高海拔视网膜病变的研究进展

Progress in research on high-altitude retinopathy

摘要

高原环境通常具有低气压、低氧分压、强紫外辐射及气候干燥等特征，当机体快速进入高原地区，可引发机体多个系统的损伤。高海拔视网膜病变（HAR）主要的临床表现为视网膜出血、血管扩张、视神经盘水肿及视网膜血管微循环异常，甚至患者视觉功能下降。近年来，随着高原旅游、科学考察及人员流动的增加，HAR的发生率呈现出上升的趋势。本研究系统论述了高原环境的特征、HAR的流行病学和临床特点、发病机制及临床防治的进展，重点从分子和细胞信号通路层面深入阐述高原低压低氧、氧化应激、神经细胞损伤等在 HAR 的病理机制，并结合甘肃省地理特点探讨其在 HAR 研究和防治中的独特价值及未来研究方向。

Abstract

The plateau environment is characterized by low atmospheric pressure，low oxygen，strong ultravi- olet radiation and the dry climate．A rapid exposure to high-altitude areas could result in damage to multiple systems of the human body．High-altitude retinopathy（HAR）is a typical complication occurring during the exposure to plateau conditions．Its dominant clinical manifestations include retinal hemorrhage，retinal vascular dilation，optic disc edema，abnormalities of retinal microcirculation and varying degrees of visual function impairment．In recent years，with the increasing frequency of high-altitude tourism，scientific explo- ration，and population mobility，the incidence of HAR has shown a rising trend．This review systematically revealed the characteristics of the plateau environment，the epidemiology and clinical features of HAR，as well as recent advances in the pathogenesis and clinical prevention and treatment．Particular emphasis was placed on the molecular and cellular signaling pathways involved in its pathological mechanisms，including hypo- baric hypoxia，oxidative stress and neural cell injury．Furthermore，the peculiar geographical characteristics of Gansu Province were discussed in relation to their worth for research on the pathogenesis，prevention and future directions of it．

关键词

高原环境 / 高海拔视网膜病变 / 低压缺氧 / 氧化应激 / 机制

Key words

plateau environment / high-altitude retinopathy / hypobaric hypoxia / oxidative stress / mechanism

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基金资助

朗视界•沐光明中青年眼科科研项目(BCF-KH-YK-20240906-03)

兰州大学第二医院萃英学子科研培育计划资助项目(CYXZPT2025-04，CYXZ2023-09)

兰州大学萃英基金科研项目(CY2022-HL-B11)