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陆军军医大学(第三军医大学):第一附属医院眼科,高原军事医学系寒区医学教研室
黄小勇,E-mail:huangxiaoyong@tmmu.edu.cn
收稿:2025-11-20,
修回:2025-12-03,
录用:2025-12-15,
纸质出版:2026-01-15
移动端阅览
关海东,崔琪,黄榆杰,等.心率与胆固醇:高海拔居留1.5年的非藏族青年男性视网膜血管异常的潜在危险指标及筛查意义探讨[J].陆军军医大学学报,2026,48(01):86-93.DOI:10.16016/j.2097-0927.202511086.
GUAN H D,CUI Q,HUANG Y J,et al.Heart rate and cholesterol: Exploration of potential risk indicators and screening significance for retinal vascular abnormalities in non-Tibetan young men residing at high altitudes for 1.5 years[J].J Army Med Univ,2026,48(01):86-93.DOI:10.16016/j.2097-0927.202511086.
关海东,崔琪,黄榆杰,等.心率与胆固醇:高海拔居留1.5年的非藏族青年男性视网膜血管异常的潜在危险指标及筛查意义探讨[J].陆军军医大学学报,2026,48(01):86-93.DOI:10.16016/j.2097-0927.202511086. DOI:
GUAN H D,CUI Q,HUANG Y J,et al.Heart rate and cholesterol: Exploration of potential risk indicators and screening significance for retinal vascular abnormalities in non-Tibetan young men residing at high altitudes for 1.5 years[J].J Army Med Univ,2026,48(01):86-93.DOI:10.16016/j.2097-0927.202511086. DOI:
目的
2
探讨在高海拔地区生活1.5年,对健康非藏族青年男性视网膜血管的影响,并筛选与其相关的血液学及生理学指标,为增加高原地区眼部体检项目提供依据。
方法
2
采用横断面调查研究设计方案,于2024年9月至2025年9月完成数据筛选与整理,选取2024年12月时已在海拔4 100 m地区连续居留满1.5年的非藏族青年男性作为研究对象。180名中视网膜血管异常有65例,视网膜血管正常有115例。通过两独立样本秩和检验及多因素Logistic回归分析,评估血液学及生理学指标与视网膜血管异常的关联性。
结果
2
视网膜血管异常的发生率为36.11%。两独立样本秩和检验显示,两组在慢性高原病(chronic mountain sickness,CMS)上无统计学差异(
P
=0.527);心率(
P
=0.033)、平均视觉反应时间(
P
=0.07)、γ-谷氨酰转移酶(
P
=0.18)、总胆固醇(
P
=0.033)、甘油三酯(
P
=0.149)、低密度脂蛋白(
P
=0.095)、血小板计数(
P
=0.141)、血小板压积(
P
=0.066)的
P
值均小于0.2。多因素L
ogistic回归分析显示,心率(
OR
=1.033,95%
CI
:1.003~1.064,
P
=0.033)、总胆固醇(
OR
=1.868,95%
CI
:1.004~3.477,
P
=0.049)与视网膜血管改变风险呈正相关,而视觉反应平均时间(
OR
=0.035,95%
CI
:0.002~0.723,
P
=0.03)与视网膜血管改变风险呈负相关。
结论
2
进入高海拔地区1.5年的健康青年男性中视网膜血管异常发生率较高。心率增快与总胆固醇水平升高是视网膜血管改变的独立危险因素,而视觉反应时间延长则与风险降低相关。对策 定期进行眼底照相检查,有助于早期识别视网膜血管改变,对预防高海拔相关视网膜病变乃至高原脑水肿的发生与发展具有重要临床意义,建议将其纳入高原驻留人员的健康监测体系。
Objective
2
To explore the impact of living at high altitudes for 1.5 years on the retinal blood vessels among healthy non-Tibetan young males and to screen related hematological and physiological indicators
providing a basis for increasing the eye examination items in high-altitude regions.
Methods
2
A cross-sectional survey design was employed. Data screening and collation were conducted between September 2024 and September 2025. The study subjects comprised non-Tibetan young adult males who
by December 2024
had been residing continuously at an altitude of 4 100 m for 1.5 years. Among the 180 participants
65 had retinal vascular abnormalities and 115 were normal. Two independent samples rank-sum test and multivariate logistic regression analysis were performed to analyze the association between the hematological and physiological indicators and retinal vascular abnormalities.
Results
2
The incidence of retinal vascular abnormalities was 36.11%. Two independent samples rank-sum test showed no statistical difference between the 2 groups in chronic mountain sickness (CMS) (
P
=0.527)
while the
P
-values less than 0.2 were observed in term of heart rate (
P
=0.033)
average visual reaction time (
P
=0.07)
γ-glutamyl transferase (
P
=0.18)
total cholesterol (
P
=0.033)
triglycerides (
P
=0.149)
low-density lipoprotein (
P
=0.095)
platelet count (
P
=0.141)
and plateletcrit (
P
=0.066). Multivariate logistic regression analysis revealed that heart rate (
OR
=1.033
95%
CI
: 1.003 to 1.064
P
=0.033) and total cholesterol (
OR
=1.868
95%
CI
: 1.004 to 3.477
P
=0.049) were positively
while average visual reaction time (
OR
=0.035
95%
CI
: 0.002 to 0.723
P
=0.03) was negatively correlated with the risk of retinal vascular changes.
Conclusion
2
The incidence of retinal vascular abnormalities is relatively high among healthy young men who have resided in high-altitude areas for 1.5 years. Increased heart rate and elevated total cholesterol level are independent risk factors for retinal vascular changes
while prolonged visual reaction time is associated with a reduced risk of such changes. Countermeasures Regular fundus photography helps identify retinal vascular changes at an early stage
which has important clinical significance for preventing the occurrence and development of high-altitude-related retinopathy and even high-altitude cerebral edema. It is recommended to include fundus photography in the health monitoring system for personnel residing in high-altitude areas.
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