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与降压治疗后视网膜微循环变化相关的因素。

Factors associated with changes in retinal microcirculation after antihypertensive treatment.

机构信息

Department of Internal Medicine, Hospital de Conxo Medicine Deparment, Complexo Hospitalario Universitario de Santiago de Compostela, Spain.

Department of Internal Medicine, Hospital Abente y Lago, ACoruña, Spain.

出版信息

J Hum Hypertens. 2014 May;28(5):310-5. doi: 10.1038/jhh.2013.108. Epub 2013 Nov 21.

Abstract

We report the results of hypertensive treatment over retinal arteriole narrowing in a group of 189 hypertensive patients during a 6-month treatment programme for hypertension. These patients were included in an observational study under clinical practice conditions and analysed using digital photographs of the eye fundus with a previously described semiautomatic snakes method. We analysed the relation between blood pressure control and retinal microcirculation changes during the treatment. We included 189 hypertensive patients; 74.0% of them had BP under control after 6 months of follow-up. The arteriovenous ratio (AVR), measured as the relation between the average retinal arteriole and venous diameter, significantly increased after 6 months of follow-up in both eyes (right eye AVR: 0.769±0.065 vs. 0.799±0.066 (P<0.0001); left eye AVR: 0.770±0.065 vs. 0.796±0.071 (P<0.0001)). AVR changes were caused by increases in arteriole diameter. No linear correlation was found between blood pressure-lowering levels and AVR increase, suggesting that other factors could be involved in the regression of retinal changes. We conclude that in our group of hypertensive patients it was possible to increase the retinal arteriole diameter, expressing an improvement in retinal microcirculation after 6 months of adequate BP control. Although there is an inverse tendency between blood pressure and arteriovenous ratio changes, we could not find a linear correlation between these changes.

摘要

我们报告了在 189 例高血压患者的 6 个月降压治疗方案中,视网膜小动脉狭窄与高血压治疗结果的关系。这些患者纳入了临床实践条件下的观察性研究,并使用先前描述的半自动蛇形方法对眼底数字照片进行了分析。我们分析了治疗过程中血压控制与视网膜微循环变化之间的关系。我们纳入了 189 例高血压患者;其中 74.0%的患者在 6 个月的随访后血压得到控制。在双眼中,经过 6 个月的随访,动静脉比值(AVR),即视网膜小动脉和静脉平均直径的比值,显著增加(右眼 AVR:0.769±0.065 比 0.799±0.066(P<0.0001);左眼 AVR:0.770±0.065 比 0.796±0.071(P<0.0001))。AVR 的变化是由小动脉直径的增加引起的。降压水平与 AVR 增加之间未发现线性相关,这表明其他因素可能参与了视网膜变化的消退。我们的结论是,在我们的高血压患者组中,在适当的血压控制 6 个月后,可以增加视网膜小动脉直径,这表明视网膜微循环得到改善。尽管血压和动静脉比值变化之间存在相反的趋势,但我们未能发现这些变化之间存在线性相关性。

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