高血压视网膜病变与高血压心脏改变及肾病的关系

摘要

目的：分析高血压视网膜病变（HRP）与高血压心脏改变及肾病的关系。方法：选择我院2012年1月至2013年12月诊治的100例高血压患者为研究对象，其中 HRP 者90例（HRPⅠ级34例、Ⅱ级49例、Ⅲ级6例、Ⅳ级1例），正常眼底10例（正常眼底组），分析所有患者临床资料，检测左心室重量指数（LVMI）、颈动脉内膜中层厚度（IMT）、肾小球滤过率（GFR）等指标。结果：与正常眼底组比较，HRPⅠ级＋Ⅱ级组，Ⅲ级＋Ⅳ级组 IMT [（0.62±0.30）mm比（0.87±0.16）mm 比（1.10±0.28）mm]显著增厚，Ⅲ级＋Ⅳ级组的 IMT 较Ⅰ级＋Ⅱ级组显著增厚（P 均＜0.01）；与正常眼底组比较，HRPⅠ级＋Ⅱ级组，Ⅲ级＋Ⅳ级组心脏扩大（0％比12.05％比71.43％）及肾脏功能损害（0％比24.10％比85.71％）发生率显著升高，Ⅲ级＋Ⅳ级组的心脏扩大和肾脏功能损害发生率较Ⅰ级＋Ⅱ级组显著升高（P均＜0.01）。结论：高血压视网膜病变严重程度与高血压心脏扩大及肾脏功能损害有密切关系。%Objective:To analyze the relationship among hypertensive cardiac change,kidney disease and hyperten-sive retinopathy (HRP).Methods:A total of 100 patients with hypertension,who were diagnosed and treated in our hospital from Jan 2012 to Dec 2013,were enrolled,including 90 HRP patients (34 cases of class Ⅰ,49 cases of class Ⅱ,six cases of class Ⅲ and one case of class Ⅳ)and 10 cases with normal fundus (normal control group). Clinical data of all patients were analyzed,left ventricular mass index (LVMI),carotid intima-media thickness (IMT)and glomerular filtration rate (GFR)etc.were measured.Results:Compared with normal control group, there were significant thickening in IMT [(0.62±0.30)mm vs.(0.87±0.16)mm vs.(1.10±0.28)mm]in HRP class Ⅰ+Ⅱ group,class Ⅲ+Ⅳ group,the IMT of class Ⅲ+Ⅳ group was significantly thickened than that of class Ⅰ+Ⅱ group (P <0.01 all);Compared with normal control group,the incidence rates of cardiac dilation (0%vs.12.05% vs.71.43%)and kidney function damage (0% vs.24.10% vs.85.71%)significantly rose in HRP class Ⅰ+Ⅱ group,class Ⅲ+Ⅳ group,the incidence rates of cardiac dilation and kidney function damage in HRP class Ⅲ+Ⅳ group significantly rose than those of class Ⅰ+Ⅱ group (P <0.01 all).Conclusion:Severity of hyper-tension retinopathy is closely related to hypertensive cardiac dilation and kidney function damage.