CAJ | 학술논문

目的：探讨视网膜中央静脉阻塞( central retinal vein occlusion,CRVO)与颈动脉粥样硬化斑块( atherosclerosis, AS)的相关性。 　　方法：选取我院2012-10/2014-10收治的CRVO患者50例作为观察组, AS患者(未发生CRVO )50例作为对照组。对照组中, AS轻度狭窄22例,中度狭窄24例,重度狭窄4例(3例植入血管支架),根据病情轻重,按脑血管病的一级预防治疗、脑卒中的二级预防治疗进行相应的药物治疗。两组患者均进行颈部颈动脉彩超检查,检测项目包括斑块评估,颈动脉内膜中层厚度( IMT )、狭窄程度以及颈内动脉收缩峰值血流速( PSV )、舒张末期血流速(EDV)、阻力指数(RI)值等动力学参数。比较两组患者颈动脉彩超检查结果各项指标,评价 CRVO 与 AS 的相关性。 　　结果：观察组检出15例患眼同侧颈总动脉轻度狭窄,动脉内径缩小<50%,28例患眼同侧颈总动脉中度狭窄,动脉内径缩小50%~69%,6例患眼同侧颈总动脉重度狭窄,动脉内径缩小70%~99%,1例患者患眼同侧颈总动脉接近闭塞。对照组中,AS患者颈总动脉轻度狭窄22例,中度狭窄24例,重度狭窄4例(3例植入血管支架)。观察组中CRVO患者患眼同侧颈动脉IMT升高, PSV及EDV降低,RI值升高(P<0.05)。观察组与对照组比较,高血压、高脂血症、高胆固醇血症、糖尿病均有统计学差异(P<0.05)。对照组随访2 a期间均无CRVO新发病例。 　　结论：CRVO与AS具有高度相关性,颈部多普勒超声检查可以明确反映视网膜中央静脉血供情况,对AS患者进行规范治疗,可降低CRVO发病风险,具有一定的临床意义。
목적：탐토시망막중앙정맥조새( central retinal vein occlusion,CRVO)여경동맥죽양경화반괴( atherosclerosis, AS)적상관성。 　　방법：선취아원2012-10/2014-10수치적CRVO환자50례작위관찰조, AS환자(미발생CRVO )50례작위대조조。대조조중, AS경도협착22례,중도협착24례,중도협착4례(3례식입혈관지가),근거병정경중,안뇌혈관병적일급예방치료、뇌졸중적이급예방치료진행상응적약물치료。량조환자균진행경부경동맥채초검사,검측항목포괄반괴평고,경동맥내막중층후도( IMT )、협착정도이급경내동맥수축봉치혈류속( PSV )、서장말기혈류속(EDV)、조력지수(RI)치등동역학삼수。비교량조환자경동맥채초검사결과각항지표,평개 CRVO 여 AS 적상관성。 　　결과：관찰조검출15례환안동측경총동맥경도협착,동맥내경축소<50%,28례환안동측경총동맥중도협착,동맥내경축소50%~69%,6례환안동측경총동맥중도협착,동맥내경축소70%~99%,1례환자환안동측경총동맥접근폐새。대조조중,AS환자경총동맥경도협착22례,중도협착24례,중도협착4례(3례식입혈관지가)。관찰조중CRVO환자환안동측경동맥IMT승고, PSV급EDV강저,RI치승고(P<0.05)。관찰조여대조조비교,고혈압、고지혈증、고담고순혈증、당뇨병균유통계학차이(P<0.05)。대조조수방2 a기간균무CRVO신발병례。 　　결론：CRVO여AS구유고도상관성,경부다보륵초성검사가이명학반영시망막중앙정맥혈공정황,대AS환자진행규범치료,가강저CRVO발병풍험,구유일정적림상의의。
AIM: To explore the relationship of central retinal vein occlusion ( CRVO) and atherosclerosis ( AS) . METHODS:Fifty cases of CRVO patients were chosen as the observation group in our hospital from October 2012 to October 2014, other 50 patients with AS ( non-CRVO) as control group. In the control group, 22 cases of AS mild stenosis, moderate stenosis in 24 cases, 4 cases of severe stenosis ( 3 cases implanted stent ) . According to the severity, two grade prevention primary prevention therapy, and cerebral vascular disease treating stroke, corresponding drug treatment was undergone. Two groups of patients were performed cervical carotid artery color Doppler ultrasound examination, including assessing plaque, carotid artery intima-media thickness ( IMT) , the degree of stenosis of internal carotid artery blood flow velocity and the systolic peak ( PSV ) , end diastolic blood flow velocity ( EDV) , resistance index ( RI) values for kinetic parameters etc. All the indexes of the two groups were compared with color Doppler ultrasound examination results, to evaluate the correlation between CRVO and AS. RESULTS: In the observation group, 15 cases were detected of carotid artery with mild stenosis, 28 cases of arterial diameter reduced <50%, carotid artery moderate stenosis, arterial diameter was reduced from 50% ~69%, 6 cases of carotid artery stenosis, arterial diameter was reduced from 70% ~99%, 1 patient with ipsilateral carotid artery near occlusion. In the control group, 22 cases were of AS mild stenosis, moderate stenosis in 24 cases, 4 cases of severe stenosis ( 3 cases implanted stent ) . The eyes with CRVO increased IMT, PSV and EDV decreased, RI value increased (P<0. 05). Compared with the control group, hypertension, hyperlipidemia, hypercholesterolemia, diabetes mellitus in observation group were statistically significant difference (P<0. 05). The control group of 2a of follow-up showed no recurrence during CRVO. CONCLUSION: CRVO and AS are highly correlated, the neck of Doppler ultrasound examination can clearly reflect the central retinal vein blood supply, the standard treatment for AS disease, can reduce the risk of CRVO, with certain clinical significance.