频域相干光断层扫描定量分析视网膜大血管腔内直径变化及其与原发性高血压病的相关性
빈역상간광단층소묘정량분석시망막대혈관강내직경변화급기여원발성고혈압병적상관성
Spectral domain optical coherence tomography to assess the association between the inner caliber of large retinal vessel and the primary hypertension
  • 万方数据
    中华眼科杂志 중화안과잡지
    Chinese Journal of Ophthalmology
    2012年 8期 718-724 ,共7页

    马进%童毓华%欧会林%朱铁培

    마진%동육화%구회림%주철배

    高血压%视网膜血管%体层摄影术,光学相干 高血壓%視網膜血管%體層攝影術,光學相榦
    고혈압%시망막혈관%체층섭영술,광학상간
    Hypertension% Retinal vessels%Tomography,optical coherence
    目的 探讨频域相干光断层扫描(SD-OCT)定量检测视网膜大血管腔内直径变化及其与原发性高血压的相关性.方法 回顾性病例对照研究.对215例确诊的原发性高血压患者和210例正常血压对照者分别按年龄段分组,采用SD-OCT定量检测眼底视网膜大血管腔内直径变化,包括视网膜动脉腔内直径(RAIC)、静脉腔内直径(RVIC)及动静脉腔内直径比值(RAVICR).患者与正常对照者各年龄组间检测数据比较采用t检验；再按患者不同血压值分组,进行多重比较的SNK检验；患者血压对视网膜大血管腔内直径的影响采用单因素方差分析；患者RAVICR与舒张压、收缩压、年龄等因素的相关性采用多元线性逐步回归分析.结果 患者各年龄组(＜40、40～ 49、50～ 59、60～69、≥70岁)RAIC分别为(93.0±6.3)、(86.2±6.1)、(84.5±5.1)、(84.0±5.5)、(81.7±5.4) μm,RVIC分别为(129.4±5.8)、(130.7±6.5)、(129.6±5.4)、(132.2±6.4)、(131.6±5.1)μm,RAVICR分别为(0.720±0.07)、(0.661±0.06)、(0.653±0.04)、(0.637±0.06)、(0.621±0.05) μm,均较正常血压对照者检测值降低,差异有统计学意义(RAIC:t=-4.813,- 10.893,-15.689,-8.811,- 10.151;RAVICR:t=- 3.276,-8.654,-13.470,- 7.801,-9.210;P＜0.05).高血压患者按收缩压分组,进行组间RAIC和RAVICR多重比较的SNK检验,显示140～ 149 mm Hg(1 mm Hg =0.133 kPa)组与170～179mmHg组(q=9.46,10.61)、140～149 mm Hg组与≥180 mm Hg 组(q=11.03,13.98)、150～159 mmHg组与170～179 mm Hg组(q=8.13,8.82)、150～159 mm Hg 组与≥180 mm Hg组(q =9.01,9.97)差异均有统计学意义(P＜0.05)；按舒张压分组进行组间RAIC和RAVICR多重比较的SNK检验,显示90～ 99 mm Hg组与100～109 mm Hg组(q=6.79,5.95)、90～99 mm Hg组与≥110 mm Hg组(q=9.72,10.21)、100- 109 mm Hg组与≥110 mm Hg组(q=5.93,6.07)差异均有统计学意义(P＜0.05).单因素方差分析显示患者血压对视网膜大血管腔内直径变化有直接影响(F=11.231,P＜0.05)；多元线性逐步回归分析,显示患者RAVICR与舒张压和收缩压两个因素相关(标准化后的回归系数:β=-0.024,-0.019;P ＜0.05).结论 借助SD-OCT可对视网膜大血管腔内直径进行对比分析；RAIC和RAVICR的变化与原发性高血压的舒张压和收缩压变化相关.
    목적 탐토빈역상간광단층소묘(SD-OCT)정량검측시망막대혈관강내직경변화급기여원발성고혈압적상관성.방법 회고성병례대조연구.대215례학진적원발성고혈압환자화210례정상혈압대조자분별안년령단분조,채용SD-OCT정량검측안저시망막대혈관강내직경변화,포괄시망막동맥강내직경(RAIC)、정맥강내직경(RVIC)급동정맥강내직경비치(RAVICR).환자여정상대조자각년령조간검측수거비교채용t검험；재안환자불동혈압치분조,진행다중비교적SNK검험；환자혈압대시망막대혈관강내직경적영향채용단인소방차분석；환자RAVICR여서장압、수축압、년령등인소적상관성채용다원선성축보회귀분석.결과 환자각년령조(＜40、40～ 49、50～ 59、60～69、≥70세)RAIC분별위(93.0±6.3)、(86.2±6.1)、(84.5±5.1)、(84.0±5.5)、(81.7±5.4) μm,RVIC분별위(129.4±5.8)、(130.7±6.5)、(129.6±5.4)、(132.2±6.4)、(131.6±5.1)μm,RAVICR분별위(0.720±0.07)、(0.661±0.06)、(0.653±0.04)、(0.637±0.06)、(0.621±0.05) μm,균교정상혈압대조자검측치강저,차이유통계학의의(RAIC:t=-4.813,- 10.893,-15.689,-8.811,- 10.151;RAVICR:t=- 3.276,-8.654,-13.470,- 7.801,-9.210;P＜0.05).고혈압환자안수축압분조,진행조간RAIC화RAVICR다중비교적SNK검험,현시140～ 149 mm Hg(1 mm Hg =0.133 kPa)조여170～179mmHg조(q=9.46,10.61)、140～149 mm Hg조여≥180 mm Hg 조(q=11.03,13.98)、150～159 mmHg조여170～179 mm Hg조(q=8.13,8.82)、150～159 mm Hg 조여≥180 mm Hg조(q =9.01,9.97)차이균유통계학의의(P＜0.05)；안서장압분조진행조간RAIC화RAVICR다중비교적SNK검험,현시90～ 99 mm Hg조여100～109 mm Hg조(q=6.79,5.95)、90～99 mm Hg조여≥110 mm Hg조(q=9.72,10.21)、100- 109 mm Hg조여≥110 mm Hg조(q=5.93,6.07)차이균유통계학의의(P＜0.05).단인소방차분석현시환자혈압대시망막대혈관강내직경변화유직접영향(F=11.231,P＜0.05)；다원선성축보회귀분석,현시환자RAVICR여서장압화수축압량개인소상관(표준화후적회귀계수:β=-0.024,-0.019;P ＜0.05).결론 차조SD-OCT가대시망막대혈관강내직경진행대비분석；RAIC화RAVICR적변화여원발성고혈압적서장압화수축압변화상관.
