缺血性眼病与颈动脉狭窄的相关研究

Association between ischemic ophthalmopathy and carotid artery stenosis

目的探讨颈动脉狭窄的病因及缺血性眼病的发生与颈动脉狭窄的关系。方法经颅多普勒超声(TCD)及数字减影血管造影(DSA)检查明确有颈动脉狭窄患者300例,男性246例,女性54例,年龄31～78岁,单侧126例,双侧174例。利用统计学方法对颈动脉狭窄发病的相关因素、狭窄程度及颈动脉狭窄与其所导致的缺血性眼病的关系进行分析。结果颈动脉狭窄的主要发病因素是动脉粥样硬化;颈动脉狭窄的发病与年龄、性别、高血压、高血脂、高同型半胱氨酸血症等因素相关;颈动脉狭窄患者中37.3%出现了眼部症状,包括一过性黑矇、复视、视力下降、甚至失明,一过性黑矇是最常见的眼部症状(占37.5%),其原因与颈动脉狭窄导致视网膜中央(分支)动脉阻塞、静脉淤滞性视网膜病变、新生血管性青光眼等有关;眼部症状的出现与狭窄的程度、部位有关。结论颈动脉狭窄造成的眼部供血下降可以导致多种缺血性眼病,眼部症状的出现与颈动脉狭窄的程度及部位有密切关系。同时也为今后的预防、治疗提供了重要的依据。

Objective To explore the association between ischemic ophthalmopathy（IPO） and carotid artery stenosis （CAS）. Methods 300 patients with CAS（male：246,female：54;age：31-78;unilateral CAS：126,bilateral CAS：174） were diagnosed by transeranial doppler sonography （TCD） and digital subtraction angiography （DSA）. By using statistical methods,we analyzed the risk factors of CAS, stenosis degree and the association between the CAS and IPO. Results The main risk factor of CAS was atherosclerosis, and other factors, such as age, sex, hypertension, hyperlipemia, and hyperhomocysteinaemia were related with the onset of CAS. 37.3% of all subjects presented eye symptoms, including amaurosis fugax, diplopia,impaired vision and even blindness. The amaurosis fugax was the commonest eye symptom（37.5% ） ,which were associated with the obstruction of arteria centralis （branch） retinae, venous stasis retinopathy, neogenesis vascular glaucoma as the results of CAS. The presences of eye symptoms were related to the locus and degree of CAS. Conclusion The lower blood supply of ocular region caused by CAS might lead to many kinds of IPO. The presences of eye symptoms were closely related to the locus and degree of CAS.