增强型血流显像及频谱多普勒对高尿酸血症患者眼动脉的血流动力学研究

Enhance-flow and spectral Doppler study on the hemodynamics of ophthalmic artery in hyperuricemia

目的采用增强型血流显像（eFlow）及频谱多普勒研究高尿酸血症患者视网膜中央动脉（CRA）和眼动脉内径及血流动力学改变。方法选择经确诊为痛风或高尿酸血症患者101例作为研究对象，并以性别、年龄相匹配的健康者30名为健康对照，eFlow观察眼动脉、CRA在眶内的走形并在所规定位置测其内径，频谱多普勒检测眼动脉、CRA的收缩期峰值血流速度（PSV）、舒张末期血流速度（EDV）、血流阻力指数（RI）及血流搏动指数（PI）。根据确诊高尿酸血症的年限分为≤5年组和〉5年组，采用独立样本t检验比较两组样本均数；再根据有无高血压分为高尿酸血症伴高血压组和不伴高血压组，所得数据和对照组做单因素方差分析，组间两两比较采用SNK法。结果确诊高尿酸血症〉5年组眼动脉的RI（0．68±0．09）、PI（1．3±0．4）较≤5年组（RI：0．63±0．09，PI：1．1±0．3）明显升高（t=3．504，P=0．001；t=3．164，P=-0．002），眼动脉舒张末期血流速度（EDV）〉5年组（6±3）crrds较≤5年组（8±5）cm／s明显降低（￡=1．988，P=0．049）；高尿酸血症伴高血压组CRA的PSV：（11．5±3．5）cm／s、EDV：（3．7±1．1）errds较高尿酸血症不伴高血压组[PSV：（13．5±4．0）cm／s，EDV：（4．1±1．2）cm／s]明显降低，RI明显升高（伴高血压组：0．88±1．40，不伴高血压组：0．67±0．08，P〈0．01）。高尿酸血症组眼动脉及CRA内径和对照组比较差异无统计学意义（P〉0．05）。结论eFlow结合多普勒技术对研究高尿酸血症所致眼动脉血流动力学改变具有较高的临床价值，并提示高尿酸血症可加速眼动脉及CRA的粥样硬化改变，而高尿酸血症合并高血压可进一步加速终末小血管的粥样硬化改变。

Objective To study the inner diameter and hemodynamics of ophthalmic artery （OA） and central retinal artery （CRA） in hyperuricemia by Enhance-flow （eFlow） imaging and spectral Doppler. Methods One hundred and one patients with hyperuricemia and 30 volunteers were selected, the inner diameter in eFlow imaging and the peak systolic velocities （PSV）, the end diastolic velocities （EDV）, the resistive index （RI） were measured, and pulsatility index （PI） of OA and CRA were measured by spectral Doppler. The 101 patients were divided into two groups according to the time of diagnosing hyperuricemia, one group had a diagnosis of hyperuricemia for more than five years and the other had such a diagnosis for less than five years. The data were compared by t-test. Then, the patients were further divided into a group of hyperuricemia combined with hypertension and the other without hypertension. The differences between the experimental group and the group of volunteers were carried out by One-way ANOVA, the comparison between two groups were analyzed with SNK. Results The RI （0.68±0.09） and PI （1.3±0.4） of OA in patients who were diagnosed as hyperuricemia for more than 5 years was higher [RI： 0.63±0.09, PI： 1.1±0.3 （t=3.504, P=0.001; t=3.164, P=-0.002）], the EDV [ （6±3） cm/s ] of OA was lower than those patients with a diagnosis of hyperuricemia for less than 5 years [（8±5） cm/s, t=1.988, P=0.049]. The PSV[（ll.5±3.5） cm/s] and EDV [（3.7±1.1） cm/s] of CRA in hyperuricemia combination hypertension group was lower, and the RI （0.88±1.40） was higher than hyperuricemia without hypertension group [PSV： （13.5±4.0） cm/s, EDV： （4.1±1.2） cm/s, RI： 0.67±0.08]. Conclusion By eFlow and spectral Doppler, we have found that hyperu-ricemia could accelerate OA and CRA atherosclerosis. The eFlow and spectral Doppler are valuable methods to study the hemodynamics in ophthalmic artery of patients with hyperuricemia.