摘要目的:观察强反射点（HRD）与视网膜分支静脉阻塞（BRVO）和视网膜中央静脉阻塞（CRVO）患者血脂水平和炎症指标的相关性。方法:横断面临床研究。2016年12月至2020年6月于解放军中部战区总医院眼科确诊为视网膜静脉阻塞的118例患者118只眼纳入研究。其中，BRVO 67例，CRVO 51例，并据此分为CRVO组、BRVO组。眼部检查后3 d内抽取患者外周静脉血，检测中性粒细胞百分比、单核细胞绝对数、超敏C反应蛋白（CRP）、总胆固醇、甘油三酯、高密度脂蛋白、低密度脂蛋白、脂蛋白a水平；计算单核细胞绝对数与高密度脂蛋白比值（MHR）。采用日本Topcon公司3D OCT-2000测量患眼黄斑中心凹视网膜厚度（CRT），计数HRD。根据HRD在视网膜不同分布位置将HRD分为视网膜内层HRD、外层HRD、全层HRD。两组连续变量比较采用独立样本 t检验，率的比较采用 χ2检验；HRD计数与血脂水平和外周血炎症指标的相关性采用Spearman相关性分析。 结果:BRVO组、CRVO组患者平均年龄分别为（60.1±9.5）、（53.6±15.7）岁；高血压患病率分别为53.7% （36/67）、24.5% （12/51 ）。两组患者间年龄（ t=2.634 ）、高血压患病率（ χ2=11.298）比较，差异有统计学意义（ P<0.05 ）；性别（ χ2=2.000 ）、病程（ t=-1.101 ）、糖尿病患病率（ χ2=1.315）、眼别（ χ2=1.742 ）、基线视力（ t=1.792）、眼压（ t=0.708）、CRT （ t=1.318）以及外周血指标包括中性粒细胞百分比、单核细胞绝对数、CRP、总胆固醇、甘油三酯、高密度脂蛋白、低密度脂蛋白、脂蛋白a、MHR （ t=-0.559、1.126、0.579、1.299、-0.134、0.556、1.230、-0.267、0.483）比较，差异均无统计学意义（ P>0.05 ）。相关性分析结果显示，BRVO患者视网膜外层HRD计数与总胆固醇呈正相关（ r=0.289， P=0.036）；CRVO患者视网膜内层HRD、全层HRD计数与CRP呈正相关（ r=0.406、0.343， P=0.004、0.014）。HRD计数与BRVO、CRVO患者中性粒细胞百分比、单核细胞绝对数、甘油三酯、高密度脂蛋白、低密度脂蛋白、脂蛋白a、MHR均无相关性（ P>0.05）。 结论:HRD计数与BRVO患者血脂水平和CRVO患者炎性指标CRP相关。

abstractsObjective:To investigate the correlation between hyperreflective dots (HRD) and lipid levels and systemic inflammatory factors in patients with branch retinal vein occlusion (BRVO) or central retinal vein occlusion (CRVO).Methods:A cross-sectional clinical study. From December 2016 to June 2020, 118 eyes of 118 patients with retinal vein occlusion diagnosed in the Department of Ophthalmology, Central Theater Command Hospital of People's Liberation Army were included in the study. Among them, 67 cases of BRVO and 51 cases of CRVO were divided into CRVO group and BRVO group accordingly. Peripheral venous blood was drawn from the patients within 3 days after the eye examination to detect the percentage of neutrophils, monocytes, hypersensitive C-reactive protein (CRP), total cholesterol, triglyceride, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and lipoprotein(a). The ratio of monocytes to high-density lipoprotein (MHR) was also calculated. The 3D OCT-2000 instrument from Topcon (Japan) was used to measure the central retinal thickness (CRT) and the numbers of HRD. According to the different distribution position, HRD is divided into inner retina HRD, outer retina HRD, and total retina HRD.The independent sample t test was used to compare the continuous variables of the two groups, and the χ2 test was used to compare the rates. The correlation between HRD counts and blood lipid levels and peripheral blood inflammation indicators in patients with different types of RVO was analyzed by Spearman correlation analysis. Results:The average age of patients in the BRVO group and CRVO group were 60.1±9.5 and 53.6±15.7 years, respectively; the prevalence of hypertension was 53.7% (36/67) and 24.5% (12/51), respectively. Comparison of age ( t=2.634) and prevalence of hypertension ( χ2=11.298) between the two groups showed statistically significant differences ( P<0.05). Gender ( χ2=2.000), course of disease ( t=-1.101), prevalence of diabetes ( χ2=1.315), eye category ( χ2=1.742), baseline visual acuity ( t=1.792), intraocular pressure ( t=0.708), CRT ( t=1.318), and peripheral blood include the percentage of neutrophils, the absolute number of monocytes, CRP, total cholesterol, triglycerides, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, lipoprotein(a), MHR ( t=-0.559, 1.126, 0.579, 1.299, -0.134, 0.556, 1.230, -0.267, 0.483), the difference was not statistically significant. Correlation analysis showed that the HRD counts in the outer retina of BRVO patients were positively correlated with total cholesterol ( r=0.289, P=0.036); the HRD in the inner retina and total HRD counts of CRVO patients were positively correlated with CRP ( r=0.406, 0.343; P=0.004, 0.014). There was no correlation between HRD counts and percentage of neutrophils, absolute number of monocytes, triglycerides, high-density lipoprotein, low-density lipoprotein, lipoprotein(a), and MHR ( P>0.05). Conclusion:The number of HRD is related to the blood lipid level in BRVO patients and CRP (an inflammatory index) in CRVO patients.