颅内段颈内动脉狭窄与眼部动脉血流状态及视网膜血管形态的相关性

Correlation between intracranial carotid artery stenosis and ocular arterial blood flow and retinal vascular morphology

摘要:

目的：探讨颅内段颈内动脉狭窄与眼部动脉血流状态及视网膜血管形态的相关性。

方法：选取2017-01/2018-06因疑似脑缺血来我院就诊的患者251例，根据颈内动脉狭窄程度分为无狭窄组(39例)、轻度狭窄组(80例)、中度狭窄组(83例)、重度狭窄组(49例)。比较四组患者眼部动脉血流动力学指标及视网膜血管管径，分析眼部血流参数与颅内段重度颈内动脉狭窄的相关性及诊断价值。

结果：重度狭窄组患者眼动脉(OA)、视网膜中央动脉(CRA)、睫状后动脉(PCA)的血管血流参数收缩峰流速(PSV)和舒张峰流速(EDV)均低于其他三组，且PSV、EDV与重度狭窄组患者颈内动脉狭窄率呈显著负相关，其中PCA PSV、PCA EDV对颅内段重度颈内动脉狭窄诊断最佳临界值分别为11.26、5.21cm/s。

结论：颅内段颈内动脉狭窄与眼部动脉PSV、EDV呈显著负相关，其中PCA PSV、PCA EDV对于颅内段颈内动脉狭窄最敏感。

Abstract:

AIM: To investigate the correlation between intracranial internal carotid artery stenosis and ocular arterial blood flow and retinal vascular morphology.

METHODS: Totally, 251 patients admitted to our hospital due to suspected cerebral ischemia from January 2017 to June 2018 were selected. According to the degree of internal carotid artery stenosis, the patients were divided into non-stenosis group(39 cases), mild stenosis group(80 cases), moderate stenosis group(83 cases), and severe stenosis group(49 cases). The ocular hemodynamic indexes and retinal vascular diameters of the four groups were compared. The correlation and diagnostic value were analyzed between eye blood flow parameters and severe intracranial internal carotid artery stenosis.

RESULTS: In the severe stenosis group, the peak systolic velocity(PSV)and diastolic peak velocity(EDV)of ophthalmic artery(OA), central retinal artery(CRA)and posterior ciliary artery(PCA)were significantly lower than those of the other three groups. In the blood flow parameters of OA, CRA and PCA, PSV and EDV were significantly negatively correlated with severe intracranial internal carotid artery stenosis. The optimal diagnostic thresholds of PCA PSV and PCA EDV for severe intracranial internal carotid artery stenosis were 11.26cm/s and 5.21cm/s, respectively.

CONCLUSION: Intracranial internal carotid artery stenosis was significantly negatively correlated with PSV and EDV in the ocular arteries. PCA PSV and PCA EDV were most sensitive to intracranial internal carotid artery stenosis under the same index.