冠状动脉慢血流与视网膜动静脉直径比值的相关性研究  

Correlation between coronary slow flow and retinal arteriovenous diameter ratio

作　　者：王增帅[1] 冯彩霞[1] 谢瑞[1] 薛开成[1] Wang Zengshuai;Feng Caixia;Xie Rui;Xue Kaicheng(The Second Affiliated Hospital of Baotou Medical College,Inner Mongolia University of Science and Technology,Baotou 014030,China)

机构地区：[1]内蒙古科技大学包头医学院第二附属医院,包头014030

出　　处：《心脑血管病防治》2023年第9期32-34,47,共4页CARDIO-CEREBROVASCULAR DISEASE PREVENTION AND TREATMENT

基　　金：内蒙古自治区自然科学基金项目(2021LHS08011);内蒙古自治区卫生健康委医疗卫生科技计划项目(202202255)。

摘　　要：目的探讨冠状动脉慢血流现象(CSFP)与视网膜血管直径的相关性及CSFP的危险因素。方法2020年5月至2022年5月就诊于包头医学院第二附属医院行冠状动脉造影检查的2143例患者中,冠状动脉狭窄≤30%且校正心肌梗死溶栓治疗帧数法≥27帧的86例作为CSFP组,随机选择冠状动脉狭窄≤30%且血流正常的86例为对照组。两组患者均接受眼底照相,使用半自动软件IVAN测定,计算视网膜中央动脉直径等效值(CRAE)、视网膜中央静脉直径等效值(CRVE)、视网膜动静脉直径比值(AVR)。分析两组患者临床资料、CSFP的危险因素及CSFP与视网膜血管直径的相关性。结果与对照组相比,CSFP组体质量指数、同型半胱氨酸、糖化血红蛋白、纤维蛋白原升高;CRAE、AVR、淋巴细胞计数下降,差异有统计学意义(t=2.403、2.822、2.102、2.084、3.037、4.044、2.006,P<0.05)。体质量指数、同型半胱氨酸、糖化血红蛋白、纤维蛋白原、淋巴细胞计数、AVR是CSFP的危险因素。排除混杂因素后,AVR仍是CSFP的危险因素[OR(95%CI)=0.001(0.000~0.112),P<0.01]。AVR诊断CSFP的曲线下面积为0.678,AVR小于0.617时,对CSFP诊断的敏感度和特异度分别为75.60%和53.50%。结论AVR的减小是CSFP的独立危险因素,眼底影像可作为观测CSFP的良好窗口。Objective To explore the correlation between coronary slow flow phenomenon(CSFP)and retinal vessel diameters,as well as the risk factors associated with CSFP.Methods Among 2143 patients who underwent coronary angiography at the Second Affiliated Hospital of Baotou Medical College from May 2020 to May 2022,86 cases with coronary artery stenosis≤30%and corrected thrombolysis in myocardial infarction(TIMI)frame count≥27 frames were selected as the CSFP group.Meanwhile,86 cases with coronary artery stenosis≤30%and normal blood flow were randomly chosen as the control group.All participants underwent fundus photography,and the semi-automated IVAN software was employed to measure central retinal artery equivalent(CRAE),central retinal vein equivalent(CRVE),and arteriole-to-venule diameter ratio(AVR).Clinical data,risk factors of CSFP,and the correlation between CSFP and retinal vessel diameters were analyzed.Results Compared to the control group,the CSFP group exhibited elevated body mass index(BMI),homocysteine,glycated hemoglobin and fibrinogen,as well as decreased CRAE,AVR and lymphocyte count,the differences were statistically significant(t=2.403,2.822,2.102,2.084,3.037,4.044,2.006;P<0.05).BMI,homocysteine,glycosylated hemoglobin,fibrinogen,lymphocyte count and AVR were risk factors for CSFP.After adjusting for confounding factors,AVR remained a risk factors for CSFP[OR(95%CI)=0.001(0.000-0.112),P<0.01].The area under the curve for AVR diagnosing CSFP was 0.678.When AVR was less than 0.617,the sensitivity and specificity for the diagnosis of CSFP were 75.60%and 53.50%,respectively.Conclusion Reduced AVR is an independent risk factor for CSFP,and fundus imaging provides a valuable window to observe CSFP.

关 键 词：冠状动脉慢血流 视网膜血管直径 冠状动脉 微血管 

分 类 号：R541.4[医药卫生—心血管疾病]