目的:比较青光眼32眼小梁切除术前后的血流动力学变化。方法:利用彩色多普勒成像技术(CDI)分别检测正常对照组与青光眼组术前、术后2,12wk的眼部血流情况,包括眼动脉(OA)、睫状后短动脉(SPCA)和视网膜中央动脉(CRA)的收缩期峰值血流速度(PSV)、舒张末期血流速度(EDV)和阻力指数(RI)。结果:(1)青光眼组手术前后比较:青光眼组在小梁切除术后血流灌注明显好转,表现为PSV,EDV增高,RI下降;(2)青光眼术后组之间比较:PSV,EDV,RI有改变,但差异无统计学意义;(3)青光眼组术后与正常对照组比较:青光眼组在小梁切除术后眼压降至正常范围时OA,SPCA,CRA的PSV,EDV和RI仍不及正常人(P<0.05);(4)青光眼组术前与正常对照组比较:OA,SPCA,CRA均表现为PSV,EDV下降,RI增高(P<0.01)。结论:(1)青光眼患者与正常人相比较存在明显的血流灌注不足,小梁切除术可以有效的改善眼部血流灌注情况;(2)CDI可长期用于监测和评价青光眼小梁切除术的治疗效果。

AIM:To compare the hemodynamic changes before and after trabeculectomy in glaucoma ( 32 eyes).METHODS: Color Doppler ultrasonograph was used to measure retrobulbar blood flow of normal controls and 32 patients before surgery and at 2 and 12 weeks after trabeculectomy, respectively. The measurements included peak systolic velocity (PSV), end-diastolic velocity (EDV) and resistent index (RI) in central retinal artery(CRA) short posterior ciliary artery(SPCA) and ophthalmic artery(OA).RESULTS: Compared with normal control group, PSV and EDV were decreased while RI was elevated in CRA, SPCA and OA of glaucoma group (P<0.01). The hemodynamic of glaucoma group had significant improvement after trabeculectomy, PSV and EDV were elevated while RI was decreased. Intraocular pressure of glaucoma patients after trabeculectomy restored to the normality, PSV,EDV and RI of CRA, SPCA and OA in glaucoma group were still inferior to normal control group (P<0.05).CONCLUSION: Glaucoma patients have more insufficiency of blood flow than normal person. Trabeculectomy can effectively improve ophthalmic blood flow. Color Doppler imaging is a potential approach to evaluate and monitor glaucoma.

R779.6