颈内动脉狭窄对眼部血流频谱形态的影响及颈内动脉内膜切除术后眼部血流的变化  

The effect on ocular blood spectrum morphology of internal carotid stenosis and the changes after carotid endarterectomy

作　　者：李琳[1] 魏世辉[2] 安立春[3] 陈洁[2] 朱丹[1] 

机构地区：[1]内蒙古医学院附属医院眼科,呼和浩特010050 [2]解放军总医院眼科 [3]解放军总医院超声科

出　　处：《中华眼科医学杂志（电子版）》2011年第1期54-62,共9页Chinese Journal of Ophthalmologic Medicine(Electronic Edition)

摘　　要：目的分析颈内动脉狭窄对眼部血流频谱形态影响及颈动脉内膜切除术后眼部血流动力学变化。方法选取2009年7至10月在解放军总医院神经外科和血管外科住院至少一侧颈内动脉狭窄并拟行颈内动脉内膜剥除术治疗患者20例,均行数字减影血管造影或核磁共振血管造影检查明确患者颈内动脉狭窄率≥60%。入选患者均用超声检测视网膜中央动脉和眼动脉的收缩期血流速峰值,同时记录频谱形态。其中,接受手术治疗患者于术后第7日再次行上述检查。采用Wilcoxon配对秩和检验比较术前术后视网膜中央动脉和眼动脉血流动力学参数变化。结果 74.2%患侧眼动脉频谱出现改变,83.9%患侧视网膜中央动脉频谱形态出现改变。行手术治疗患者,与术前相比,眼动脉(Z值=-2.37,P值<0.05)和视网膜中央动脉(Z值=-2.20,P值<0.05)收缩期峰值流速术后均有增加。结论当颈内动脉狭窄率≥60%时,眼部的球后血流频谱形态已经出现改变。从血流动力学角度和频谱形态分析,颈内动脉内膜剥除术可以改善颈内动脉狭窄患者眼部血供。Objective To investigate the effect on ocular blood spectrum morphology of internal carotid stenosis,and the changes about ocular vessel blood velocity after carotid endarterectomy( CEA). Methods The patients being treated with CEA were defined the rate of internal carotid artery stenosis ≥60% by digital subtraction angiography( DSA) or magnetic resonance angiography( MRA) in neurosurgery surgery and vascular surgery departments of People's Liberation Army General Hospital. 20 patients were selected and suffered eye examination and color doppler flow imaging( CDFI) for measurement of the peak systolic velocity( PSV) of the ophthalmic,and the central retinal arteries. CDFI were done again 7 days after CEA. To compare the difference between preoperative and postoperative hemodynamics of central retinal artery and ophthalmic artery using wilcoxon signed ranks. Results About 74. 2% of the patients showed the change of ocular artery spectrum. And 83. 9% of the patients showed the change of central retinal artery spectrum. PSV in the ophthalmic( Z =- 2. 37,P < 0. 05),central retinal arteries( Z =-2. 20,P < 0. 05) increased significantly 1 week after CEA. Conclusions The retrobulbar blood spectrum had emerged to change when the rate of internal carotid artery stenosis ≥60%. CEA could improve the ocular blood supply.

关 键 词：颈内动脉狭窄 缺血性眼病 彩色多普勒血流成像 颈动脉内膜切除术 

分 类 号：R651.1[医药卫生—外科学] R77[医药卫生—临床医学]