频域相干光断层扫描定量分析视网膜大血管腔内直径变化及其与原发性高血压病的相关性  

Spectral domain optical coherence tomography to assess the association between the inner caliber of large retinal vessel and the primary hypertension

作　　者：马进[1] 童毓华[2] 欧会林[1] 朱铁培[1] 

机构地区：[1]浙江大学医学院附属第二医院眼科中心,杭州310009 [2]浙江省衢州市人民医院眼科

出　　处：《中华眼科杂志》2012年第8期718-724,共7页Chinese Journal of Ophthalmology

基　　金：卫生部科学研究基金-浙江省医药卫生重大科技计划（WKJ2011-2-006）;浙江省科技厅公益类项目（2011C23090）

摘　　要：目的探讨频域相干光断层扫描（SD—OCT）定量检测视网膜大血管腔内直径变化及其与原发性高血压的相关性。方法回顾性病例对照研究。对215例确诊的原发性高血压患者和210例正常血压对照者分别按年龄段分组，采用SD—OCT定量检测跟底视网膜大血管腔内直径变化，包括视网膜动脉腔内直径（RAIC）、静脉腔内直径（RVIC）及动静脉腔内直径比值（RAVICR）。患者与正常对照者各年龄组间检测数据比较采用t检验；再按患者不同血压值分组，进行多重比较的SNK检验；患者血压对视网膜大血管腔内直径的影响采用单因素方差分析；患者RAVICR与舒张压、收缩压、年龄等因素的相关性采用多元线性逐步回归分析。结果患者各年龄组（〈40、40～49、50—59、60～69、／〉70岁）RAIC分另0为（93．0±6．3）、（86．2±6．1）、（84．5±5．1）、（84．0±5．5）、（81．7±5．4）μm，RVIC分男4为（129．4±5．8）、（130．7±6．5）、（129．6±5．4）、（132．2±6．4）、（131．6±5．1）μm，RAVICR分另0为（0．720±0．07）、（0．661±0．06）、（0．653±0．04）、（0．637±0．06）、（0．621±0．05）μm，均较正常血压对照者检测值降低，差异有统计学意义（RAIC：t=-4．813，-10．893，-15．689，-8．811，-10．151；RAVICR：t=-3．276，-8．654，-13．470，-7．801，-9．210；P〈0．05）。高血压患者按收缩压分组，进行组间RAIC和RAVICR多重比较的SNK检验，显示140～149mmHg（1mmHg=0．133kPa）组与170～179mmHg组（q=9．46，10．61）、140～149mmHg组与≥180mmHg组（9=11．03，13．98）、150～159mmHg组与170—179mmHg组（g=8．13，8．82）、150～159mmHg组与≥180mmHg组（q=9．01，9．97）差异均有统计学意义（P〈0．05）；按舒张压分组进行组间RAIC和RAVICR多重比较的SNK检验，显示90～99mmHg组与100～109mmHg组（q=6．79，5．95）、90～99mmHg组�Objective To assess the inner caliber of large retinal vessel quantitatively using spectral domain optical coherence tomography （SD-OCT） and to reveal the association between changes in the inner caliber of large retinal vessel and the primary hypertension. Methods A retrospective case-control study was carried out including 215 cases （with primary hypertension ） and 210 controls （without primary hypertension） admitted to our hospital since 2009 and all the cases and controls were grouped according to age. SD-OCT was performed to assess the inner caliber of large retinal vessel quantitatively including retinal artery inner caliber（RAIC） , retinal vein inner caliber（ RVIC ） and retinal arterio-venous inner caliber ratio （RAVICR）. The differences in the inner caliber of large retinal vessel between the cases and the controls in each age groups were analyzed by t test. In all cases, multiple comparisons were performed according to their blood pressure level by SNK test of one way ANOVA. The RAVICR was also correlated with the following relevant determinants via multiple stepwise regression analysis： age, diastolic and systolic blood pressure. Results In each age group of cases （ 〈 40, 40 to 49, 50 to 59, 60 to 69, 〉170 years）, the values of RAIC were （93.0±6.3）, （86.2±6.1）, （84.5±5.1）, （84.0±5.5）, and （81.7 ±5.4） μm respectively, and the values of RVIC were （129.4±5.8）, （130.7±6.5）, （129.6±5.4）, （132.2 ±6.4）, and （ 131.6 ± 5.1 ） μm respectively, and the values of RAVICR were （0. 720 ± 0. 07 ）, （ 0. 661 ± 0. 06）, （0. 653 ±0. 04）, （0. 637 ±0. 06）, and （0. 621 ±0. 05） μm respectively. Compared with controls, RAIC （t = -4. 813, - 10. 893, - 15. 689, - 8.811, and - 10. 151 respectively;P 〈 0. 05 ） and RAVICR （t = -3.276, - 8.654, - 13.470, - 7.801, and - 9.210 respectively; P 〈 0.05） were significantly decreased in each age group of cases. Multiple comparisons were made among each systolic and diast

关 键 词：高血压 视网膜血管 体层摄影术 光学相干 

分 类 号：R774.1[医药卫生—眼科] R544.1[医药卫生—临床医学]