视网膜中央静脉阻塞与球后血流动力学及血液流变学的临床分析

Retrobulbar hemodynamics and hemorheology in central retinal vein occlusion

目的 探讨视网膜中央静脉阻塞 (CRVO)患者的视网膜中央动脉 (CRA)、眼动脉 (OA)的血液动力学、血液流变学改变及其相互关系。方法 采用美国AcusoN12 8XP/ 10彩色多普勒成像 (CDI)技术检测 33例CRVO患者和 33例正常人CRA OA血流动力学及血液流变学改变。结果 CRVO患眼CRA收缩期最大血流速度 (Vmax)比对侧眼 (P <0 0 5 )及对照组 (P <0 0 1)下降 ,舒张末期最小血流速度 (Vmin)比对侧眼及对照组减低 (P <0 0 5 ) ,阻力指数 (RI)比对侧眼 (P <0 0 5 )及对照组 (P <0 0 1)增高。低切率全血比粘度较对照组显著性增高 (P <0 0 1) ,并与CRAO患者Vmax(r=- 0 .6 41,P <0 0 1)、Vmin(r=- 0 .5 38) ,P <0 0 1)成负相关。结论 CRVO患眼CRA的CDI参数异常 ,表明动脉血流速度的下降与CRVO发病相关 ,CRA供血减少是引起视网膜损害的主要原因之一。低切率全血比粘度增高是导致CRVO患眼CRA血流下降因素之一。

Objective To study the changes of hemodynamics and hemorheology in central retinal artery (CRA) and ophthalnic artery (OA) in patients with central retinal vein occlusion (CRVO).Methods Blood flow velocity in CRA and OA and change of hemorheology in 33 patients with CRVO and 33 controls were measured by color doppler imaging (CDI) using Acuso N-128XP/10(USA).Results The systolic maximum blood flow velocity (Vmax) in CRA of eyes with CRVO was lower than that of fellow eyes (P<0.05) and controls (P<0.01),and the end diastolic minimum blood flow velocity (Vmin) also was lower in fellow eyes and controls(P<0.05).However,the resistive index(RI) in CRA of eyes with CRVO was higher than that of fellow eyes (P<0.05) and controls (P<0.01).The whole blood viscosity at low shear rate in patients with CRVO was significantly higher than that of controls (P<0.01),which was negatively correlated with V max and V min of eyes with CRVO (Rvmax=-0.641 Rvmin=-0.538,P<0.01).Conclusions The CDI parameters in CRA of eyes with CRVO were abnormal,indicating the correlation between the decrease of artery blood flow velocity and the pathogenesis of CRVO.The reduction in blood supply in CRA is one of major causes of retinal damage with CRVO.The increased whole blood viscosity at low shear rate is one of factors leading to decrease of blood flow in CRA with CRVO.