中华眼底病杂志
中華眼底病雜誌
중화안저병잡지
CHINESE JOURNAL OF OCULAR FUNDUS DISEASES
2015年
1期
49-51
,共3页
邵嘉涛%李萍%王海波%刘艳凤
邵嘉濤%李萍%王海波%劉豔鳳
소가도%리평%왕해파%류염봉
颈动脉狭窄/诊断%颈动脉狭窄/并发症%血流动力学
頸動脈狹窄/診斷%頸動脈狹窄/併髮癥%血流動力學
경동맥협착/진단%경동맥협착/병발증%혈류동역학
Carotid stenosis/diagnosis%Carotid stenosis/complications%Hemodynamics
目的 观察不同程度的颈内动脉狭窄对患者眼部缺血表现及视网膜中央动脉(CRA)和眼动脉(OA)的血流动力学影响.方法 前瞻性研究.经彩色多普勒血流显像(CDFI)及数字减影血管造影检查确诊为颈动脉狭窄的60例患者纳入研究.同时纳入经CDFI检查明确颈动脉正常的30例健康者作为对照组.根据不同的颈内动脉狭窄程度将患者分为狭窄率≥60％组及狭窄率＜60％组,每组各30例.所有患者行全面眼科检查,确定其是否伴有眼部缺血表现;对比分析两组患者眼部症状及体征的发生率.3组受检者均行CDFI检查,观察其CRA、OA的血流频谱形态;测量CRA、OA的收缩期血流峰值速度(PSV)、舒张末期血流速度(EDV)、血管内径(BVD)及阻力指数(RI).结果 狭窄率≥60％组30例患者中,有眼部症状24例,占80.0％;有眼部体征9例,占30.0％.狭窄率＜60％组30例患者中,有眼部症状9例,占30.0％;有眼部体征3例,占10.0％.CDFI检查发现,狭窄率≥60％组患者CRA呈馒头样波形改变;OA三峰双切迹峰行消失,变为单峰.狭窄率＜60％组患者的CRA及OA血流频谱形态为三峰双切迹,与对照组类似.与对照组比较,狭窄率≥60％组患者CRA的PSV、EDV均降低,差异有统计学意义(t=5.255、4.949,P=0.007、0.005);BVD、RI均无明显变化,差异无统计学意义(t=0.457、0.213,P=0.572、0.885).与对照组比较,狭窄率＜60％组患者CRA的PSV、EDV、BVD、RI均无明显变化,差异无统计学意义(t=0.755、0.254、0.356、0.105,P=0.072、0.825、0.751、0.955).与狭窄率＜60％组比较,狭窄率≥60％组患者CRA的PSV、EDV均降低,差异有统计学意义(t=4.457、4.558,P=0.010、0.009);BVD、RI均无明显变化,差异无统计学意义(t=0.387、0.253,P=0.662、0.804).3组患者OA的PSV、EDV、BVD、RI比较,差异均无统计学意义(P＞0.05).结论 颈动脉狭窄率≥60％的患者有更高的眼部缺血表现发生率,其CRA的PSV、EDV明显降低,OA的血流动力学指标无明显变化.颈动脉狭窄率＜60％患者CRA、OA的血流动力学指标均无明显变化.
目的 觀察不同程度的頸內動脈狹窄對患者眼部缺血錶現及視網膜中央動脈(CRA)和眼動脈(OA)的血流動力學影響.方法 前瞻性研究.經綵色多普勒血流顯像(CDFI)及數字減影血管造影檢查確診為頸動脈狹窄的60例患者納入研究.同時納入經CDFI檢查明確頸動脈正常的30例健康者作為對照組.根據不同的頸內動脈狹窄程度將患者分為狹窄率≥60％組及狹窄率＜60％組,每組各30例.所有患者行全麵眼科檢查,確定其是否伴有眼部缺血錶現;對比分析兩組患者眼部癥狀及體徵的髮生率.3組受檢者均行CDFI檢查,觀察其CRA、OA的血流頻譜形態;測量CRA、OA的收縮期血流峰值速度(PSV)、舒張末期血流速度(EDV)、血管內徑(BVD)及阻力指數(RI).結果 狹窄率≥60％組30例患者中,有眼部癥狀24例,佔80.0％;有眼部體徵9例,佔30.0％.狹窄率＜60％組30例患者中,有眼部癥狀9例,佔30.0％;有眼部體徵3例,佔10.0％.CDFI檢查髮現,狹窄率≥60％組患者CRA呈饅頭樣波形改變;OA三峰雙切跡峰行消失,變為單峰.狹窄率＜60％組患者的CRA及OA血流頻譜形態為三峰雙切跡,與對照組類似.與對照組比較,狹窄率≥60％組患者CRA的PSV、EDV均降低,差異有統計學意義(t=5.255、4.949,P=0.007、0.005);BVD、RI均無明顯變化,差異無統計學意義(t=0.457、0.213,P=0.572、0.885).與對照組比較,狹窄率＜60％組患者CRA的PSV、EDV、BVD、RI均無明顯變化,差異無統計學意義(t=0.755、0.254、0.356、0.105,P=0.072、0.825、0.751、0.955).與狹窄率＜60％組比較,狹窄率≥60％組患者CRA的PSV、EDV均降低,差異有統計學意義(t=4.457、4.558,P=0.010、0.009);BVD、RI均無明顯變化,差異無統計學意義(t=0.387、0.253,P=0.662、0.804).3組患者OA的PSV、EDV、BVD、RI比較,差異均無統計學意義(P＞0.05).結論 頸動脈狹窄率≥60％的患者有更高的眼部缺血錶現髮生率,其CRA的PSV、EDV明顯降低,OA的血流動力學指標無明顯變化.頸動脈狹窄率＜60％患者CRA、OA的血流動力學指標均無明顯變化.
