【摘要】 目的了解山东省宁阳县城乡居民中高血压视网膜病变(HR)的患病率,分析其相关危险因素。方法采用整群随机抽样方法,抽取宁阳县城区和农村部分35岁以上居民进行血压测量、问卷调查、眼科检查及静脉血实验室检测。结果 1 086例(81.78%)高血压患者完成了全部的问卷调查、体格检查和实验室检测。其中313例眼底正常,783例存在不同程度的HR,患病率为71.18%,其中Ⅰ期532例(68.82%),Ⅱ期159例(20.57%),Ⅲ期79例(10.22%),未发现Ⅳ期HR。53例(6.86%)出现眼部并发症。1 086名高血压患者中,知道自己患高血压病变的占79.1%(859人),曾经接受药物治疗的占31.5%(342人)。农村居民HR患病率为73.68%,城区居民HR患病率为64.82%,前者明显高于后者。HR的患病率随着患者的年龄、血压值以及高血压病程的增加而升高,与患者的性别没有明显相关性。经有序logistic回归分析,年龄、城乡差别、高血压病程等是HR的危险因素。混合型高血压者HR患病率是血压值正常的2.44倍,高血压病程10年以上者HR患病率是病程1年以下者的4.15倍。结论宁阳县城乡居民HR患病率较高,血压、年龄、城乡差别、高血压病程等是其相关的危险因素,存在对疾病的知晓率低、治疗率低且不规范、控制率低的情况。建立HR的立体防治体系需要眼科与社区、基层医疗机构以及各级卫生机构在不同层面上的密切协作。更多还原

【Abstract】 Objective To explore the morbidity of hypertensive retinopathy(HR)in the residents of Ningyang county in the Shandong province and to analyze its related risk factors.Methods Some residents over 35 years old in the Ningyang county were selected by a cluster random sampling method and investigated with questionnaire surveys,physical examination and venous blood tests.Results 1 086(81.78%) hypertension patients completed all of the questionnaire,physical examination and laboratory detection.There were 313 patients with normal retinal and 783 with hypertensive retinopathy in varying degrees,including 532 cases of gradeⅠ(68.82%),159 cases of grade Ⅱ(20.57%),79 cases of grade Ⅲ(10.22%) and none of grade Ⅳ,and only 53 cases occurred ocular complications(6.86%).The morbidity of HR in Ningyang county was 71.18%.859 patients knew that they were suffering from high blood pressure diseases(79.1%) and 342 had been treated with drug therapy(31.5%).The morbidity of HR in the rural residents was 73.68%,which was clearly higher than that in county residents(64.82%).With the increase of patient’s age,blood pressure value and the course of the disease,the morbidity of HR was increased,but there was no significant correlation with the gender of the patients.By ordinal logistic regression analysis,age,rural area,and the course of hypertension were risk factors of HR.The severity of HR in patients with mix-type hypertension(sbp≥140 and dbp≥90) was 2.44 times than that of the normal blood pressure group.The severity of HR with the group over 10-years hypertension course was 4.15 times than that of the group of the course <1 year.Conclusion The morbidity of hypertensive retinopathy in Ningyang county is relatively high.The risk factors include blood pressure,age,residential area,and the course of hypertension.And it is characterized with low awareness rate,low treatment rate and low control rate.Ophthalmologists need close cooperation with medical institutions at all levels to establish the prevention and control system of HR.更多还原