视网膜Hollenhorst斑与高危颈动脉狭窄特征关系的研究

The correlation analysis between retinal Hollenhorst plaque and characteristic of high-risk carotid artery stenosis

目的探讨视网膜Hollenhorst斑与高危颈动脉狭窄的特征关系。方法选取单侧高危颈动脉狭窄的患者210例,使用颈动脉超声、颈部CT血管造影术或脑血管造影评估颈动脉狭窄程度和颈动脉斑块的稳定性,使用眼底照相评估Hollenhorst斑。将有Hollenhorst斑的患者纳入Hollenhorst斑组,将无Hollenhorst斑的患者纳入对照组。比较两组的一般临床特征、实验室指标及颈动脉狭窄的相关指标,分析Hollenhorst斑与高危颈动脉狭窄的特征关系。结果在所有210例患者中,Hollenhorst斑患者32例,占15.24%。两组年龄、吸烟、不稳定斑块、症状性颈动脉狭窄、中度颈动脉狭窄、重度颈动脉狭窄比较,差异均有统计学意义(t=-4.17,χ^(2)分别=6.24、4.52、5.18、7.95、18.10,P均<0.05)。多因素分析显示,年龄、吸烟、症状性颈动脉狭窄、重度颈动脉狭窄显著增加Hollenhorst斑风险(OR分别=1.09、2.74、2.61、3.86,P均<0.05)。结论症状性颈动脉狭窄、重度颈动脉狭窄会显著增加Hollenhorst斑的风险。对于高危颈动脉狭窄患者应常规进行眼底筛查。

Objective To investigate the relationship between Hollenhorst plaque(HP)and characteristic of high-risk carotid artery stenosis.Methods A total of 210 patients with unilateral high-risk carotid artery stenosis were enrolled in this study.Carotid Ultrasound,cervical CT angiography,or digital subtraction angiography(DSA)were used to assess the stenosis of carotid artery the and the stability of carotid plaque.Fundus imaging were used to assess the HP.Patients with HP were enrolled into the HP group,and patients without HP were included in the control group.Results Among the 210 patients,32 patients(15.24%)had HP.There were significant differences in age,smoking,unstable plaque,symptom-atic carotid artery stenosis,moderate carotid artery stenosis and severe carotid artery stenosis between the two groups(t=-4.17,χ^(2)=6.24,4.52,5.18,7.95,18.10,P<0.05).Multivariate analysis showed that age,smoking,symptomatic carotid ar-tery stenosis,and severe carotid artery stenosis significantly increased the risk of HP(OR=1.09,2.74,2.61,3.86,P<0.05).Conclusion Symptomatic carotid artery stenosis and severe carotid artery stenosis significantly increase the risk of HP.Fundus examination should be performed routinely in patients with high-risk carotid artery stenosis.