    Objective To assess the inner caliber of large retinal vessel quantitatively using spectral domain optical coherence tomography (SD-OCT) and to reveal the association between changes in the inner caliber of large retinal vessel and the primay hypertension.Methods A retrospective case-control study was carried out including 215 cases (with primary hypertension) and 210 controls (without primary hypertension ) admitted to our hospital since 2009 and all the cases and controls were grouped according to age. SD-OCT was performed to assess the inner caliber of large retinal vessel quantitatively including retinal artery inner caliber( RAIG),retinal vein inner caliber(RVIC) and retinal arterio-venous inner caliber ratio (RAVICR).The differences in the inner caliber of large retinal vessel between the cases anti the controls in each age groups were analyzed by t test.In all cases,multiple comparisons were performed according to their blood pressure level by SNK test of one way ANOVA.The RAVICR was also correlated with the following relevant determinants via multiple stepwise regression analysis:age,diastolic and systolic blood pressure.Results In each age group of cases ( ＜40,40 to 49,50 to 59,60 to 69,≥70 years),the values of RAIC were (93.0±6.3),(86.2±6.1),(84.5±5.1),(84.0±5.5),and (81.7±5.4) μm respectively,and the values of RVIC were (129.4±5.8),(130.7 ±6.5),(129.6 ±5.4),(132.2 ±6.4),and (131.6±5.1) μm respectively,and the values of RAVICR were (0.720 ±0.07),(0.661 ±0.06),(0.653 ±0.04),(0.637 ±0.06),and (0.621 ±0.05 ) μm respectively.Compared with controls,RAIC (t =-4.813,- 10.893,- 15.689,-8.811,and - 10.151 respectively;P ＜0.05) and RAVICR (t =-3.276, -8.654, -13.470, -7.801,and -9.210 respectively; P＜0.05) were significantly decreased in each age group of cases. Multiple comparisons were made among each systolic and diastolic pressure groups in all cases.In systolic groups,difference of RAIC or RAVICR were significant( SNK test) between 140 to 149 mm Hg(1 mm Hg=0.133 kPa) and 170 to 179 mm Hg group ( q =9.46,10.61;P＜ 0.05 ),140 to 149 mm Hg and ≥ 180 mm Hg group ( q =11.03,13.98 ; P ＜ 0.05 ),150 to 159 mm Hg and 170 to 179 mm Hg group (q=8.13,8.82;P＜0.05),150 to 159 mm Hg group and ≥180 mm Hg group ( q =9.01,9.97;P ＜0.05 ). In diastolic groups,difference of RAIC or RAVICR were significant ( SNK test) between 90 to 99 mm Hg and 100 to 109 mm Hg group ( q =6.79,5.95 ;P ＜0.05 ),90 to 99 mm Hg and ≥110 mm Hg group ( q =9.72,10.21 ;P＜0.05),100 to 109 mm Hgand ≥110 mm Hg group ( q=5.93,6.07 ;P ＜0.05 ).RAVICR was associated with the diastolic and systolic blood pressure revealed by the multiple stepwise regression analysis ( ANOVA:F =11.231 ; Standardized regression coefficient:β =-0.024,-0.019,respectively; P ＜0.05).Conclusions Quantitative assessment for the inner caliber of large retinal vessel can be done by SD-OCT.The value of RAI and RAVICR were correlated with diastolic and systolic blood pressure in primary hypertension.
    원문보기 원문다운로드 사이트로이동
저자의 최근 논문