[1]郭佳,汪军,赵蕾,等. 经颅多普勒超声观察单侧重度颈内动脉狭窄时眼动脉血流改变[J].眼科新进展,2015,35(2):171-173.[doi:10.13389/j.cnki.rao.2015.0046]
　GUO Jia,WANG Jun,ZHAO Lei,et al. Hemodynamical changes of ophthalmic artery in patients with severe internal carotid artery stenosis determined by transcranial Doppler[J].Recent Advances in Ophthalmology,2015,35(2):171-173.[doi:10.13389/j.cnki.rao.2015.0046]
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 经颅多普勒超声观察单侧重度颈内动脉狭窄时眼动脉血流改变
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《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:
35卷
期数:
2015年2期
页码:
171-173
栏目:
应用研究
出版日期:
2015-02-05

文章信息/Info

Title:
 Hemodynamical changes of ophthalmic artery in patients with severe internal carotid artery stenosis determined by transcranial Doppler
作者:
 郭佳; 汪军; 赵蕾; 孟忻
 100029　北京市，首都医科大学附属北京安贞医院眼科
Author(s):
 GUO Jia;  WANG Jun;  ZHAO Lei;  MENG Xin
 Department of Ophthalmology, Beijing Anzhen HospitaL Affiliated to Capital MedicaL University, Beijing 100029 . China
关键词:
 ; 眼动脉; 颈内动脉狭窄; 经颅多普勒超声; 眼部缺血性疾病
Keywords:
 ; ophthalmic artery;  internal carotid artery stenosis;  transcranial Doppler ;  ocular ischemic disease
DOI:
10.13389/j.cnki.rao.2015.0046
文献标志码:
A
摘要:
 目的　通过经颅多普勒超声（ｔｒａｎｓｃｒａｎｉａｌＤｏｐｐｌｅｒ，ＴＣＤ）对单侧重度颈内动脉狭窄（ｉｎｔｅｒｎａｌｃａｒｏｔｉｄａｒｔｅｒｙｓｔｅｎｏｓｉｓ，ＩＣＡＳ）的患者进行眼动脉血流的检测，观察眼动脉血流与眼部缺血性疾病及颈内动脉狭窄程度的关系。方法　将经颈动脉彩色多普勒超声检查确诊为单侧重度ＩＣＡＳ的３１例及颈内动脉完全闭塞的１９例患者纳入研究。利用ＴＣＤ检查ＩＣＡＳ侧眼动脉血流方向、收缩期峰值血流速度（ｐｅａｋｓｙｓｔｏｌｉｃｖｅｌｏｃｉｔｙ，ＰＳＶ）及阻力指数（ｒｅｓｉｓｔａｎｃｅｉｎｄｅｘ，ＲＩ），对比分析眼动脉逆向血流（ｒｅ-ｖｅｒｓｅｄｏｐｈｔｈａｌｍｉｃａｒｔｅｒｙｆｌｏｗ，ＲＯＡＦ）患眼及对侧眼眼动脉ＰＳＶ及ＲＩ值，同时对眼动脉血流方向与眼部缺血以及ＩＣＡＳ程度的关系进行分析。结果　经ＴＣＤ检查发现ＲＯＡＦ２４眼，其中单侧重度ＩＣＡＳ者９眼，颈内动脉完全闭塞者１５眼，ＲＯＡＦ在颈内动脉完全闭塞组更易出现，差异有统计学意义（χ２＝１１．７６，Ｐ＝０．００１）。２４例ＲＯＡＦ患者的阻塞侧ＰＳＶ值为（３８．６８±１１．５８）ｃｍ?ｓ－１，与健侧的（３３．５３±２．７４）ｃｍ?ｓ－１相比差异有统计学意义（ｔ＝２９．７３，Ｐ＝０．０００）；阻塞侧ＲＩ值为０．６０±０．１０，与健侧的０.７８±０.１０相比差异有统计学意义（ｔ＝－６．２０，Ｐ＝０．０００）。２４只ＲＯＡＦ眼中５８．３％有明确的眼部缺血体征，而２６只正流患侧眼中该比例为１５．４％，ＲＯＡＦ组患眼更容易出现眼部缺血体征（χ２＝９．９９，Ｐ＝０．００２）。利用Ｌｏｇｉｓｔｉｃ回归预测ＲＯＡＦ与眼部缺血的关系：回归系数为０．２１１（χ２＝１２．２６，Ｐ＝０．０００），ＯＲ值为１．２３５。结论　当出现ＲＯＡＦ时，提示重度ＩＣＡＳ甚至完全闭塞；ＲＯＡＦ的流速越快，提示眼部出现缺血性病变的几率越大。
Abstract:
 Objective To observe the hemodynamical changes of the ophthalmic artery ( OA) in patients with severe internal carotid artery stenosis ( ICAS) by transcranial Doppler ( TCD) . and investigate the correlation between hemodynamical changes of OA and ocular ischemic diseases , ICAS degree. Methods Thirty-one patients with unilateral high-grade ICAS and 19 patients with ICAS were chosen. The blood direction of OA,peak systolic velocity ( PSV) and resistance index ( RI) were examined by TCD , the reversed ophthalmic artery flow ( ROAF) was alao analyzed. And the correlation between blood direction and ocular ischemic disease,ICAS degree was analyzed. Results The presences of ROAF were in 24 eyes ,including unilateral server ICAS in 9 eyes , total internal carotid artery stenosis in 15 eyes ,there was statistical difference (X2 = 11. 76 ,P = 0. 001) . The PSV of diseased eyes and healthy eyes in 24 ROAF patients were ( 38. 68 + 11. 58 ) cm . s-l . ( 33. 53 + 2. 74 ) cm . s-l , respectively , the difference was significant ( t = - 29. 73 ,P = 0. 000 ) ; The RI of diseased eyes and healthy eyes were 0. 60 +0. 10 and 0. 78 + 0. 10, the difference was significant ( t = - 6. 20 , P = 0. 000 ). Fourteen eyes (58. 3% )in ROAF patients had signs of ocular ischemia, was significantly higher than the normal flow patients ( 15. 4% ) .the difference was sigruficant (X2 = g. gg ,p = 0. 002 ) . Logistic regression analyses was done to deternune the relationship between the ROAF and ocular ischemic disease, β = 0. 211 (X2 = 12. 26 ,P = 0. 000 ) . OR = 1. 235. Conclusions The presence of the ROAF indicates the ICAS or occlusion. With the increasing of PSV in the ROAF patients , the incidence of the ocular ischemia increase.

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更新日期/Last Update: 2015-02-03