糖尿病对应用视网膜血管直径评价冠心病严重程度的影响  

Influence of diabetes on severity assessment of coronary atherosclerotic heart disease using diameters of retina vessels

作　　者：董昕[1,2] 兰琳[2] 谢芳元[2] 田刚[1] 

机构地区：[1]西安交通大学医学院第一附属医院心内科,陕西西安710061 [2]西安市第四医院心内科,陕西西安710004

出　　处：《心脏杂志》2011年第6期794-797,共4页Chinese Heart Journal

摘　　要：目的:探讨糖尿病对使用视网膜动脉、视网膜静脉直径评价冠状动脉粥样硬化性心脏病(CHD)患者病变严重程度的影响。方法:对120例经冠状动脉造影确诊为CHD的患者进行眼底照相,使用Parr-Hubbard公式计算视网膜中央动脉直径等效值(central retinal arteriolar equivalents,CRAE)和视网膜中央静脉直径等效值(central retinalvenular equivalents,CRVE),以此分别代表视网膜动脉和视网膜静脉的平均直径。应用Gensini评分标准评价冠状动脉病变程度。通过问卷调查和抽取静脉血获取其他心血管危险因素。研究糖尿病对视网膜血管直径和Gensini评分结果相关性的影响,以及其它心血管危险因素对视网膜血管直径的影响。结果:糖尿病可使患者的CRVE增加,而对CRAE无影响。糖尿病对Gensini评分与CRAE的相关性具有显著性影响,而不影响Gensini与CRVE的相关性。其他与CRAE有相关性的其他指标有年龄、性别、收缩压、舒张压、平均动脉压、体质量指数、吸烟史、高血压病史和低密度脂蛋白胆固醇、高密度脂蛋白胆固醇。而与CRVE有相关性的有年龄、吸烟史、高血压病史和糖化血红蛋白。结论:视网膜血管直径在一定程度上可反映CHD病变严重程度,但是需考虑到糖尿病及其它心血管危险因素对于评估的影响。AIM： To investigate the influence of diabetes on the severity assessment of coronary atherosclerotic heart disease（CHD） using diameters of the retina vessels.METHODS： Retina photos were taken in 120 patients who were diagnosed with CHD by coronary arteriography（CAG）.Central retinal arteriolar equivalents（CRAE） and central retinal venular equivalents（CRVE） were calculated by Parr-Hubbard formulas,and Gensini scores were obtained.Other cardiovascular risk factors were obtained by questionnaires and venous blood.The influence of diabetes on the relevance between Gensini score and CRAE and CRVE were calculated by covariance analysis,and the influences of other risk factors on the CRAE and CRVE were analyzed by variance and χ2 analysis.RESULTS： Diabetes increased the CRVE in CHD patients but had no obvious effect on CRAE.Diabetes significantly affected the relevance between Gensini score and CRAE,but no such effect was seen between Gensini score and CRVE.Other factors that affected CRAE were age,gender,systolic pressure,diastolic pressure,mean arterial tension,body mass index,current smoking,hypertension,low-density lipoprotein and high-density lipoprotein,whereas the factors that affected CRVE were gender,smoking history,hypertension and HbA1c.CONCLUSION： Diameters of retinal vessels can partly report the severity of CHD,but diabetes and other cardiovascular risk factors should be considered in the severity assessment.

关 键 词：冠状动脉粥样硬化性心脏病 糖尿病 冠状动脉造影 视网膜 

分 类 号：R541.4[医药卫生—心血管疾病]