视网膜静脉阻塞与颈动脉病变及血流动力学相关性研究  

Relationship between retinal vein occlusion with carotid artery lesions and hemodynamic changes

作　　者：林贞丽 窦晓燕[2] 郭疆[2] 陈伽俐[2] 李振洲[3] 王晶[3] Lin Zhenli Dou Xiaoyan Guo Jiang Chen Jiali Li Zhenzhou Wang Jing(Department of Ophthalmology, Shenzhen Second People＇s Hospital, Shantou University, Shenzhen518000, China Department of Ophthalmology, Shenzhen Second People＇s Hospital, Shenzhen University First Affiliated Hospital, ShenzhenS18000, Chin Department of Ultrasonography, Shenzhen Second People＇ s Hospital, Shenzhen University First Affiliated Hospital, Sherzzhen518000, Chin)

机构地区：[1]汕头大学附属深圳市第二人民医院眼科,深圳518000 [2]深圳大学第一附属医院深圳市第二人民医院眼科 [3]深圳大学第一附属医院深圳市第二人民医院超声科

出　　处：《中国实用眼科杂志》2017年第7期677-681,共5页Chinese Journal of Practical Ophthalmology

基　　金：深圳市科技创新研究基金（JCYJ20150330102720161）;深圳市卫生计生系统科研基金（201607020）

摘　　要：目的利用彩色多普勒超声检查（colour doppler flow lmaging，CDFI）对视网膜静脉阻塞（retinal vein occlusion，RVO）患者进行颈部血管及眼部血管检查，以探讨RVO与颈动脉血管相关病变及血流动力学的关系。方法临床病例对照研究。选取2015年10月至2016年12月就诊于深圳市第二人民医院眼科，经荧光素眼底血管造影（FFA）确诊为视网膜静脉阻塞（RVO）的患者22例（22只眼），年龄为25～85（56．8±15．4）岁。对照组为同期就诊的经FFA检查排除RVO的患者26例（26只眼），年龄为30～81（56．4±13．1）岁。实验组及对照组均由同一医师进行颈动脉及眼部血管CDFI检查，包括检测颈动脉情况以及颈内动脉、眼动脉、视网膜中央动脉、视网膜中央静脉血流动力学参数。结果22例RVO患者中发现颈动脉斑块15例（68．2％，15／22）。与对照组比较，患侧颈内动脉（ICA）、眼动脉（OA）、视网膜中央动脉（CRA）及视网膜中央静脉（CRV）收缩期峰值流速（PSV，cm／s）、舒张末期流速（EDV，ends）、阻力指数（RI）均无明显改变（P〉0．05）。与健侧比较，颈内动脉RI及视网膜中央动脉EDV有统计学意义（P〈0．05），其余血流动力学指标均无统计学意义（P〉0．05）。RVO组与对照组比较，糖尿病、高血压差异均有统计学意义（P〈0．05），冠心病、脑卒中、吸烟、年龄、性别差异均无统计学意义（P〉0．05）。结论RVO的发生与颈动脉病变相关，可以利用彩超检测颈部病变及测量颈内动脉、眼部血管血流动力学指标，判断颈部及眼部循环情况，但彩超检查是否可用于对RVO患者进行病情定量分析及预后评估尚需进一步研究。Objective To explore the relationship between retinal vein occlusion （RVO） and ca- rotid artery lesion and the hemodynamic changes of ocular and carotid arteries using Colour Doppler Flow Imaging （CDFI）. Methods Twenty-two patients （22 eyes） were enrolled with RVO diagnosed by fundus fluoresecine angiography （FFA） who presented to Shenzhen Second People＇s Hospital, from October 2015 to December 2016. Age of patients ranged from 25 years to 85 years （56.8±15.4years）; 26 patients （26 eyes） were enrolled as controlled group with the age ranged from 30 years to 81 years （56.4±13.lyears）. CDFI was performed to detect the quantity and appearance of ca- rotid artery plagues, the degree of stenosis and the parameters of internal carotid artery （ICA）, oph- thalmic artery （OA）, central retinal artery （CRA） and central retinal vein （CRV） hemodynamic. Re- sults In all 22 cases diagnosed by FFA, carotid artery lesions were detected in 15 （68.2%, 15/22） pa- tients. Compared with the controlled group, the peak systolic velocity （PSV）, end diastolic velocity （EDV）, resistance index （RI） of ICA, OA, CRA, CRV were not statistically significant （P 〉0.05）. Compared with the healthy side, the RI of ICA and EDV of CRA were statistically different （P 〈 0.05）. There werestatistically significant differences in thecarotid artery lesions, diabetes and hyperten- sion （P 〉0.05） while there were no differences in coronary heartdisease, stroke, smoking, age and gender between RVO group and controlled group （P 〈0.05）. Conclusions There is a relationship be- tween RVO and carotid artery lesions. CDFI could indirectly measure the carotid artery lesions and hemodynamic parameters of the ocular and carotid arteries. However, whether CDFI could be used to investigate the condition and the progress of RVO should be further explored.

关 键 词：视网膜静脉阻塞 彩色多普勒超声 血流动力学 颈动脉 眼部血管 

分 类 号：R774.1[医药卫生—眼科]