents(CRAEs), the central retinal venular equivalents(CRVEs), and the artery-to-vein ratios(AVRs)of the three groups were analyzed. Multivariate logistic regression was performed to evaluate the association between blood pressure and AVR. ResultsThere were significant differences among the CRAEs and AVRs of the three groups(F=4.543, 4.308; P=0.013, 0.016). The CRAE and AVR of the SDH group were the lowest; those of the IDH group were the highest. There were no significant differences among the CRVEs of the three groups(F=0.417, P=0.660). After correction for risk factors, such as gender and age, multivariate logistic regression showed that patients with high systolic blood pressure were more likely to have AVRs of < 0.7 (OR=1.080, P=0.015). ConclusionsAmong the three types of hypertension, SDH was associated with the lowest CRAE and AVR. High systolic pressure is a risk factor for AVRs of < 0.7.

Key words:Spectral domain;
Optical coherence tomography;
Hypertension;
Classification;
Retina;
vascular diameter全球高血压的患病率呈升高趋势, 预计2025年将累及全世界近1/3的人口^［1］。高血压可引起眼^［2］、脑^［3］、肾^［4］等多个靶器官损害。高血压早期, 视网膜动脉痉挛变细^［5］, 随着高血压的进展, 可出现高血压性小动脉硬化改变, 即视网膜动脉管腔狭窄等病理变化^［6］。关于高血压的不同类型对视网膜血管管径影响的相关研究报道较少。我们应用频域光学相干断层成像(Spectral domain optical coherence tomography, SD-OCT)对以下三种类型的高血压即单纯收缩期高血压(isolated systolic hypertension, ISH)、单纯舒张期高血压(isolated diastolic hypertension, IDH)、收缩期和舒张期联合性高血压(systolic combined with diastolic hypertension, SDH)患者的视网膜血管管径进行测量, 旨在探讨视网膜血管管径在不同高血压类型方面的差异。

Received:2020-05-22 Online:2020-07-20 Published:2020-08-28

摘要/Abstract

摘要： 目的应用频域光学相干断层成像(SD-OCT)测量视网膜血管管径,分析高血压类型与视网膜血管管径的关系。方法研究为横断面研究,将103例高血压患者共103眼纳入研究。根据高血压类型将入组患者分为3个组:单纯收缩期高血压(ISH)组34例(34眼)、单纯舒张期高血压(IDH)组34例(34眼)、收缩期和舒张期联合性高血压(SDH)组35例(35眼),应用SD-OCT测量视网膜血管管径,分析3组之间的视网膜动脉直径(CRAE)、视网膜静脉直径(CRVE)、视网膜动静脉直径比例(AVR)的差异。应用logistic回归分析血压与AVR的关系。结果 3组之间在CRAE、AVR方面相比,差异均有统计学意义(F=4.543、4.308,P=0.013、0.016),SDH组CRAE、AVR最小,IDH组CRAE、AVR最大。3组之间在CRVE方面相比,差异无统计学意义(F=0.417,P=0.660)。多因素logistic回归分析,控制年龄、性别等混杂因素后,高收缩压与AVR<0.7的发生显著相关(OR=1.080,P=0.015)。结论三种类型高血压中,SDH型高血压患者的视网膜动脉最细、视网膜动静脉直径比例最小。高收缩压是AVR<0.7发生的危险因素。

关键词: 频域, 光学相干断层扫描, 高血压, 分型, 视网膜, 血管管径

Abstract: Objective To analyze the association between the classification of blood pressure and retinal vessel diameter measured by spectral-domain optical coherence tomography(SD-OCT). Methods This was a cross-sectional study that included 103 patients(103 eyes)with hypertension. Based on the classification of hypertension, the subjects were divided into three groups: the isolated systolic hypertension(ISH)(34 eyes), isolated diastolic hypertension(IDH)(34 eyes), and systolic combined with diastolic hypertension(SDH)(35 eyes)groups. Retinal vessel diameters were measured by SD-OCT. The differences among the central retinal arteriolar equivalents(CRAEs), the central retinal venular equivalents(CRVEs), and the artery-to-vein ratios(AVRs)of the three groups were analyzed. Multivariate logistic regression was performed to evaluate the association between blood pressure and AVR. Results There were significant differences among the CRAEs and AVRs of the three groups(F=4.543, 4.308; P=0.013, 0.016). The CRAE and AVR of the SDH group were the lowest; those of the IDH group were the highest. There were no significant differences among the CRVEs of the three groups(F=0.417, P=0.660). After correction for risk factors, such as gender and age, multivariate logistic regression showed that patients with high systolic blood pressure were more likely to have AVRs of < 0.7 (OR=1.080, P=0.015). Conclusions Among the three types of hypertension, SDH was associated with the lowest CRAE and AVR. High systolic pressure is a risk factor for AVRs of < 0.7.

Key words: Spectral domain, Optical coherence tomography, Hypertension, Classification, Retina, vascular diameter

中图分类号:

R774.1

冯雪,王海伟,李闻思,杨新同,孙存,赵媛,赵朋波,张建强. 基于SD-OCT分析高血压类型与视网膜血管管径的关系[J]. 山东大学耳鼻喉眼学报, 2020, 34(4): 64-68.

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基于SD-OCT分析高血压类型与视网膜血管管径的关系

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