视网膜血管变化特征与不同亚型脑小血管病的关系研究  

The correlation between retinal vascular changes and different subtypes of cerebral small vessel disease

作　　者：夏洪莲 唐茜 蒋子贺 王本玄 张艳丽 XIA Hong-lian;TANG Qian;JIANG Zi-he(Hongqi Hospital Affiliated to Mudanjiang Medical College,Mudanjiang 157011,China)

机构地区：[1]牡丹江医学院附属红旗医院,157011

出　　处：《中国实用医药》2022年第17期6-10,共5页China Practical Medicine

基　　金：黑龙江省教育厅项目(项目编号:2019-KYYWFMY-0045),项目名称:视网膜血管变化特征与不同亚型脑小血管病的相关性研究。

摘　　要：目的 探讨视网膜血管变化特征与不同亚型脑小血管病的关系,为疾病防治提供参考。方法 选取50例脑小血管病患者为实验组,同时选取同期同年龄层头颅磁共振成像(MRI)检查结果正常且既往无脑血管病史的50例志愿者为对照组。两组均进行影像检查、一般资料收集、眼底检查等,并且经多因素Logistic回归分析脑小血管病的危险因素。结果 实验组高血压病史占比、冠心病史占比、心房颤动(房颤)史占比、总胆固醇(TC)、甘油三酯(TG)均高于对照组,差异有统计学意义(P<0.05)。实验组简易智力状态检查量表(MMSE)、蒙特利尔认知评估量表(MoCA)、日常生活活动能力量表(ADL)评分分别为(25.02±1.42)、(24.41±1.52)、(62.25±5.86)分,均低于对照组的(28.45±1.02)、(27.12±1.05)、(77.41±6.13)分,临床痴呆评定量表(CDR)评分(12.23±1.42)分高于对照组的(7.56±1.02)分,差异有统计学意义(P<0.05)。实验组小动脉直径(12.25±1.45)μm小于对照组的(20.41±2.26)μm,小动脉分支系数、小静脉分支系数、不对称指数、分支角度分别为(0.71±0.11)、(0.73±0.12)、(0.67±0.11)、(22.25±4.12)°,均大于对照组的(0.50±0.08)、(0.48±0.07)、(0.52±0.05)、(13.36±1.75)°,差异具有统计学意义(P<0.05)。实验组视网膜病变程度高于对照组,差异具有统计学意义(P<0.05)。经多因素Logistic回归分析显示:高血压病史、冠心病史、高分支系数、高分支角度、视网膜病变均是脑小血管病的独立危险因素(OR=2.451、3.021、2.714、2.886、2.228, P<0.05)。结论 视网膜血管变化可引起脑小血管病,其中高血压病史、冠心病史、高分支系数、高分支角度、视网膜病变均是脑小血管病的独立危险因素。Objective To discuss the correlation between retinal vascular changes and different subtypes of cerebral small vessel disease,so as to provide reference for disease prevention and treatment.Methods 50 patients with cerebral small vessel disease were selected as the experimental group,while 50 volunteers of the same age with normal cranial magnetic resonance imaging(MRI)findings and no previous history of cerebrovascular disease were selected as the control group.Imaging examination,general data collection,fundus examination were performed in both groups,and the risk factors of cerebral small vessel disease were analyzed by multivariate Logistic regression.Results The percentage of history of hypertension,the percentage of history of coronary heart disease,the percentage of history of atrial fibrillation,total cholesterol(TC)and triglycerides(TG)in the experimental group were higher than those in the control group,and the differences were statistically significant(P<0.05).In the experimental group,the scores of mini-mental state examination(MMSE),Montreal cognitive assessment(MoCA),and activities of daily living(ADL)were(25.02±1.42),(24.41±1.52),and(62.25±5.86)points,which were lower than(28.45±1.02),(27.12±1.05),and(77.41±6.13)points in the control group;the clinical dementia rating scale(CDR)score(12.23±1.42)points was higher than(7.56±1.02)points in the control group;all the differences were statistically significant(P<0.05).The diameter of arterioles(12.25±1.45)μm in the experimental group was smaller than(20.41±2.26)μm in the control group;the branching coefficient of arterioles,the branching coefficient of venules,asymmetry index and branching angle in the experimental group were(0.71±0.11)and(0.73±0.12),(0.67±0.11),(22.25±4.12)°,which were higher than (0.50±0.08), (0.48±0.07), (0.52±0.05), (13.36±1.75)° in the control group;all the differences were statistically significant (P<0.05). The degree of retinopathy in the experimental group was higher than that in the control group, and the

关 键 词：视网膜 血管变化 脑小血管病 视网膜病变 

分 类 号：R743[医药卫生—神经病学与精神病学]