摘要目的 应用计算机辅助技术测定视网膜微血管径,旨在分析原发性高血压患者视网膜微血管径与代谢综合征组份之间的关系.方法 原发性高血压患者450例,采集病史,进行体格检查、代谢指标测定、眼底摄片,并测量视网膜微动脉和微静脉血管径,分析微血管径与血压、血糖及血脂等代谢综合征组份的关系及其变化的危险因素.结果 450例高血压患者平均年龄(57.53±10.01)岁,平均收缩压(138±17)mm Hg(1 mm Hg=0.133 kPa),舒张压(84± 10)mm Hg,平均视网膜微动脉径(129.26±12.68) μm,微静脉径(198.25±18.37) μm.校正年龄、性别等后,血压控制不良组的视网膜微动脉径小于控制良好组[(126.45±15.74) μm对(130.30±11.30) μm,P=0.029].随血压控制不良加重,视网膜微动脉径呈减小趋势(P=0.075).高密度脂蛋白胆固醇正常组视网膜微静脉径小于异常组[(197.36±17.62) μm对(203.07 ±21.52) μm,P=0.040].视网膜微血管径三分位比较中,随着微动脉径减小,舒张压逐渐升高(P=0.009)；随着微静脉径增宽,高密度脂蛋白胆固醇逐渐降低(P=0.042).年龄增加(r=-0.090,P=0.013)、血压控制不良(r=-0.098,P=0.038)是微动脉狭窄的独立危险因素,低高密度脂蛋白胆固醇(r=0.105,P=0.024)、吸烟(r=0.141,P=0.010)是微静脉增宽的独立危险因素.结论 高血压人群中,血压控制不良与视网膜微动脉狭窄密切相关,低高密度脂蛋白胆固醇与微静脉增宽密切相关；血压控制不良、增龄是微动脉狭窄的独立危险因素,低高密度脂蛋白胆固醇、吸烟则是微静脉增宽的独立危险因素.

abstractsObjective With a computer-assisted program,retinal vascular calibers were measured quantitatively.In this study the relationship between retinal vascular calibers and components of the metabolic syndrome was examined.Methods A total of 450 hypertensive patients were collected.Medical history,physical examination,blood tests,and retinal photographs were taken.Retinal vascular calibers were measured quantitatively from digital retinal photographs.In the hypertensive population the associations of retinal vascular calibers with components of the metabolic syndrome were described,and the factors that influenced retinal vascular calibers were analyzed.Results In the enrolled population,mean age was (57.53 ± 10.01) years,mean systolic blood pressure (138 ± 17) mm Hg(1 mm Hg =0.133 kPa),diastolic blood pressure (84 ± 10) mm Hg.Mean central retinal arteriolar equivalent(CRAE) was(129.26 ± 12.68) μm,and mean central retinal venular equivalent (CRVE) (198.25 ± 18.37) μm.After adjusting for age,gender,etc,CRAE in group with poor blood pressure control was smaller than that in the group with good blood pressure control [(126.45 ± 15.74) μm vs (130.30 ± 11.30) μm,P =0.029].CRAE tended to be narrower with worsened blood pressure control (P =0.075).CRVE was smaller in patients with normal high density lipoprotein-cholesterol (HDL-C) than in those with abnormal level [(197.36 ±17.62) μm vs (203.07 ± 21.52) μm,P =0.040].The diastolic blood pressure was raised along with the decreasing CRAE(P=0.009).And the HDL-C level was reduced as CRVE was increasing(P=0.042).Old age (r =-0.090,P=0.013) and poor blood pressure control(r=-0.098,P=0.038) were independent risk factors for narrow CRAE,while lowered HDL-C (r =0.105,P =0.024) and smoking (r =0.141,P =0.010) were independent risk factors for wide CRVE.Conclusions Narrow CRAE was related to poor blood pressure control,while wide CRVE was related to lowed HDL-C.Aging and poor blood pressure control were independent risk factors for narrow CRAE,while lowed HDL-C and smoking were independent risk factors for wide CRVE in the hypertensive patients.