眼底血管变化与原发性高血压分期和危险分层及心脏功能的关系研究

摘要

目的 探讨眼底血管变化与原发性高血压分期和危险分层及心脏功能的关系.方法 选取2011年4月至2016年3月该院收治的原发性高血压患者100例,依据Keith-Wagener眼底分级法分为对照组(29例)、Ⅰ～Ⅱ组(56例)和Ⅲ～Ⅳ组(15例),比较3组患者的原发性高血压分期和危险分层(轻度、中度、重度)及心功能[左心室舒张期末内径(LVEDD)、左心室后壁厚度(LVPWT)、室间隔厚度(LVST)、左心室质量指数(LVMI)、颈动脉内膜中层厚度(IMT)、左心室射血分数(LVEF)].结果 对照组、Ⅰ～Ⅱ组、Ⅲ～Ⅳ组轻度高血压比例分别为55.17％、21.43％、6.67％,中度高血压比例分别为31.03％、30.36％、26.67％,重度高血压比例分别为13.79％、48.21％、66.67％,差异有统计学意义(x2=5.568,P=0.019).对照组、Ⅰ～Ⅱ组、Ⅲ～Ⅳ组患者的左心室舒张期末内径(LVEDD)、左心室后壁厚度(LVPWT)等心功能指数差异有统计学意义(P＜0.05).眼底血管变化与原发性高血压分期和危险分层呈正相关(r=0.742,P=0.002)、LVMI(r=0.674,P=0.028)、IMT(r=0.598,P=0.014),与LVEF呈负相关(r=-0.623,P=0.035).结论 眼底血管变化与原发性高血压分期和危险分层及心脏功能具有明显相关性,可作为判断高血压病情程度及靶器官受损情况的重要指标.%Objective To explore the relationship between the fundus vascular changes with the stage and risk stratification of essential hypertension(EH) and the cardiac function.Methods One hundred patients with EH in our hospital from April 2011 to March 2016 were selected and divided into the control group(n=29),Ⅰ-Ⅱ group(n=56) and Ⅲ-Ⅳ group(n=15) according to the Keith-Wagener fundus grading.The stage and risk stratification of EH (mild,moderate,severe),cardiac function indexes[left ventricular end-diastolic inner diameter (LVEDD),left ventricular wall thickness (LVPWT),interventricular septum thickness (LVST),left ventricular mass index (LVMI),carotid intima-media thickness (IMT),left ventricular ejection fraction (LVEF)] were compared among 3 groups.Results The proportions of mild hypertension in the control group,Ⅰ-Ⅱ group and Ⅲ-Ⅳ group were 55.17％,21.43％ and 6.67％ respectively,the proportions of moderate hypertension were 31.03％,30.36％ and 26.67 ％ respectively,which of severe hypertension were 13.79 ％,48.21 ％ and 66.67 ％ respectively,the differences were statistically significant(x2 =5.568,P=0.019).The cardiac indexes of LVEDD,LVPWT,etc.had statistical differences among the control group,Ⅰ-Ⅱ group and Ⅲ-Ⅳ group(P＜0.05).The fundus vascular changes were positively correlated with the stages and risk stratification of EH (r=0.742,P =0.002),while LVMI (r =0.674,P =0.028) and IMT (r =0.598,P =0.014) were negatively correlated with LVEF(r=-0.623,P=0.035).Conclusion The fundus vascular changes have close correlation with the stage and risk stratification of EH and cardiac function,which could be used as an important index for judging the hypertensive severity and target organ damage situation