甲亢突眼征眼部动脉血流频谱特征和血流动力学研究

Study on spectral flow Doppler and hemodynamics in Graves' disease with exophthalmus

目的:探讨甲亢突眼征眼部动脉血流频谱特征和血流参数变化的规律,及与眼轴、眼压等的关系。方法:应用彩色多普勒超声诊断仪对甲亢突眼征患者(31例,62只眼)和正常人(25例,50只眼)的眼动脉(OA)、睫状后短动脉(SPCA)、视网膜中央动脉(CRA)的收缩期峰值流速(PSV)、舒张期最小流速(EDV)和阻力指数(RI)以及眼轴等进行检测。结果:①6项超声指标中,甲亢突眼组与正常对照组比较,眼轴、球横径无显著性差异(P>0.05);球尖距、球后软组织周长、球后软组织面积及球后软组织体积差异显著(P<0.05或<0.01)。②甲亢突眼征眼部动脉频谱形态OA第一峰高尖,第二峰降低圆钝,甚至出现两峰融合,峰时延长、后移;SPCA第一峰增高且宽大,第二、三波峰圆钝,峰时后移;CRA第一峰上升速度明显加快,波峰较高,而第二峰峰时延长、后移。③眼部血流动力学变化特点为:甲亢突眼组与正常对照组比较OA、SPCA和CRA的PSV均明显增高(P<0.01),EDV和RI有显著性差异(P<0.05,P<0.01)。结论:甲亢突眼征眼部血流频谱形态特征、血流动力学参数和球尖距、球后软组织周长、球后软组织面积及球后软组织体积发生改变。

Objective： To study the spectral flow Doppler and hemodynamics in the ophthalmic artery （OA）, the short post culinary artery （SPCA） , and the central retinal artery（CRA） in Graves disease with exophthalmus. Methods： Sixty-two eyes of 31 patients in Graves disease with exophthalmus and 50 eyes of 25 normal subjects were studied. Peak systolic velocity （PSV）, end diastolic velocity （EDV）, and resistance index （R1） of OA , SPCA, and CRA were measured and compared with the normal. Results： （1） There was no significant differences in ocular axes and pathway across eyeball between the hyperthyroidism group and the control group（ P 〉0.05）. But there was significant difference in the horizental ocular dimensions and perimeter and area and volume of the post-eyeball soft tissue increased （ P 〈0.05 or P 〈0.01）. （2）The character of the eye of hyperthyroidism valve flow spectrum in Doppler imaging. The abnormity indicated that the first peak of OA was high and acute, and the second was decreased and round and blunt, sometimes two peaks were consolidated or moved behind. And the first peak of SPCA was as the same as that of OA. But the second and the third were round and blunt, especially the appearing time of these peaks delayed. The velocity of the first peak of CRA was faster than those of OA and SPCA, and its peak was higher than those of OA and SPCA also, but its velocity of the second peak was delaied a lot. （3） The changing rule of the hemodynamics of ocular blood flow parameters in the eye of hyperthyroidism was that PSV of OA and SPCA and CRA was significantly higher than those in the control group（ P 〈0.01）. EDV and RI in the eye of hyperthyroidism group was more significant than those eyes in the control group（ P 〈0.05, P 〈0.01）. Conclusion： There was a changing rule in the valve flow spectrum, the parameters of hemodynamies and the horizental ocular dimensions and perimeter and area and volume in Graves disease with exophthalmus.