彩色多普勒超声检测老年人眼动脉和视网膜中央动脉血流

目的了解老年人眼动脉和视网膜中央动脉的血流动力学变化,为脑血管性疾病和糖尿病的诊断提供有价值的数据。方法采用美国Ａｃｕｓｏｎ－１２８型电脑影像仪测量２０９例老年人眼动脉和视网膜中央动脉的收缩期、舒张末期血流速度、阻力指数和搏动指数。结果正常老年人血流动力改变与患脑血管病和糖尿病的老年人相比有显著性差异（Ｐ＜０．０１）。结论此项检查对预测老年人脑血管病和糖尿病的发生和判断病情的发展有重要意义     

妊高征患者视网膜中央动脉的彩色多普勒超声检测

目的：探讨妊高征患者视网膜中央动脉的血流动力学改变。方法：应用彩色多普勒超声分别测量２８例妊高征患者硫酸镁静滴前后及２０例正常人的视网膜中央动脉的收缩期血流峰值速度、舒张末期血流速度、平均血流速度、搏动指数及阻力指数，同时测血压。结果：妊高征患者视网膜中央动脉舒张末期血流速度明显低于正常人及用药后，搏动指数、阻力指数较正常人及用药后明显升高（Ｐ＜０．０５）。收缩期峰值血流速度及平均血流速度相差不显著（Ｐ＞０．０５）。结论：彩色多普勒超声检查视网膜中央动脉血流状况对妊高征患者的病情及疗效有监测价值     

彩色多普勒超声对正常老年人眼动脉和视网膜中央动脉血流速度测定

本文应用彩色多普勒超声测量正常老年人68例136只眼的眼动脉（OA）和视网膜中央动脉（CRA）血流速度。结果，正常老年人OA收缩期峰值血流速度32．54±7．69cm／s，舒张末期血流速度9．10±2．66cm／s，阻力指数0．72±0．06，搏动指数1．67±0．43。CRA收缩期峰值血流速度9．80±1．67cm／s，舒张末期血流速度4．10±0．90cm／s，阻力指数0．60±0．10，搏动指数1．15±0．21。老年人年龄组间OA和CRA的收缩期与舒张末期血流速度无差异而阻力指数和搏动指数随年龄增长有差异（P＜0．05）。     

无糖尿病性视网膜病变的糖尿病患者视网膜中央动脉彩色多普勒超声检测

目的：探讨糖尿病患者尚无可见的糖尿病性视网膜病变时的视网膜中央动脉血流动力学改变，为临床防治糖尿病视网膜病变提供资料。方法：经散瞳眼底检查及眼底荧光血管造影确定无糖尿病视网膜病变者４８例，３２例对照组。使用美国Ａｃｕｓｏｎ１２８ＸＰ／１０型彩色超声诊断仪，测视网膜中央动脉的收缩期峰值、舒张末期、平均血流速度、脉动指数、阻力指数及收缩期峰值与舒张末期血流速度比值。结果：糖尿病患者视网膜中央动脉收缩期峰值血流速度、平均血流速度均低于正常对照值，二组间差异有极显著性（Ｐ＜０．０１）。结论：糖尿病患者在无可见的糖尿病视网膜病变时视网膜中央动脉已发生血流动力学改变     

彩色多普勒超声对慢性青光眼视网膜中央动脉血流动力学的分析

为评价慢性青光眼视网膜中央动脉血流动力学的改变。对正常人２０例４０只眼和慢性青光眼２９例４４只眼进行彩色多普勒成像（ＣＤＩ）检查，分析收缩期峰值速度（ＰＳＶ）舒张末期速度（ＥＤＶ）和阻力指数（ＲＩ）。结果：青光眼视网膜中央动脉ＰＳＶ和ＥＤＶ较正常眼明显慢，Ｐ＜０．０１，ＲＩ则显著增高，Ｐ＜０．０１。结果表明：慢性青光眼视网膜中央动脉血管床阻力增加，可能伴有供血受损。     

