重度颈动脉狭窄支架成形术前后视网膜血管密度观察  

Observation of retinal blood vessel density before and after stenting for severe carotid stenosis

作　　者：姚晓喜 彭婧利 刘茹 冯刚华 田涛 Yao Xiaoxi;Peng Jingli;Liu Ru;Feng Ganghua;Tian Tao(Internal Medicine-Neurology,Chenzhou First People's Hospital,Chenzhou 423000,China;Ophthalmology Department,Chenzhou First People's Hospital,Chenzhou 423000,China;The First Clinical College of Xiangnan University,423000,China)

机构地区：[1]湘南学院第一临床分院、郴州市第一人民医院神经内科,423000 [2]湘南学院第一临床分院、郴州市第一人民医院眼科,423000

出　　处：《临床眼科杂志》2023年第2期101-104,共4页Journal of Clinical Ophthalmology

基　　金：湖南省技术创新计划项目(编号:2020SK50304)。

摘　　要：目的探究重度颈动脉狭窄支架成形术前后视网膜血管密度。方法前瞻性病例对照研究。选取100例我院2019年3月至2021年3月诊治的重度颈动脉狭窄患者为研究组,另选取于我院进行健康体检的志愿者50例为对照组。研究组所有患者均采用支架成形术进行治疗,对对照组及研究组术前、术后7 d、术后3个月进行视网膜相干光层析血流成像术(OCTA)检测。结果与对照组右眼相比,狭窄对侧眼视网膜神经纤维层厚度、神经节细胞复合体厚度、黄斑区浅层血管密度、黄斑区血流灌注密度、视盘区血管密度、视盘区血流灌注密度降低,中心凹无血管区(FAZ)面积增加(P>0.05),狭窄同侧眼视网膜神经纤维层厚度、神经节细胞复合体厚度、黄斑区浅层血管密度、黄斑区血流灌注密度、视盘区血管密度、视盘区血流灌注密度降低,FAZ面积增加(P<0.05)。与术前相比,术后1周、术后3个月狭窄同侧眼视网膜神经纤维层厚度、神经节细胞复合体厚度黄斑区浅层血管密度、黄斑区血流灌注密度、视盘区血管密度、视盘区血流灌注密度上升,FAZ面积减少(P<0.05);与术后1周相比,术后3个月狭窄同侧眼视网膜神经纤维层厚度、神经节细胞复合体厚度、黄斑区浅层血管密度、黄斑区血流灌注密度、视盘区血管密度、视盘区血流灌注密度上升,FAZ面积减少(P<0.05)。结论重度颈动脉狭窄患者视网膜血管密度发生异常变化,经支架成形术治疗后患者视网膜血管密度恢复,表明支架成形术可使患者眼部血液循环及灌注提高。Objective To investigate retinal vascular density before and after stenting for severe carotid stenosis.Methods 100 patients with severe carotid artery stenosis diagnosed and treated in our hospital from March 2019 to March 2021 were selected as the research group,and 50 volunteers who underwent physical examination in our hospital were selected as the control group.All patients in the study group were treated with stenting,and OCTA was performed in the control group and study group before surgery,7 days after surgery,and 3 months after surgery.Results Compared with the right eye of the control group,the retinal nerve fiber layer thickness,ganglion cell complex thickness,superficial macular blood vessel density,macular blood perfusion density,optic disc blood vessel density,optic disc blood perfusion density in the stenotic contralateral eye decreased,the FAZ area increased(P>0.05),The retinal nerve fiber layer thickness,ganglion cell complex thickness,superficial macular blood vessel density,macular blood perfusion density,optic disc blood vessel density,and optic disc blood perfusion density in eyes on the ipsilateral side of the stenosis decreased,while the FAZ area increased(P<0.05).Compared with before operation,retinal nerve fiber layer thickness,ganglion cell complex thickness,superficial macular blood vessel density,macular blood perfusion density,and optic disc blood vessel density in the ipsilateral eye after stenosis at 1 week and 3 months after operation,increased blood perfusion density in optic disc area,decreased FAZ area(P<0.05);Compared with 1 week after operation,retinal nerve fiber layer thickness,ganglion cell complex thickness,superficial macular vascular density,macular blood perfusion density,optic disc vascular density,optic disc 3 months after stenosis The regional blood perfusion density increased and the FAZ area decreased(P<0.05).Conclusions The retinal vascular density of patients with severe carotid stenosis has abnormal changes.After stenting,the retinal vascular density of the pati

关 键 词：重度颈动脉狭窄 支架成形术 视网膜血管密度 血流灌注密度 

分 类 号：R651.12[医药卫生—外科学]