高海拔地区非颞动脉炎性前部缺血性视神经病变的病因与临床研究

The pathogenic factors and clinical relevance study of non-arteritic anterior ischemic optic neuropathy in the population of high altitude regions

摘要:

目的：探讨高海拔地区非颞动脉炎性前部缺血性视神经病变(non-arteritic anterior ischemic optic neuropathy，NAION)的发病因素与临床的相关研究。

方法：将2011-03/2012-09来我科门诊就诊，并确诊为NAION的住院患者纳为病例组。并将同一时期来我院参加门诊体检并与病例组年龄、性别相匹配的人群作为对照组。将纳入对象的个人资料进行详细登记和详尽的眼科检查，并进行血压监测及血常规、血脂、血糖、血液流变等化验检查，并将观察指标详细记录。

结果：病例组与对照组之间总胆固醇、HDL-脂蛋白、血常规无统计学差异(P>0.05)，而甘油三脂、血糖、血压有统计学差异(P<0.05)，NAION组较高。全血黏度高切、血浆黏度、全血还原黏度中切、红细胞变形指数、血沉、血沉方程K值二组之间无统计学差异(P>0.05)，而全血黏度中低切、红细胞压积、全血还原黏度高低切、红细胞聚集指数有统计学差异(P<0.05)，NAION组较高。

结论：高海拔地区NAION的发病因素不是单一的，是多因素相互作用的结果。高海拔低压低氧等环境条件下，NAION的发病与人体微循环发生的一系列病理生理变化相关。甘油三脂、血压、血糖对高海拔地区NAION的发生具有统计学差异(P<0.05)。高血黏度是高海拔地区NAION发生的危险因素。应加强高海拔地区人群对NAION的健康教育，提高其对NAION防治的认识。

Abstract:

AIM: To explore the pathogenic factors and clinical relevance study of non-arteritic anterior ischemic optic neuropathy(NAION)in the population of high altitude regions.

METHODS: The patients who came to our ophthalmology clinic outpatient to see a doctor and diagnosed with NAION from March 2011 to September 2012 were included as case group. During the same period, persons who participated in medical examination in our outpatient department and whose age and gender matched with case group were regarded as the control group. 1)Registering personal information of each object included in detail. 2)Taking detailed ophthalmologic examinations to included objects. 3)For the included objects, blood pressure monitoring and laboratory tests including blood routine, serum lipid, blood glucose, hemorrheology and so on were taken. These observational indexes were detailed recorded.

RESULTS: 1)Between NAION group and control group, there were no significant differences among the total cholesterol, HDL lipoprotein and blood routine(P>0.05); however, as to the triglycerides, blood glucose, blood pressure had a significant difference(P<0.05), NAION group was higher than the control one. 2)To high shear viscosity of whole blood, plasma viscosity, shear between high and low reduction viscosity of whole blood, erythrocyte deformation index, ESR and KESR, there was no significant difference between two groups(P>0.05); low shear and shear between high and low viscosity of whole blood, HCT, high and low shear reduction viscosity of whole blood, erythrocyte aggregation index had a significant difference(P<0.05), NAION group was higher.

CONCLUSION: 1)The pathogenic factors of NAION in the population of high altitude regions are multiple factors instead of single one. 2)Under the environment conditions of high altitude, low atmospheric pressure and low oxygen, the onset of NAION is associated with a series of pathophysiologic changes in the microcirculation of human body. 3)It had statistical significances among triglycerides, blood pressure, blood glucose and the onset of NAION at high altitudes. 4)High blood viscosity is a risk factor of the onset of NAION at high altitudes. 5)It is time to strengthen health education of NAION among the population of high altitude regions and improve their awareness of prevention and cure of that.