摘要
目的比较双眼与单眼非动脉炎性前部缺血性视神经病变(NAION)患者临床特征与危险因素的差异。设计回顾性病例系列。研究对象解放军总医院神经眼科2009年10月至2015年3月NAION患者201例。方法收集患者的病史、实验室检查、颈动脉超声、头颅磁共振(MRI)、多导睡眠监测、24小时动态血压检查结果,并对单眼、双眼患者两组间差异性比较。主要指标年龄、性别、基础疾病、药物使用、视盘形态。结果 201例患者中,双眼受累67例(61例双眼同时受累,6例双眼同时发病间隔小于1周),单眼受累134例。双眼受累组与单眼受累组在年龄(54.69±10.43岁、54.47±9.90岁,P=0.988)、男女比例(1.34:1、2.05:1,P=0.22)方面无明显差异。相比于单眼受累组,双眼受累组患者高血压比例更高(52.2%、37.3%,P=0.04)、夜间睡眠低血压比例更低(19.2%、37.2%,P=0.026)、使用降血压药物更多(65.7%、40.3%,P=0.03)、合并阻塞性睡眠呼吸暂停低通气更多(35.4%、21.2%,P=0.036)、肥胖比例更大(17.9%、9.7%,P=0.031)。吸烟、饮酒、糖尿病、血脂紊乱、颈动脉粥样硬化、脑梗死、高同型半胱胺酸血症、拥挤视盘、诱发因素等在两组间无明显差异。结论高血压、使用降血压药物、肥胖及合并睡眠呼吸暂停综合征是发生双眼NAION的危险因素。
Objective To compare the clinical characteristics and risk factors of unilateral and bilateral onset in non-arteritic anterior ischemic optic neuropathy （NAION） patients. Design Retrospective case series. Participants A total of 201 patients of NAION were recruited in Department of Ophthalmology of PLA General Hospital from October 2009 to March 2015. Methods Differences in clinical characteristics, including disease history, laboratory tests, carotid artery ultrasound, brain magnetic resonance imaging （MRI）, polysomnography （PSG） and ambulatory blood pressure monitoring （ABPM）, between groups were analyzed using Chi-square test or t-test. Main Outcome Measures Age, gender, systemic disease, medications taken and anatomy of optic disc. Results Among the 201 NAION patients, 67 patients were bilateral onset （6 of them happened bilaterally simultaneously or with an internal less than 1 week between the two eyes） and the other 134 patients were unilateral onset. There was no difference found between the two groups in age （54.69±10.43 vs 54.47±9.90 years old, P=0.988） and gender （Male： Female： 1.34：1 vs 2.05：1, P=0.22）. Compare to the unilateral group, the bilateral group showed a higher percentage of hypertension （52.2% vs 37.3%, P=0.04）, lower percentage of noctural hypotension （19.2% vs 37.2%, P=0.026）, more frequent using of hypotensors （65.7% vs 40.3%, P=0.03） , more frequent coexisting with obstructive sleep apnea syndrome （OSAHS） （35.4% vs 21.2%, P=0.036）, and more frequent of obesity（17.9% vs 9.7%, P=0.031）. There were no significant differences in smoking and drinking status, diabetes, dyslipidemia, carotid atherosclerosis, cerebral infarction, homocysteine serum cystine, crowded disc, or precipitating factor. Conclusions Hypertension, hypotensive medications, obesity and coexist with OSAHS may be risk factors for the development of bilateral NAION.
出处
《眼科》
CAS
CSCD
北大核心
2016年第6期377-380,共4页
Ophthalmology in China
