缺血性脑血管病患者白质病变与视网膜血管病的相关性

Relationship of white matter lesions to retinal angiopathy in patients with ischemic cerebrovascular disease

目的探讨缺血性脑血管病患者的脑白质病变与视网膜血管病之间的相关性。方法通过磁共振扫描及眼底照片检查对入组的128例缺血性脑血管病患者的脑白质病变及视网膜血管病变情况进行评估,按有无脑白质病变分对照组和病例组,对两组间年龄、性别、高血压、糖尿病、血脂、吸烟、饮酒、同型半胱氨酸、颈动脉硬化等暴露因素进行分析,并对两者严重程度进行相关分析。结果年龄、高血压、颈动脉病变、视网膜血管病与白质疏松关系密切,其中视网膜血管病与白质疏松关联性较强(OR=5.948,95%CI=2.133～16.584),并且两者之间存在正相关性(r=0.623,P<0.01)。结论视网膜血管病和脑白质病变具有相关性。视网膜血管病变的严重程度能够反映脑白质病变的程度,眼底血管检查可以用于间接评估脑小血管病变。

Objective To discuss the relationship of white matter lesions to retinal angiopathy （RA） in patients with ischemic cerebrovascular disease.Methods One hundred and twenty-eight patients were recruited from No.1 affiliated hospital of Wenzhou medical college.RA was detected by fundus photography and white matter lesions （leukoaraiosis,LA） were detected by magnetic resonance imaging.The cases were divided into the control group and the LA group.The severity of LA was valued according to Fazekas Scale.Age,sex,hypertension,diabetes,smoke and alcohol drink were confirmed by review of medical record.Homocysteine and dyslipidemia were detected by blood test.Carotid artery was detected by type-B ultrasonic.All the risk factors ofcerebral vascular disease were analyzed by use of logistic recurrence analysis.Results Age,hypertension,carotid artery atherosclerosis and RA were connected with LA.Correlation analysis showed LA had a positive relation with RA （r=0.623,P＜0.01）.Conclusions From our study,the relationship of LA to RA was established.Indirect evaluation of cerebral small vessels can be made by taking fundus photography.