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为了探讨原发性高血压 (以下简称高血压 )患者血压与眼底改变的关系 ,分别观察 1 86例轻中度高血压患者的脉压、诊所舒张压、2 4h平均舒张压、血压负荷及夜间血压下降率与眼底小动脉改变的关系。结果 :1 86例患者中 ,眼底正常 46例 ( 2 4.7% ) ,Ⅰ级改变 1 1 6例 ( 62 .4% ) ,Ⅱ级改变 2 4例 ( 1 2 .9% )。眼底正常组左室肥厚 (LVH)的发生率为 1 0 .9% ( 5 /46) ,而眼底异常组的发生率为 89.3 % ( 1 2 5 /1 40 )。诊所舒张压≥ 1 3 .3kPa( 1 0 0mmHg)、2 4h舒张压≥ 1 2 .0kPa( 90mmHg)的高血压组与其对应组相比眼底改变有显著性差异 (P分别 <0 .0 5、<0 .0 1 ) ;舒张期血压负荷超过 40 %组与对应组比较眼底改变有显著性差异 (P <0 .0 5 ) ,而收缩压负荷、杓型与非杓型血压及不同脉压差组的眼底变化组间比较无显著性差异 (P >0 .0 5 )。提示 :无合并症的轻中度高血压患者早期眼底改变大多为Ⅰ级 ,受舒张压的影响较明显 ,视网膜动脉硬化的程度也提示高血压的时限及病情。
In order to investigate the relationship between blood pressure and fundus changes in patients with essential hypertension (Hypertension), the pulse pressure, clinic diastolic pressure, mean diastolic blood pressure at 24 hours, blood pressure load and nighttime The relationship between the rate of blood pressure drop and the change of fundus arterioles. Results: Of 866 patients, 46 (24.7%) had normal fundus, 116 (62.4%) had grade I, and 14 (12.9%) had grade II. The incidence of left ventricular hypertrophy (LVH) was 10.9% (5/46) in the normal fundus, and 89.3% (125/240) in the fundus abnormalities group. Clinic diastolic blood pressure ≥ 1.3 3kPa (100 mmHg), 24 h diastolic blood pressure ≥ 1 2. 0kPa (90mmHg) hypertension group compared with the corresponding group of fundus changes were significantly different (P <0.05, <0. 01). Compared with the corresponding group, the changes of fundus in diastolic blood pressure more than 40% were significantly different (P <0.05), and systolic blood pressure, dipper and non-dipper blood pressure and pulse pressure There was no significant difference between the fundus changes in the poor group (P> 0.05). Tip: no complications of mild to moderate hypertensive patients with early fundus changes mostly grade Ⅰ, diastolic pressure more obvious impact, the extent of retinal atherosclerosis also prompts the timing and severity of hypertension.