彩色多普勒血流显像对低压性青光眼的血流动力学研究

Color Doppler imaging analysis of ocular hemodynamics in low tension glaucoma

目的观察低压性青光眼血流动力学变化。方法应用彩色多普勒检测１５例正常人和１９例低压性青光眼（ｌｏｗ－ｔｅｎｓｉｏｎｇｌａｕｃｏｍａ，ＬＴＧ）的眼动脉、睫状后短动脉及视网膜中央动脉的血流参数。测定收缩期血流峰值速度（ｐｅａｋｓｙｓｔｏｌｉｃｆｌｏｗｖｅｌｏｃｉｔｙ，Ｖｍａｘ）、舒张末期血流速度（ｅｎｄｄｉａｓｔｏｌｉｃｆｌｏｗｖｅｌｏｃｉｔｙ，Ｖｍｉｎ）、平均血流速度（ｍｅａｎｅｎｖｅｌｏｐｅｄｖｅｌｏｃｉｔｙ，Ｖｍｅａｎ）、搏动指数（ｐｕｌｓｅｉｎｄｅｘ，ＰＩ）、阻力指数（ｒｅｓｉｓｔａｎｃｅｉｎｄｅｘ，ＲＩ）及收缩期血流峰值速度和舒张末期血流速度比值（Ｖｍａｘ／Ｖｍｉｎ，Ｓ／Ｄ）。结果（１）ＬＴＧ组睫状后短动脉血流速度低于正常人组（两组双眼Ｖｍａｘ、Ｖｍｉｎ及右眼Ｖｍｅａｎ比较，Ｐ＜０．０５），左眼ＲＩ及Ｓ／Ｄ低于正常人组（Ｐ＜０．０５）；（２）ＬＴＧ组左眼视网膜中央动脉血流的Ｖｍａｘ及Ｖｍｅａｎ低于正常人组（Ｐ＜０．０１）；（３）ＬＴＧ组与正常人组眼动脉血流的Ｖｍａｘ等６项参数比较，差异无显著性（Ｐ＞０．０５）。结论ＬＴＧ组的睫状后短动脉血流速度低于正常人组，支持ＬＴＧ视乳头损害的血管学说。

Obiective To investigate ocular hemodynamics with color Doppler imaging in lowtension glaucome. Methods Nineteen patients with low tension glaucoma (LTC) and 15 normal subjects were studied. The peak systolic velocity (Vmax), the end diastolic velocity (Vmin), the meanenveloped velocity (Vmean), the pulse index (PI), the resistance index (RI) and S/D (Vmax/Vmin) of the ophthalmic artery (OA), the short posterior ciliary arteries (SPCA) and the central retinal artery (CRA) were compared in the two groups. Results (1) Compared with the normal subjects, the patients with LTG showed a decreased Vmax and Vmin in SPCA in bilateral eyes and Vmean in the right eye ( P <0 05),and a decreased RI and S/D in the left eye ( P <0 05). (2)Vmax and Vmean of CRA in LTG were lower than that in normal subjects ( P <0 01). (3)All six blood flow parameters of OA in the two groups were not significantly different from each other. Conclusions Blood flow velocity of SPCA in LTG was lower than that in the normal subjects. The results support the theory that LTG is induced by the perfusion impairment of optic nerve head.