视网膜血管管径与颈动脉狭窄患者脑梗死发生的相关性分析  

Relation between retinal vessel diameters and carotid artery stenosis patients with cerebral infarction

作　　者：赵露[1] 谢国丽[1] 王佳琳[1] 王艳玲[1] 

机构地区：[1]首都医科大学附属北京友谊医院眼科,100050

出　　处：《中华眼底病杂志》2016年第4期387-390,共4页Chinese Journal of Ocular Fundus Diseases

基　　金：北京市医院管理局临床技术创新项目（XMLX201305）

摘　　要：目的 观察探讨视网膜血管管径与颈动脉狭窄患者脑梗死发生的相关性。方法 彩色多普勒血流显像检查确诊的颈动脉狭窄患者87例174只眼纳入研究。患者中，男性49例，女性38例；平均年龄（65.25±7.85）岁。以是否有脑梗死将患者分为脑梗死组和对照组，分别为34、53例。两组患者间年龄（t=1.916）、男性构成比（χ2=0.142）、颈动脉狭窄程度（χ2=0.785）比较，差异均无统计学意义（P=0.059、0.706、0.675）。散瞳后拍摄以黄斑和视盘之间中点为中心周围45°彩色眼底像，包括视盘、黄斑、颞侧黄斑区上下血管弓以及距离视盘边缘2个视盘直径（DD）的鼻侧区域。应用IVAN计算机图像分析软件，测量距视盘边缘1/2～1 DD范围内视网膜动静脉的血管直径。主要参数为视网膜中央动脉直径（CRAE）、视网膜中央静脉直径（CRVE）、视网膜动静脉比值（ARV）。视网膜血管管径与脑梗死关系行logistic回归分析。结果 脑梗死组 CRVE、CRAE、AVR分别为（132.90±20.67）、（243.47±43.92） μm和0.56±0.10；对照组分别为（145.26±21.59）、（224.99±32.35） μm和0.68±0.13。两组CRVE、CRAE、AVR比较，差异均有统计学意义（t=-2.648、2.257、-4.631，P＜0.05）。多因素logistic回归分析，控制年龄、吸烟、低密度脂蛋白混杂因素后，CRAE与脑梗死发生相关性降低，CRVE与脑梗死发生呈显著相关 （P=0.015、0.011）。结论 CRAE降低、CRVE增加是颈动脉狭窄患者脑梗死发生的危险因素；对颈动脉狭窄患者脑梗死发生有一定预测价值。Objective To investigate the relationship between retinal vessel diameters and cerebral infarction of carotid artery stenosis patients. Methods Eighty-seven patients （174 eyes） with carotid stenosis were included in this study. There were 49 males and 38 females, with an average age of （65.25±7.85） years. Thirty-four patients were suffered from cerebral infarction （cerebral infarction group）, and the other 53 patients had no cerebral infarction （control group）. There was no significant difference in age （t=1.916）, male rate （χ2=0.142） and carotid stenosis extent （χ2=0.785） between the two groups （P=0.059, 0.706, 0.675）. All patients underwent color fundus photography after mydriasis. Retinal vascular caliber measurements were performed using IVAN software. The main parameters were central retinal artery diameter （central retinal artery equivalent, CRAE）, the diameter of the central retinal vein （central retinal vein equivalent, CRVE） and the retinal arteriole to venular ratio （AVR）. The relationship between retinal vessel diameter and cerebral vascular disease were analyzed with logistic regression analysis. Results In cerebral infarction group, CRVE, CRAE and AVR ratios were （132.90±20.67） μm, （243.47±43.92） μm and 0.56±0.10, while the control group was （145.26±21.59） μm, （224.99±32.35） μm and 0.68±0.13 respectively. There were significant differences between the two groups （t=-2.648, 2.257, -4.631; P〈0.05）. After correction for risk factors, such as age, smoking history, CRAE reduction and CRVE increases were significantly correlated with cerebral infarction. Conclusion CRAE reduction and CRVE increases are risk factors of cerebral infarction in patients with carotid stenosis, and it is useful in the prediction.

关 键 词：视网膜血管/病理生理学 颈动脉狭窄/并发症 脑梗死/病因学 

分 类 号：R774.1[医药卫生—眼科] R743.3[医药卫生—临床医学]