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

发布时间：2018-04-05 09:04

  本文选题：眼动脉　切入点：颈内动脉狭窄　出处：《眼科新进展》2015年02期

【摘要】：目的通过经颅多普勒超声(transcranial Doppler,TCD)对单侧重度颈内动脉狭窄(internal carotid artery stenosis,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(peak systolic velocity,PSV)及阻力指数(resistance index,RI),对比分析眼动脉逆向血流(reversed ophthalmic artery flow,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ROAF 24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 investigate the relationship between ophthalmic artery flow, ocular ischemic disease and internal carotid artery stenosis in patients with unilateral severe internal carotid artery stenosis by transcranial Doppler Doppler echocardiography (TCD).Methods 31 patients with unilateral severe ICAS and 19 patients with complete occlusion of internal carotid artery were included in the study.TCD was used to examine the direction of blood flow, peak systolic velocity-PSV (peak systolic velocity-PSV) and resistance index (RI) in ICAS. The values of PSV and RI in patients with reverse ophthalmic artery flow of ophthalmic artery and contralateral ophthalmic artery were compared and analyzed.The relationship between the direction of ophthalmic artery blood flow and the degree of ocular ischemia and ICAS was analyzed.Results 24 eyes of ROAF were found by TCD examination, including 9 eyes with unilateral severe ICAS and 15 eyes with complete internal carotid artery occlusion.宸�寮傛湁缁熻�″�︽剰涔�(蠂2=11.76,P=0.001).24渚婻OAF鎮ｈ，

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