视锥视杆细胞营养不良患者脉络膜和视网膜血流的异常变化  

The anomalies of choroidal and retinal blood flow in cone-rod dystrophy

作　　者：陶天畅 王蕾 崇伟华 张芷萌 代贺华 许静 李根林 TAO Tian-Chang;WANG Lei;CHONG Wei-Hua;ZHANG Zhi-Meng;DAI He-Hua;XU Jing;LI Gen-Lin(From the Beijing Tongren Hospital of Capital Medical University,Beijing Tongren Eye Center,Beijing Ophthalmology&Visual Sciences Key Laboratory,Beijing 100730,China)

机构地区：[1]首都医科大学附属北京同仁医院,北京同仁眼科中心,北京市眼科学与视觉科学重点实验室,北京市100730

出　　处：《眼科新进展》2018年第5期444-447,共4页Recent Advances in Ophthalmology

基　　金：国家自然科学基金资助(编号:81271046);北京市自然科学基金项目暨北京市教育委员会科技发展计划重点项目(编号:KZ201510025025)

摘　　要：目的观察视锥视杆细胞营养不良(cone-rod dystrophy,CRD)患者的眼动脉、视网膜中央动脉和睫状后动脉血流参数的变化特征。方法选择临床诊断为CRD的患者[CRD组50例(100眼)]和正常人[对照组90名(180眼)],应用彩色多普勒血流成像技术(color doppler flow imaging,CDI)检测其眼动脉、视网膜中央动脉和睫状后动脉的收缩期峰速(peak systolic velocity,PSV)、舒张末期流速(end diastolic velocity,EDV)、时间平均最大流速(time-averaged maximum velocity,TAMV)、脉动指数(pulsatility index,PI)和阻力指数(resistance index,RI)。将CRD组与对照组的各项参数进行比较。结果 CRD组患者的眼动脉TAMV为(14.29±3.88)cm·s^(-1),与对照组(12.44±3.64)cm·s^(-1)相比明显上升,差异有统计学意义(P<0.05);PI为1.75±0.42,与对照组(2.02±0.71)相比明显下降,差异有统计学意义(P<0.05)。CRD组患者的视网膜中央动脉PSV、EDV、TAMV、PI、RI分别为(4.60±1.29)cm·s^(-1)、(1.61±0.41)cm·s^(-1)、(2.59±0.67)cm·s^(-1)、1.11±0.31、0.63±0.10,与对照组[(10.82±2.97)cm·s^(-1)、(3.28±1.11)cm·s^(-1)、(5.50±2.06)cm·s^(-1)、1.48±0.49、0.71±0.08]相比均显著降低,差异均有统计学意义(均为P<0.05)。CRD患者的睫状后动脉PSV、EDV、TAMV、PI、RI分别为(7.36±2.18)cm·s^(-1)、(2.28±0.82)cm·s^(-1)、(3.99±1.22)cm·s^(-1)、1.28±0.37、0.68±0.09,与对照组[(11.61±3.41)cm·s^(-1)、(3.34±1.25)cm·s^(-1)、(5.83±1.91)cm·s^(-1)、1.49±0.43、0.70±0.09]相比均明显降低,差异均有统计学意义(均为P<0.05)。结论 CRD患者眼动脉、视网膜中央动脉及睫状后动脉血流参数的异常改变提示眼部血液供应与CRD的病理过程可能存在关联性,具体机制值得进一步探讨。Objective To study the alteration of blood flow indexes of ophthalmic artery(OA),central retinal artery(CRA)and posterior ciliary artery(PCA)of the patients with cone-rod dystrophy(CRD).Methods The color doppler flow imaging was used in 50 CRD patients(100 eyes,CRD group)and 90 controls(180 eyes,control group)to measure the peak systolic velocity(PSV),end diastolic velocity(EDV),time-averaged maximum velocity(TAMV),pulsatility index(PI)and resistance index(RI)in OA,CRA and PCA,respectively,and the data was obtained and analyzed statistically by one-sample t test to compare the alteration of these parameters between the CRD group and control group.Results The TAMV of OA was(14.29±3.88)cm·s-1 in CRD group and(12.44±3.64)cm·s-1 in the control group,and the difference was statistically significant(P<0.05);meanwhile,the PI was 1.75±0.42 in CRD group and 2.02±0.71 in the control group,and the difference was statistically significant(P<0.05).Moreover,the PSV,EDV,TAMV and PI,RI of CRA was(4.60±1.29)cm·s-1,(1.61±0.41)cm·s-1,(2.59±0.67)cm·s-1 and 1.11±0.31,0.63±0.10 in CRD group,respectively,and(10.82±2.97)cm·s-1,(3.28±1.11)cm·s-1,(5.50±2.06)cm·s-1 and 1.48±0.49,0.71±0.08,in the control group,accordingly,and the differences were statistically significant(all P<0.05).Furthermore,the PSV,EDV,TAMV and PI,RI of PCA was(7.36±2.18)cm·s-1,(2.28±0.82)cm·s-1,(3.99±1.22)cm·s-1 and 1.28±0.37,0.68±0.09 in CRD group,respectively,and(11.61±3.41)cm·s-1,(3.34±1.25)cm·s-1,(5.83±1.91)cm·s-1 and 1.49±0.43,0.70±0.09 in the control group,accordingly,and the differences were statistically significant(all P<0.05).Conclusion Hemodynamic unusual alterations of OA,CRA and PCA in CRD patients suggest there is the correlation between the ocular blood supply and the pathological process of CRD,which remains to be observed further.

关 键 词：视锥视杆细胞营养不良 眼动脉 视网膜中央动脉 睫状后动脉 彩色多普勒血流成像 

分 类 号：R774.1[医药卫生—眼科]