| Objective: To discuss the clinical significance of microvascular disease in patients with hypertension and to provide the basis of clinical diagnosis and treatment for hypertension,by the study of retinal vascular changes in patients with essential hypertension,Methods:The study objects were selected from hospitalize patients with essential hypertension and suspected coronary heart disease,since January 2014 and August 2015,including 30 men and 32 women.the average age was 58.32±10.43 years old. The control group was selected from Center of Health Examination at the same time, including 10 men and 17 women.the average age was 55.72±9.33 years old. The general data was gathered including gender, age,BMI,smoking,hypertension duration, blood pressure level et al. The experimental group was divided into different groups by the diagnosis of coronary heart disease,left ventricular myocardial hypertrophy, hypertension duration, blood pressure level, nocturia. The experimental group had received coronary angiography examination by 5F Judkins catheter. All patients had received funds photography examination, then we calculated retina vascular calibers by modified Parr-Hubbard-knudtson formula. Statistical methods: Using SPSS 17.0 statistical software for analyzing data of retina vascular calibers?Results: 1. By the diagnostic criteria of coronary heart disease of coronary angiography, the experimental group is divided into non-CHD group and CHD group. Then we compared retina vascular calibers control group. The overall comparison(ANOVA) of three groups indicated CRAE(F =111.50, P<0.05), CRVE(F=112.50, P<0.05) were significantly different, there was no significant difference in AVR(F=0.45, P=0.636). Pairwise comparison among the three groups indicated CRAE, CRVE were statistically significant(P<0.05), but AVR had no significant difference(P> 0.05).2. By the diagnostic criteria of left ventricular hypertrophy, the experimental group is divided into left ventricular hypertrophy group and non-group. The overall comparison(ANOVA) of there groups indicated CRAE(F=138.00, P<0.05), CRVE(F= 115.57, P<0.05) were significantly different and AVR is not significant difference(F=0.40, P=0.672). Pairwise comparison among the three groups indicated CRAE, CRVE were significantly different(P<0.05) but AVR was not statistically significant(P>0.05).3. We compared retina vascular calibers among different hypertension level group and control group. Overall comparison by ANOVA indicated the CRAE, CRVE of T1, T2, T3 and control groups were significantly different(P<0.05), AVR was no significant difference(P=0.731). It indicated CRAE, CRVE were significantly different(P<0.05), that T1, T2, T3 groups were separately compared with control group. Pairwise comparison in CRAE among T1,T2 and T3 indicated that T3 group was significantly different with T1, T2 group(P<0.05), T1 group and T2 group had no significant difference(P=0.295). Pairwise comparison in CRVE among T1,T2 and T3 indicated that T3 group was significantly different with T1, T2 group(P<0.05), T1 group and T2 group had no significant difference(P=0.174). Pairwise comparison in AVR among Four groups had no significant difference(P>0.05).4. We compared retina vascular calibers among different hypertension duration group and control group. Overall comparison(ANOVA) among three indicated CRAE(F=149.89.00, P<0.05), CRVE(F=107.56, P<0.05), were significantly different, but AVR had no significant difference(F=0.66, P=0,519) Pairwise comparison among three groups, CRAE, CRVE were statistically significant(P<0.05), AVR had no significant difference(P>0.05).5. By the diagnostic criteria of nocturnal enuresis, the experimental group is divided into nocturnal hypertension group and the non-nocturnal hypertension group. We compared retina vascular calibers among nocturnal hypertension group, the non-nocturnal hypertension group and control group. Overall comparison(ANOVA) of three groups indicated CRAE, CURVE, were significantly different(P<0.05),but AVR had no significant difference(P=0.594). Pairwise comparisons among three groups indicated CRAE, CRVE were significantly different(P<0.05), AVR had no significant difference(P> 0.05).6. We had analysised the correlation of Multivariate and retina vascular calibers? Retina vascular calibers was corrected with age(b=0.192, P=0.042), hypertension duration(b=1.025, P=0.036), cardiac hypertrophy(b= 0.257, P=0.001), nocturia(b=0.247, P=0.014), hypertension with non-coronary heart disease(b=1.251, P=0.001), hypertension level(b=0.398, P=0.021),and the correction of retina vascular calibers and hypertension with non-coronary heart disease was the most significant. Retinal vein calibers was corrected with hypertension level(b=0.418, P=0.031), hypertension duration(b =1.005, P=0.038), cardiac hypertrophy(b=0.250, P=0.027), nocturia(b=0.257, P=0.024), hypertension with non-coronary heart disease(b=1.362, P=0.030). the correction of retina vein calibers and hypertension with non-coronary heart disease was the most significant.Conclusion: 1. in patients with hypertension, retinal vascular calibers was significance for evaluation of target-organ damage.2. Coronary microcirculation lesion was significantly related with retinal vascular calibers... |
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