经颅多普勒超声观察单侧重度颈内动脉狭窄时眼动脉血流改变  

Hemodynamical changes of ophthalmic artery in patients with severe internal carotid artery stenosis de-termined by transcranial Doppler

作　　者：郭佳[1] 汪军[1] 赵蕾[2] 孟忻[1] 

机构地区：[1]首都医科大学附属北京安贞医院眼科,北京市100029 [2]首都医科大学附属北京安贞医院神经内科,北京市100029

出　　处：《眼科新进展》2015年第2期171-173,共3页Recent Advances in Ophthalmology

摘　　要：目的通过经颅多普勒超声(transcranial Doppler,TCD)对单侧重度颈内动脉狭窄(internal carotid artery stenosis,ICAS)的患者进行眼动脉血流的检测,观察眼动脉血流与眼部缺血性疾病及颈内动脉狭窄程度的关系。方法将经颈动脉彩色多普勒超声检查确诊为单侧重度ICAS的31例及颈内动脉完全闭塞的19例患者纳入研究。利用TCD检查ICAS侧眼动脉血流方向、收缩期峰值血流速度(peak systolic velocity,PSV)及阻力指数(resistance index,RI),对比分析眼动脉逆向血流(reversed ophthalmic artery flow,ROAF)患眼及对侧眼眼动脉PSV及RI值,同时对眼动脉血流方向与眼部缺血以及ICAS程度的关系进行分析。结果经TCD检查发现ROAF 24眼,其中单侧重度ICAS者9眼,颈内动脉完全闭塞者15眼,ROAF在颈内动脉完全闭塞组更易出现,差异有统计学意义(χ2=11.76,P=0.001)。24例ROAF患者的阻塞侧PSV值为(38.68±11.58)cm·s-1,与健侧的(33.53±2.74)cm·s-1相比差异有统计学意义(t=29.73,P=0.000);阻塞侧RI值为0.60±0.10,与健侧的0.78±0.10相比差异有统计学意义(t=-6.20,P=0.000)。24只ROAF眼中58.3%有明确的眼部缺血体征,而26只正流患侧眼中该比例为15.4%,ROAF组患眼更容易出现眼部缺血体征(χ2=9.99,P=0.002)。利用Logistic回归预测ROAF与眼部缺血的关系:回归系数为0.211(χ2=12.26,P=0.000),OR值为1.235。结论当出现ROAF时,提示重度ICAS甚至完全闭塞;ROAF的流速越快,提示眼部出现缺血性病变的几率越大。Objeetive To observe the hemodynamical changes of the ophthalmic artery （OA） in patients with severe internal carotid artery stenosis （ICAS） by transcrani- al Doppler （TCD）, and investigate the correlation between hemodynamical changes of OA and ocular ischemic diseases, ICAS degree. Methods Thirty-one patients with u- nilateral high-grade ICAS and 19 patients with ICAS were chosen. The blood direction of OA, peak systolic velocity （PSV） and resistance index （RI） were examined by TCD, the reversed ophthalmic artery flow （ROAF）was alao analyzed. And the correlation between blood direction and ocular ischemic disease, ICAS degree was analyzed, llhesults The presences of ROAF were in 24 eyes, including unilateral server ICAS in 9 eyes, total in- ternal carotid artery stenosis in 15 eyes,there was statistical difference （x2 = ll. 75 ,P = 0.001 ）. The PS~ of diseased eyes and healthy eyes in 24 ROAF patients were （38.68 ± 11.58 ） cm · s - 1, （ 33.53 ± 2.74 ） cm ·s - 1, respectively, the difference was significant （ t = - 29.73 ,P = 0.000） ; The RI of diseased eyes and healthy eyes were 0.60 ± 0.10 and 0.78 ± 0. 10, the difference was significant （ t = - 6.20, P = 0. 000 ）. Fourteen eyes （58.3%）in ROAF patients had signs of ocular ischemia, was significantly higher than the normal flow patients （ 15.4% ）, the difference was significant （X2 = 9.99 ,P = 0.002 ）. Logistic regression analyses was done to determine the relationship between the ROAF and ocular ischemic disease,~ =0. 211 （X2 = 12.26,P =0. 000） ,OR = 1. 235. CA）nelu- sions The presence of the ROAF indicates the ICAS or occlusion. With the increasing of PSV in the ROAF patients, the incidence of the ocular ischemia increase.

关 键 词：眼动脉 颈内动脉狭窄 经颅多普勒超声 眼部缺血性疾病 

分 类 号：R543.4[医药卫生—心血管疾病]