高龄缺血性眼病患者高频彩超下球后血流动力学特点分析

Characteristics of retrobulbar hemodynamics in elderly patients with ischemic ophthalmopathy under high-frequency color Doppler ultrasound

目的分析高龄缺血性眼病(IOP)患者高频彩超下球后血流动力学特点。方法选取2019年2月至2021年2月于本院眼科住院治疗的42例IOP患者作为研究组,另选取同期于本院眼科进行检查的42例非IOP患者作为对照组。比较研究组患眼与对照组同侧健眼血流参数,比较研究组患眼与健眼血流参数,分析研究组眼动脉(OA)、视网膜中央动脉(CRA)、睫状后短动脉(SPCA)血流频谱变化。结果研究组患眼臂视网膜循环时间(A-RCT)长于健眼与对照组,OA、CRA及PCA的最大收缩期峰值流速(PSV)、舒张期血流速度(EDV)均慢于健眼与对照组,阻力指数(RI)均高于健眼与对照组,且研究组健眼A-RCT长于对照组,OA、CRA及SPCA的PSV、EDV均慢于对照组,RI高于对照组,差异有统计学意义(P<0.05)。研究组患眼OA未检测到血流频谱的比例为0.00%,血流频谱中第一峰值变钝占比80.95%,单峰血流频谱占比23.81%;CRA未检测到血流图谱占比9.52%,血流频谱中第一峰值变钝占比76.19%,单峰血流频谱占比19.05%;SPCA未检测到血流频谱占比2.38%,血流频谱中第一峰值变钝占比71.43%,单峰血流频谱占比21.43%。结论高频彩超能灵敏地检测高龄IOP患者的血流动力学和血流频谱,其主要血流动力学特点为患者各眼部动脉的血流速度下降,血管阻力增加,且各眼部动脉的血流频谱的信号和峰值也发生变化,患者患眼病变多以第一峰值变钝为主,少数患者可出现单峰变化,对于IOP的诊断和鉴别具有一定参考价值。

Objective To analyze the characteristics of retrobulbar hemodynamics in elderly patients with ischemic ophthalmopathy(IOP)under highfrequency color Doppler ultrasound.Methods A total of 42 patients with IOP admitted to Ophthalmology department of our hospital from February 2019 and February 2021 were enrolled as study group,while 42 non-IOP patients during the same period were enrolled as control group.The blood flow parameters of affected eyes in study group and the healthy eyes in control group,and which of the affected eyes and the healthy eyes in study group were compared,the changes in blood flow spectrum of ophthalmic artery(OA),central retinal artery(CRA)and short posterior ciliary artery(SPCA)in study group were analyzed.Results The armretinal circulation time(A-RCT)of the affected eye in the study group was longer than that of the healthy eye and the control group,the maximum systolic peak systolic velocity(PSV)and enddiastolic volume(EDV)of OA,CRA and PCA were slower than those of the healthy eye and the control group,and the regular insulin(RI)was higher than that of the healthy eye and the control group,the A-RCT of the healthy eye in the study group was longer than that of the control group,the PSV and EDV of OA,CRA and SPCA were slower than those of the control group,and the RI was higher than that of the control group,the differences were statistically significant(P<0.05).In the study group,the proportion of OA not detected in the blood flow spectrum was 0.00%,the proportion of the first peak blunting in the blood flow spectrum was 80.95%,and the proportion of unimodal blood flow spectrum was 23.81%;the proportion of undetected blood flow pattern in CRA was 9.52%,the proportion of first peak blunting in blood flow spectrum was 76.19%,and the proportion of unimodal blood flow spectrum was 19.05%;the proportion of blood flow spectrum not detected by SPCA was 2.38%,the proportion of the first peak blunted in the blood flow spectrum was 71.43%,and the proportion of single peak blood flow spectrum was 21.43%.Conclusion High-frequency color Doppler ultrasound can detect the hemodynamics and blood flow spectrum in elderly patients with IOP sensitively,the main characteristics of hemodynamics include decreased blood flow velocity increased vascular resistance,the signals and peaks of different ocular arteries are changed.The lesions of affected eyes are mainly on blunted first peak,there are single-peaked changes in few patients,and the above characteristics have certain reference value for differential diagnosis of IOP.