一过性黑矇的相关危险因素分析

Risk factors of amaurosis fugax

目的探讨一过性黑噱发生的相关危险因素。方法收集我院眼科以一过性黑嚎为主诉的患者67例（98只眼），所有患者均经详细询问既往史、个人史等，进行眼部检查，并通过颈部彩色超声多普勒检查及血液流变学检查。67例一过性黑噱患者颈动脉超声情况作为观察组，选取非一过性黑朦患者59例颈动脉超声情况作为对照组，并对其结果进行统计学分析。结果发生一过性黑朦患者发病年龄的分组比较中，51—60岁组及61—70岁组发患者数明显高于其它年龄组，差异有统计学意义（P〈0．05）；67．16％的患者血液流变学出现异常，包括全血粘度、甘油三酯、总胆固醇、葡萄糖增高或异常；颈动脉彩色超声多普勒检查中，观察组双侧颈动脉彩色超声粥样硬化、粥样斑块、血管狭窄或闭塞总检出率与对照组双侧颈动脉相关病变总检出率差异有统计学意义（P〈0．05）。观察组颈动脉狭窄和闭塞的发生率与对照组比较差异有统计学意义（χ2=10．651，P=0．002），并且一过性黑噱患者重度狭窄及闭塞发生率明显高于对照组（χ2=9．901，P=0．003）。结论高龄、颈动脉重度狭窄或闭塞是一过性黑噱发生的危险因素，血液流变学改变与一过性黑嚎的发病密切相关，发生一过性黑噱应尽早进行颈动脉彩色超声多普勒检查及血流变学观察，及时治疗以预防缺血性眼病及脑血管意外的发生。

Objective To explore risk factors of the amaurosis fugax. Methods Totally 67 patients （ 98 eyes） with amaurosis fugax presented to our department of ophthalmdogy were enrolled. Previous history and personal history were collected, and ophthalmic examination, neck Doppler ultrasound, and hemorheology examination were conducted. Results of carotid artery ultrasound of 67 patients with amaurosis fugax were compared with 59 control subjects. Results Amauro- sis fugax had a higher incidence among 51-60 years old and 61-70 years old age subgroups. This is statistically significant （ P 〈0.05 ）. Various degrees of hemorheological changes, including abnormal blood viscosity, triglycefide, total plasma cholesterol or plasma glucose, were found in 67.16% of patients. Carotid atheroscleresis phque and stenosis were signifi- cantly more common in patients with amaurosis fngax than in control subjects （χ2 = 10.651, P --0.002）, and rate of se- vere stenesls is significantly higher （χ2 =9.901, P =0.003 ）. Conclusion The main risk factors of amaurosis fugax were severe carotid artery stenosis and advanced age. There were significant correlations between amaurosis fugax and hemorheo- logical abnormalities. Patients with amaurosis fugax should be screened with color Doppler flow imaging and hemorheelogy examinations as early as possible. It was an effective way to prevent ischemlc ophthalmopathy and cerebrovascular acci- dents.