CAJ | 학술논문

目的：研究视网膜微血管改变在脑微出血( CMBs)患者中临床参考价值并讨论其意义。 　　方法：收集2012-01/2013-12住院患者125例,男81例,女44例,年龄76.3±11.2岁。全部患者进行肝肾功及血脂和血糖等血生化检查,进行双眼数字眼底照相和头颅MRI检查。根据双眼眼底照相确定视网膜动脉直径( RAE )、静脉直径( RVE )、视网膜动静脉直径比值( AVR)和动静脉交叉征( AVN),根据头颅MRI对CMBs进行分级。全部数据用 SPSS 16.0软件进行统计学分析。 　　结果：双眼视网膜中央动脉直径( CRAE)、视网膜中央静脉直径(CRVE)和AVR值之间无统计学差异(P<0.05)。CMBs分级中,0级75例,1级27例,2级9例,3级14例, CMBs不同等级与视网膜RVE,AVR和AVN之间具有显著相关性(P<0.01),CMBs级别越高视网膜血管改变越明显。在分别控制年龄、性别、血糖、血压等危险因素后, AVR和AVN仍然是影响CMBs分级的相关因素。 　　结论：视网膜微血管改变,特别是视网膜小静脉增宽和出现动静脉交叉征更易可能伴发 CMBs。在去除性别、年龄、高血压和高血糖等传统心脑血管危险因素,视网膜微血管改变仍可作为CMBs发生参考指标。
목적：연구시망막미혈관개변재뇌미출혈( CMBs)환자중림상삼고개치병토론기의의。 　　방법：수집2012-01/2013-12주원환자125례,남81례,녀44례,년령76.3±11.2세。전부환자진행간신공급혈지화혈당등혈생화검사,진행쌍안수자안저조상화두로MRI검사。근거쌍안안저조상학정시망막동맥직경( RAE )、정맥직경( RVE )、시망막동정맥직경비치( AVR)화동정맥교차정( AVN),근거두로MRI대CMBs진행분급。전부수거용 SPSS 16.0연건진행통계학분석。 　　결과：쌍안시망막중앙동맥직경( CRAE)、시망막중앙정맥직경(CRVE)화AVR치지간무통계학차이(P<0.05)。CMBs분급중,0급75례,1급27례,2급9례,3급14례, CMBs불동등급여시망막RVE,AVR화AVN지간구유현저상관성(P<0.01),CMBs급별월고시망막혈관개변월명현。재분별공제년령、성별、혈당、혈압등위험인소후, AVR화AVN잉연시영향CMBs분급적상관인소。 　　결론：시망막미혈관개변,특별시시망막소정맥증관화출현동정맥교차정경역가능반발 CMBs。재거제성별、년령、고혈압화고혈당등전통심뇌혈관위험인소,시망막미혈관개변잉가작위CMBs발생삼고지표。
AlM: To study clinical reference value of retinal microvascular changes in patients with cerebral microbleeds ( CMBs) and discuss its clinical significance. METHODS:From January 2012 to December 2013, 125 hospitalized patients were collected, including 81 cases were male, 44 cases were female, mean age 76. 3 ± 11. 2 years old. For all patients, functions of liver and kidney, blood - lipoids, blood sugar and blood biochemical examination were tested, and fundus photography and cerebral MR was done. According to the fundus camera eyes, retinal arteriolar equivalent ( RAE) , retinal venular equivalent ( RVE) , retinal vein diameter ratio ( AVR) and arteriovenous crossing sign ( AVN ) were identified, CMBs were classified with cerebral MRl. All the data were processed by SPSS statistical software. RESULTS: The central retinal arteriolar equivalent (CRAE), central retinal venular equivalent (CRVE) and AVR values in the eyes were found no statistical difference (P<0. 05). Of CMBs classification, the grade 0 in 75 cases, 1 in 27 cases, 2 in 9 cases and 3 in 14 cases were included. The RVE, AVR and AVN and the different grades of CMBs had statistically significant correlation ( P<0. 01). The higher CMBs classification, the more obvious retinal microvascular changes were found. ln respectively to eliminate risk factors such as age, sex, blood glucose and blood pressure, AVR and AVN were still influencing factors for CMBs classification. COCLUSlON: The results show that retinal microvascular changes, especially small retinal vein arteriovenous cross width, and arteriovenous crossing phenomenon, in which CMBs will happen more likely. After sex, age, hypertension and hyperglycemia in patients with traditional cardiovascular risk factors being ruled out, the retinal microvascular changes are still relatively factors of CMB's occurrence.