颈动脉狭窄患者眼血流动力学参数对缺血性脑血管疾病风险的评估  

Evaluating the risk of ischemic cerebral vascular disease with ocular hemodynamics in carotid artery stenosis patients

作　　者：刘喆[1] 赵露[1] 谢国丽[1] 王佳琳[1] 王艳玲[1] 冯彦红[2] 

机构地区：[1]首都医科大学附属北京友谊医院眼科,100050 [2]首都医科大学附属北京友谊医院超声科,100050

出　　处：《中华眼科杂志》2014年第12期894-899,共6页Chinese Journal of Ophthalmology

基　　金：北京市自然科学基金（7122046）;国家自然科学基金（81173412）

摘　　要：目的 探讨颈动脉狭窄患者眼血流动力学参数变化在缺血性脑血管疾病风险评估中的应用.方法 回顾性病例对照研究.收集72例颈动脉狭窄患者的临床资料,其中22例为脑梗死组,14例为腔隙性脑梗死组（简称腔梗组）,其余36例未发生脑梗死为对照组.对所有患者测量眼动脉（OA）、视网膜中央动脉（CRA）、睫状后动脉（PCA）血流动力学参数,收缩期峰值流速（PSV）,舒张末期血流速度（EDV）及阻力指数（RI）,搏动指数（PI）;通过问卷调查和抽取静脉血获取其他脑血管危险因素.比较3个组患者眼血流动力学参数的差异性以及年龄等因素对血流动力学参数的影响.对计数资料进行x2检验,组间比较采用单因素方差分析以及bonferroni方法进行两两比较的检验水准校正.结果 脑梗死组OA的PSV为（25.96±12.63） cm/s,腔梗组PSV为（32.63±13.25） cm/s,对照组PSV为（39.46±14.97） cm/s,差异有统计学意义（F=13.393,P＜0.01）;脑梗死组OA的EDV为（6.09 ±3.10） cm/s,腔梗组EDV为（6.57 ±2.85） cm/s,对照组EDV为（9.73 ±5.02） cm/s,差异有统计学意义（F=12.609,P＜0.01）.脑梗死组CRA的PSV为（8.06±2.98） cm/s,腔梗组PSV为（8.91 ±2.76） cm/s,对照组PSV为（9.71±2.60） cm/s,差异有统计学意义（F=5.027,P＜0.01）;脑梗死组CRA的EDV为（2.46 ±0.77） cm/s,腔梗组EDV为（2.35±0.89） cm/s,对照组EDV为（2.73 ±0.86） cm/s,差异无统计学意义（F =2.405,P=0.094）.结论 颈动脉狭窄患者眼血流动力学参数对缺血性脑血管疾病风险的评估有应用价值,特别是眼动脉PSV与EDV水平升高可提示缺血性脑血管疾病的发生风险增高.Objective To evaluate the association between the ocular hemodynamic and the incidence of ischemic cerebral vascular diseases in carotid artery stenosis patients.Methods Case-control study.Seventy-two cases patients with carotid artery stenosis including 22 cases of cerebral infarction group,14 cases of lacunar cerebral infarction group and the control group of the other 36 patients without cerebral infarction were recruited.All patients were measured with hemodynamic parameters of the ophthalmic artery,central retinal artery and posterior ciliary artery.PSV,EDV,PI and RI were also measured.The other risk ischemic cerebral vascular factors were obtained through the questionnaire and venous blood sampling.The differences of 3 groups and the influences of the other risk factor of hemodynamic were calculated.Results PSV of ophthalmic artery was（25.96 ± 12.63） cm/s in cerebral infarction group,（32.63 ± 13.25） cm/s in lacunar infarction group and （39.46 ± 14.97） cm/s in control group.EDV of ophthalmic artery was（6.09 ± 3.10）cm/s in cerebral infarction group,（6.57 ± 2.85）cm/s in lacunar infarction group and （9.73 ± 5.02） cm/s in control group.PSV of central retinal artery was （8.06 ± 2.98） cm/s in cerebral infarction group,（8.91 ± 2.76）cm/s in lacunar infarction group and （9.71 ± 2.60）cm/s in control group.The differences were statistically significant （F =13.393,12.609,5.027,P 〈 0.01）.EDV of central retinal artery was （2.46 ± 0.77） cm/s in cerebral infarction group,（2.35 ± 0.89） cm/s in lacunar infarction group and （2.73 ±0.86）cm/s in control group.There was no statistical difference of EDV of CRA in three group （F=2.405,P =0.094）.Conclusions There was association between the ocular hemodynamic parameters and the incidence of ischemic cerebrovascular disease in the carotid artery stenosis patients.Increased level of PSV and EDV of the ophthalmic artery raised the risk of the incidence of ischemic cerebrovascular disease.

关 键 词：颈动脉狭窄 眼动脉 血流速度 血流动力学 脑缺血 

分 类 号：R743[医药卫生—神经病学与精神病学]