高血压患者眼底改变的影响因素分析

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1、高血压患者眼底改变的影响因素分析【摘要】目的分析高血压患者发生眼底改变的影响因素，为高血压性眼底改变的防治提供临床参考。方法收集511例原发性高血压患者，根据是否存在眼底病变分为眼底病变组357例和无眼底病变组154例。比较两组患者收缩压、血总胆固醇、甘油三酯、同型半胱氨酸浓度及尿蛋白水平，并对眼底病变程度与相关影响因素的关系进行分析。结果眼底病变组收缩压2140mmHg＞总胆固醇＞5.17mmol/L＞同型半胱氨酸＞15Pmol/L及伴有蛋白尿的比例明显高于无眼底病变组（P＜0.05）o眼底病变程度随收缩压、总胆固醇、同型半胱氨酸、蛋白尿浓度的升高而加重，两者呈正相

2、关。结论影响高血压患者眼底改变的因素较多，收缩压、血总服固醇、同型半胱氨酸及蛋白尿浓度是眼底改变较为显著的影响因素，它们可能参与了高血压患者眼底改变过程，高血压早期密切监测有利于预防眼底病变或减轻眼底病变程度。【关键词】高血压；眼底改变；小动脉痉挛；动脉粥样硬化中图分类号：R773.4；R544.1文献标识码:ADOI:10.3969/j.issn.10031383.2017.02.025[Abstract]ObjectiveToanalyzeinfluencingfactorsofocularfunduschangesinpatientswithessentidlh

3、ypertension,soastoprovideclinicalreferencefortheproventionandtroatmentofhypertension.Methods511patientswithessentialhypertensionwerecollected,accordingtopreseneeoffunduslesions,theyweredividedintofunduslesiongroup(357cases)andnonfunduslesiongroup(154cases)•Andthen,systolicbloodpressure,

4、serumtotalcholesterol,triglyceride,homocysteineandurinaryproteinlevelswerecomparedbetweenthetwogroups.Andtherelationbetweenthedegreeoffundusdiseasesandtherelatedfactorswasanalyzed.ResuItsTheproportionofsystoliebloodpressured140mmHg,totalcholesterol>5.17mmol/L,homocystcinc>15Pmol/L,combi

5、nedwithproteinuriainthefunduslesionsgroupweresignificantlyhigherthanthoseinthenonfunduslesiongroup(P<0.05).Thedegreeoffunduslesionsaggravatedwiththeincreaseofsystolicbloodpressure,totalcholesterol,homocysteineandproteinurineconcentration,whichshowedapositivecorrelation.ConclusionTherear

6、emanyfactorsaffectingfunduschangesinpatientswithhypertension,andpatient?ssystolicbloodpressure,serumtotalcholesterol,homocysteineandurineproteinconcentrationarethesignifica.ntones,theymayinvolveintheprocessoffunduschanges.Earlymonitoringofhypertensionisbeneficialtothepreventionofocularf

7、undusdiseasesoralleviatethedegreeofocularfundusdiseases.［Keywords］hypertension；funduschanges；smallarteryspasm；atherosclerosis高血?旱姆2•三缙诳芍氯?身小动脉病变，随着病情的进展，血管管径、管壁会出现各种病理改变，终致动脉粥样硬化（AS）形成。高血压早期可引起眼底小动脉痉挛和收缩，严重时可致视网膜水肿、渗血，甚至可造成高血压性视神经病变，影响患者视力［1］。因此，对高血压患者发生眼底改变的危险因素进行分析，在疾病早期进行干预显