视网膜中央静脉阻塞与颈动脉粥样硬化斑块相关性的临床研究
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2012年度东莞市科技计划医疗卫生类科研项目(No.201210515000531)


Clinical research on the relationship of central retinal vein occlusion and atherosclerosis
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2012 Medical Health Research of Dongguan Science and Technology Plan(No.201210515000531)

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    摘要:

    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2a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。

    Abstract:

    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.

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程道安,陈姚若,赖静怡,等.视网膜中央静脉阻塞与颈动脉粥样硬化斑块相关性的临床研究.国际眼科杂志, 2015,15(4):662-665.

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  • 收稿日期:2014-12-16
  • 最后修改日期:2015-03-24
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  • 在线发布日期: 2015-04-08
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