眼部缺血综合征患者的临床特征及高血压对视力的影响  

Clinical Characteristics of Ocular Ischemic Syndrome and Impact of Hypertension on Vision

作　　者：王雅从[1] 尤明玲[2] 张立红[3] 董京辉[4] 张晓琳[5] 任骞[1] 于华[1] 张华[1] 叶存喜[6] 

机构地区：[1]石家庄市第四医院眼科,河北石家庄050011 [2]石家庄信息工程职业学院医院,河北石家庄050035 [3]河北医科大学第一医院神经内科,河北石家庄050031 [4]香港中文大学医学院生物医学学院 [5]河北医科大学流行病与卫生统计学教研室,河北石家庄050017 [6]河北医科大学第二医院眼科,河北石家庄050000

出　　处：《中山大学学报（医学科学版）》2012年第4期536-540,共5页Journal of Sun Yat-Sen University:Medical Sciences

摘　　要：【目的】探讨眼部缺血综合征的临床特征以及高血压对视力和眼底病变的影响。【方法】对124例眼部缺血综合征患者的病例资料进行回顾性分析。【结果】124例患者平均年龄63.64(S=12.13)岁,男女比例1.8∶1;96.77%的患者有颈动脉狭窄,主要的全身合并症是高血压,糖尿病和心脑血管疾病;主要眼部症状为视力下降和一过性黑矇,眼前节主要发生虹膜新生血管生成,视网膜主要表现为动脉狭窄和静脉扩张、点片状出血;眼底荧光血管造影主要表现为臂-视网膜循环时间和视网膜动-静脉循环时间延长、微血管囊样扩张和毛细血管无灌注区;合并高血压的患者的视力障碍与没有高血压的患者相比差异有统计学意义(P<0.01)。【结论】眼部缺血综合征是一种主要发生于老年人的严重的慢性缺血性眼部症候群,男性多于女性,主要由颈动脉狭窄引起,临床表现复杂多样,常常需要神经科和心内科等医师联合诊治,高血压可以加重患者的眼部病变,眼底镜和荧光血管造影检查是早期确诊该病的关键手段。[Objective] The project investigated clinical features of ocular ischemic syndrome （OIS） and the influence of hypertension on vision and fundus lesion. [Method] Retrospective analysis was performed on 124 patients of OIS. [Results] Mean age of all patients was 63.64 （S = 12.13）, with a ratio of 1.8：1 between male and female. Among all patients, 96.＇77% were detected carotid artery stenosis, mainly accompanied by hypertension, diabetes and cardiovascular and cerebrovascular disease. They presented with reduced visual acuity and amaurosis fugax, along with iris neovascularization at anterior segment and arteriostenosis, phlebectasia, dot and blot hemorrhage at retina by ophthalmoscope examination. Fundus fluorescein angiography （FFA） exhibited prolongation of arm-retina time and arteriovenous circulation time, microaneurysms and capillary non-perfusion region. And visual disturbance between normotensive and hypertensive patients showed significant difference （P 〈 0.01 ）. [Conclusion] OIS, characterized as complicated clinical mamfestations and deteriorated by hypertension, is mainly induced by carotid stenosis, commonly seen among aged population. Ophthalmoscope examination and FFA afford key methods for its early diagnosis with co-diagnosis and co-treatment from neurologist and cardiologist.

关 键 词：眼部缺血综合征 颈动脉狭窄 高血压 眼底荧光血管造影 眼底镜检查 

分 类 号：R77[医药卫生—眼科]