목적 관찰불동정도적경내동맥협착대환자안부결혈표현급시망막중앙동맥(CRA)화안동맥(OA)적혈류동역학영향.방법 전첨성연구.경채색다보륵혈류현상(CDFI)급수자감영혈관조영검사학진위경동맥협착적60례환자납입연구.동시납입경CDFI검사명학경동맥정상적30례건강자작위대조조.근거불동적경내동맥협착정도장환자분위협착솔≥60％조급협착솔＜60％조,매조각30례.소유환자행전면안과검사,학정기시부반유안부결혈표현;대비분석량조환자안부증상급체정적발생솔.3조수검자균행CDFI검사,관찰기CRA、OA적혈류빈보형태;측량CRA、OA적수축기혈류봉치속도(PSV)、서장말기혈류속도(EDV)、혈관내경(BVD)급조력지수(RI).결과 협착솔≥60％조30례환자중,유안부증상24례,점80.0％;유안부체정9례,점30.0％.협착솔＜60％조30례환자중,유안부증상9례,점30.0％;유안부체정3례,점10.0％.CDFI검사발현,협착솔≥60％조환자CRA정만두양파형개변;OA삼봉쌍절적봉행소실,변위단봉.협착솔＜60％조환자적CRA급OA혈류빈보형태위삼봉쌍절적,여대조조유사.여대조조비교,협착솔≥60％조환자CRA적PSV、EDV균강저,차이유통계학의의(t=5.255、4.949,P=0.007、0.005);BVD、RI균무명현변화,차이무통계학의의(t=0.457、0.213,P=0.572、0.885).여대조조비교,협착솔＜60％조환자CRA적PSV、EDV、BVD、RI균무명현변화,차이무통계학의의(t=0.755、0.254、0.356、0.105,P=0.072、0.825、0.751、0.955).여협착솔＜60％조비교,협착솔≥60％조환자CRA적PSV、EDV균강저,차이유통계학의의(t=4.457、4.558,P=0.010、0.009);BVD、RI균무명현변화,차이무통계학의의(t=0.387、0.253,P=0.662、0.804).3조환자OA적PSV、EDV、BVD、RI비교,차이균무통계학의의(P＞0.05).결론 경동맥협착솔≥60％적환자유경고적안부결혈표현발생솔,기CRA적PSV、EDV명현강저,OA적혈류동역학지표무명현변화.경동맥협착솔＜60％환자CRA、OA적혈류동역학지표균무명현변화.
Objective To observe ocular ischemic appearance (OIA) associated with carotid artery stenosis and its effects on the hemodynamics of central retinal artery (CRA) and ophthalmic artery (OA).Methods A total of 30 normal persons and 60 patients with carotid artery stenosts diagnosed by color Doppler flow imaging (CDFI) and digital subtraction angiography (DSA) were enrolled in this prospective study.Sixty patients were randomly divided into 2 groups:30 patients with the carotid artery stenosis degree ＜60％ and 30 cases with the carotid artery stenosis degree ≥60％.Thirty normal persons were enrolled in the normal control group.All patients underwent a comprehensive eye examination to determine if OIA exists.The Doppler spectral patterns of CRA and OA were observed by CDFI.The peak systolic velocity (PSV),end diastolic velocity (EDV),blood vessel diameter (BVD) and resistance index (RI) of CRA and OA were measured.Results In the group of the carotid artery stenosis degree≥60％,24/30 patients (80.0％) had the ophthalmic symptoms and 9/30 patients (30.0％) had ophthalmic signs.In the group of the carotid artery stenosis degree ＜60％,9/30 patients (30.0％) had the ophthalmic symptoms and 3/30 patients (10.0％) had ophthalmic signs.For patients with≥ 60％ stenosis,CDFI revealed a bread-like waveform of CRA,and single peak of OA instead of the typical 3-peak/2-notch waveform.For patients with ＜60％ stenosis,CDFI revealed a normal pattern of CRA and OA (3-peak/2-notch).The PSV(t=5.255,P=0.007) and EDV(t=4.949,P=0.005) of CRA in the stenosis ≥60％ group were statistically decreased compared to the normal control group,but the BVD(t=0.457,P＞0.05)and RI(t=0.213,P＞0.05)were normal.The PSV,EDV,BVD and RI of CRA in the stenosis＜60％ group were normal(P＞0.05).The PSV(t=4.457,P =0.010) and EDV (t =4.588,P =0.009) of CRA in the stenosis ≥ 60 ％ group were statistically decreased compared to the stenosis ＜60 ％ group,but the BVD and RI were the same between these 2 groups.Conclusion Patients with carotid stenosis ≥60％ had a higher OIA incidence,reduced PSV,EDV of their CRA,while had no significant changes of OA hemodynamics.
