摘要 目的 探讨角膜老年环与血脂及动脉硬化的关系。方法 观察167例40a以上住院高血压病、冠心病及脑血管病患者，探讨其角膜老年环与年龄、心脑血管病史、脑血流图、眼底及血清胆固醇的关联性。结果 显示老年环随年龄增高、有心脑血管病史而发生率增高，且与脑血流图异常、眼底改变及血清胆固醇增高呈正相关。结论 角膜老年环与血脂及动脉硬化关系密切，对了解和诊断高血压、动脉硬化及心脑血管病有一定临床意义。
Assessment of relationship between cornea arcus senilis and blood-fat %26 arteriosclerosis
PAN Wen-Xin,CHEN Wen-Li,LI Bao-Hui
Key words cornea;arcus senilis;blood-fat;arteriosclerosis
Abstract Objective To assess the relationship between cornea arcus senilis and blood-fat %26 arteriosclerosis.Method The relationship was analyzed between the arcus senilis and its possible causing factors such as the age,the medical history of cardiovascular and cerebrovascular,the rheoencephalogram,the eyeground and the serum cholesterol after the observation of 167 patients (over 40 years old) with hypertension,coronary heart diseases and cerebrovascular diseases.Results It is demonstrated that the morbidity of the arcus senilis increased with the raising of age and the existence of medical history of cardiovascular and cerebrovascular diseases,and that the morbidity were in positive proportion to the abnormality of the rheoencephalogram,the change of the retina arteries and the rise of the serum cholesterol.Conclusion The cornea arcus senilis were in close relationship with the blood-fat and the arteriosclerosis.
老年环(arcus senilis)即角膜类脂环，系在慢性组织代谢障碍基础上引起的角膜周边部混浊，其发生率随年龄的增大而增高。既往多认为老年环是局部老年变性的结果［1］。近年来有不少学者认为老年环与血脂及动脉硬化关系密切［2］。Tscbetter认为类脂环与血清胆固醇及磷脂有明确的阳性伴随关系［3］。Walton等［4］经尸检及荧光抗体技术观察，认为类脂环的形成与动脉粥样硬化的总过程是伴随关系。我们观察167例相关患者，结论与新近观点相符，现报告如下。
1 材料和方法
1.1 一般资料 40a以上住院高血压病、冠心病及脑血管病患者167例，男141例，女26例，平均年龄54.1a，有心脑血管病既往史者102例。
1.2 方法 本组患者均进行角膜老年环检查，同时检测眼底血管、脑血流图及血脂，并结合年龄、有无心脑血管病史进行比较，探讨老年环与其它检查所见的相互关系。
2 结果
2.1 老年环与年龄的关系 年龄愈大老年环发生率愈高，且程度愈重(见表1)。
表1 患者年龄与老年环的关系
Table 1 Relation between the age and the arcus senilis
| Age(a) |
Cases |
Arcus senilis |
| Positive(%) |
Negative(%) |
| 40～49 |
38 |
7(18.4) |
31(81.6) |
| 50～59 |
90 |
45(50.0) |
45(50.0) |
| 60～69 |
34 |
29(85.3) |
5(14.7) |
| ≥70 |
5 |
5(100.0) |
0(0) |
| Total |
167 |
86(51.5) |
81(48.5) |
2.2 老年环与心脑血管病既往史的关系显示有心脑血管病既往史者老年环发生率增高(见表2)。
表2 老年环与心脑血管病既往史的关系
Table 2 Relation between the arcus senilis and the
anamnesis with cardiovascular and cerebrovascular diseases
| Anamnesis |
Cases |
Arcus senilis |
| Positive(%) |
Negative(%) |
| Positive |
102 |
66(64.7) |
36(35.3) |
| Negative |
65 |
20(30.8) |
45(69.2) |
| Total |
167 |
86(51.5) |
81(48.5) |
P＜0.005
2.3 老年环与脑血流图的关系 根据脑血流图的分级标准［5］，结果显示有老年环者脑血流图异常率增高(见表3)。
表3 角膜老年环与脑血流图的关系
Table 3 Relation between the arcus
senilis and the rheoencephalogram
| Arcus senilis |
Cases |
Rheoencephalogram |
| VI(%) |
A1(%) |
A2(%) |
| Positive |
86 |
11(12.8) |
54(62.8) |
21(24.4) |
| Negative |
81 |
26(32.1) |
52(64.2) |
3(3.7) |
| Total |
167 |
37(22.2) |
106(63.4) |
24(14.4) |
P＜0.005
2.4 老年环与眼底血管改变的关系 根据眼底视网膜动脉硬化的分级标准［6］，结果显示有老年环的患者眼底改变发生率明显增高(见表4)。
表4 老年环与眼底视网膜动脉改变的关系
Table 4 Relation between the arcus senilis
and the retina arteries
| Arcus senilis |
Cases |
Retina arteries |
| -(%) |
+(%) |
(%) |
(%) |
| Positive |
86 |
13(15.1) |
47(54.7) |
24(27.9) |
2(2.3) |
| Negative |
81 |
46(56.8) |
33(40.7) |
2(2.5) |
0(0) |
| Total |
167 |
59(35.3) |
80(47.9) |
26(15.6) |
2(1.2) |
P＜0.005
2.5 老年环与血脂的关系 血清胆固醇的高低与老年环的发病情况是一致的(见表5)。
表5 老年环与血清胆固醇的关系
Table 5 Relation between the arcus senilis
and the serum cholesterol
| Arcus senilis |
Cases |
Serum cholesterol(mmol*L-1) |
| ＜5.96(%) |
5.96～9.24(%) |
＞9.24(%) |
| Positive |
86 |
60(69.8) |
19(22.1) |
7(8.1) |
| Negative |
81 |
73(90.1) |
7(8.7) |
1(1.2) |
| Total |
167 |
133(79.6) |
26(15.6) |
8(4.8) |
P＜0.005
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