论文部分内容阅读
目的:探讨糖尿病对使用视网膜动脉、视网膜静脉直径评价冠状动脉粥样硬化性心脏病(CHD)患者病变严重程度的影响。方法:对120例经冠状动脉造影确诊为CHD的患者进行眼底照相,使用Parr-Hubbard公式计算视网膜中央动脉直径等效值(central retinal arteriolar equivalents,CRAE)和视网膜中央静脉直径等效值(central retinalvenular equivalents,CRVE),以此分别代表视网膜动脉和视网膜静脉的平均直径。应用Gensini评分标准评价冠状动脉病变程度。通过问卷调查和抽取静脉血获取其他心血管危险因素。研究糖尿病对视网膜血管直径和Gensini评分结果相关性的影响,以及其它心血管危险因素对视网膜血管直径的影响。结果:糖尿病可使患者的CRVE增加,而对CRAE无影响。糖尿病对Gensini评分与CRAE的相关性具有显著性影响,而不影响Gensini与CRVE的相关性。其他与CRAE有相关性的其他指标有年龄、性别、收缩压、舒张压、平均动脉压、体质量指数、吸烟史、高血压病史和低密度脂蛋白胆固醇、高密度脂蛋白胆固醇。而与CRVE有相关性的有年龄、吸烟史、高血压病史和糖化血红蛋白。结论:视网膜血管直径在一定程度上可反映CHD病变严重程度,但是需考虑到糖尿病及其它心血管危险因素对于评估的影响。
Objective: To investigate the effect of diabetes on the severity of pathological changes in patients with coronary atherosclerotic heart disease (CHD) using retinal artery and retinal vein diameter. Methods: 120 patients with CHD diagnosed by coronary angiography were examined by fundus photography. The central retinal arteriolar equivalents (CRAEs) and the central retinal vein diameters (RVRs) were calculated using the Parr-Hubbard formula. equivalents, CRVE) to represent the average diameter of the retinal artery and retinal vein, respectively. The degree of coronary artery lesion was evaluated by Gensini score. Access to other cardiovascular risk factors by questionnaire and venous blood draw. To investigate the effect of diabetes on the correlation between retinal vessel diameter and Gensini score, and the effects of other cardiovascular risk factors on retinal vessel diameter. Results: Diabetes increased CRVE in patients without any effect on CRAE. Diabetes had a significant effect on the correlation between Gensini score and CRAE without affecting Gensini’s association with CRVE. Other indicators associated with CRAE are age, sex, systolic blood pressure, diastolic blood pressure, mean arterial pressure, body mass index, smoking history, history of hypertension and LDL cholesterol, HDL cholesterol. And associated with CRVE are age, smoking history, history of hypertension and glycosylated hemoglobin. Conclusion: The diameter of retinal vessels may reflect the severity of CHD to some degree, but the influence of diabetes and other cardiovascular risk factors on assessment should be considered.