颈内动脉狭窄与缺血性眼病的相关性研究  

A study of correlation analysis on ocular ischemic disease and carotid stenosis

作　　者：朱丹[1] 李琳[1] 安立春[2] 陈洁[3] 魏世辉[3] 

机构地区：[1]内蒙古医学院附属医院眼科,呼和浩特010050 [2]解放军总医院超声科,北京100853 [3]解放军总医院眼科,北京100853

出　　处：《中华实验眼科杂志》2011年第12期1116-1119,共4页Chinese Journal Of Experimental Ophthalmology

摘　　要：背景颈内动脉狭窄是缺血性眼病的重要病因之一，研究二者的关系有助于明确缺血性眼病的类型，对进一步的治疗具有指导意义。目的探讨颈内动脉狭窄与缺血性眼病的相关性。方法选取经数字减影血管造影或磁共振血管造影检查，明确至少一侧颈内动脉狭窄率≥60％的颈内动脉狭窄患者20例，包括一侧颈内动脉狭窄者9例及两侧颈内动脉狭窄者11例。对患者进行最佳矫正视力、眼压及眼底检查，同时用彩色多普勒超声仪检测患者视网膜中央动脉（CRA）的收缩期血流峰值速度（PSV））、舒张期血流峰值速度（EDV）及阻力指数（RI），对颈内动脉狭窄率与所测各指标的相关性进行统计学分析。结果20例31侧颈内动脉狭窄者中共24侧有眼部表现（77．4％），主要有单眼一过性黑喙（77．4％）、视物模糊（22．6％）等；发现有眼部阳性体征者12眼（38．7％），均为眼部血管异常；2例患者诊断为低灌注性视网膜病变并发新生血管性青光眼。颈内动脉狭窄率和同侧CRA的PSV呈负相关（r=-0．41，R^2=0．168，P=0．021），但与RI无明显相关性（r=-0．26，R^2=0．068，P=0．159）。结论颈内动脉狭窄可引起明显的眼部症状，颈内动脉狭窄所致的眼部视网膜血流改变为低速正常阻力型。Background Carotid stenosis is one of the important causes of ocular ischemic diseases, To study their relationship is helpful for us to classify and manage the ocular ischemic diseases. Objective This study was to investigate the correlation between ocular isehemic diseases and carotid stenosis. Methods Twenty patients with internal carotid artery stcnosis rate more than 60% defined by digital subtraction angiography（DSA） or magnetic resonance angiography （MRA） were selected,including 9 patients with lateral carotid artery stenosis and 11 patients with bilateral carotid artery stenosis. The best corrected visual acuity,intraoeular pressure and fundus examinations were carried out, and the peak systolic velocity （PSV） and end diastolic velocity （EDV） of the central retinal artery（CRA） were detected with color doppler flowimaging （CDFI）. The resistance index（RI） was calculated by the formula RI = PSV-EDV/PSV. The correlation between internal carotid artery stenosis rate and PSV or RI was evaluated by Spearman rank correlated analysis. Results The subjective manifestations included transient amaurosis in 77.4% frequency and visual blur in 22.6% frequency in the 31 carotid artery stenosis. Twelve eyes（ 38.7% ） appeared the ocular vascular abnormality. Other 2 patients were diagnosed as hypoperfusion retinopathy complicated by neovascular glaucoma. A negative relationship was found between internal carotid artery stenosis rate and PSV of CRA （ r = - 0.41, R^2 = 0. 168, P = 0. 021 〈 0.05 ） , but no significant relationships was found between internal carotid artery stenosis rate and RI （ r = - 0.26, R^2 = 0. 068, P = 0. 159 ）. Conclusions Carotid artery stenosis can cause the of ocular ischemie symptoms. The characteristies of retinal hemodynamics is the type of low speed and normal resistance.

关 键 词：颈内动脉狭窄 视网膜中央动脉 缺血性眼病 血流动力学 

分 类 号：R743.3[医药卫生—神经病学与精神病学]