彩色多普勒超声对开角型青光眼的血流动力学研究及临床意义

目的了解开角型青光眼视神经的血液供应情况。方法用彩色多普勒超声检测开角型青光眼和正常眼眼动脉、视网膜中央动脉和睫状后动脉的收缩期峰值血流速度、舒张末期血流速度、时间平均血流速度、阻力指数和搏动指数。结果在两者之中眼动脉和睫状后动脉的收缩期峰值血流速度差异无显著性（Ｐ＞０．０５）,舒张末期血流速度、时间平均血流速度、阻力指数、搏动指数差异有显著性意义（Ｐ＜０．００１）。视网膜中央动脉的多项血流动力学指标差异有显著性意义（Ｐ＜０．００１）。结论开角型青光眼的视神经存在缺血因素。     

彩色多普勒超声对慢性青光眼视网膜中央动脉血流动力学的…

为评价慢性表光眼视网膜中央动脉血流动力学的改变，对正常人２０例４０只眼和慢性青光眼２９例４４只眼进行彩色多普勒成像（ＣＤＩ）检查，分析收缩期峰值速度（ＰＳＶ）舒张末期速度（ＥＤＶ）和阻力指数（ＲＩ）。结果：青光眼视网膜中央动脉ＰＳＶ和ＥＤＶ较正常明显慢，Ｐ〈０．０１，ＲＩ则显著增高，Ｐ〈０．０１，结果表明，慢性青光眼视网膜中央动血管床阻力增加，可能伴有供血受损。     

眼挫伤的眼底血流的观察

目的：对眼挫伤的眼底血流动力学的观察。方法：应用彩色多普勒检测６２只正常眼和７０只眼挫伤患者的视网膜中央动脉（ＣＲＡ） 的血流参数。测定收缩期流速（ＰＳＶ）， 舒张末期流速（ＥＤＶ）、搏动指数（ＰＩ）、阻力指数（ＲＩ）。结果： 眼挫伤组ＣＲＡ的ＰＳＶ、ＲＩ均低于正常组（Ｐ＜ ０．０１）， ＥＤＶ、ＰＩ两组未见明显差异。结论： 眼挫伤组视网膜血供降低是引起视功能障碍的原因之一， 给临床对眼挫伤诊治和预后提供重要的依据。     

糖尿病患者视网膜中央动脉血流速度改变

本文为研究糖尿病患者的视网膜中央动脉（ＣＲＡ）血流动力学改变，用彩色多普勒超声检测了９８例糖尿病患者和５０例正常对照者ＣＲＡ的收缩期最高血流速度（Ｖｍａｘ）、舒张末期最低血流速度（Ｖｍｉｎ）、平均血流速度（Ｖｍｅａｎ）、脉动指数（ＰＩ）、阻力指数（ＲＩ）、Ｖｍａｘ／Ｖｍｉｎ值（Ｓ／Ｄ）。结果：糖尿病患者的Ｖｍａｘ、Ｖｍｉｎ、Ｖｍｅａｎ均低于正常对照组，ＰＩ、ＲＩ、Ｓ／Ｄ均高于对照组。无糖尿病视网膜病变的糖尿病患者（ＮＤＲ）和糖尿病视网膜病变（ＤＲ）Ⅰ～Ⅲ期者的Ｖｍｉｎ、Ｖｍｅａｎ均低于对照组（Ｐ＜０．０５）。增殖性糖尿病视网膜病变（ＰＤＲ）的Ｖｍａｘ、Ｖｍｉｎ均低于对照组（Ｐ＜０．０１）。结论为糖尿病患者的ＣＲＡ血流速度降低，视网膜循环阻力升高，视网膜血液供应不良     

原发性高血压病患者眼球后动脉血流变化的多普勒超声观察

目的探讨高血压病患者眼动脉和视网膜中央动脉血流动力学变化,以寻找最敏感、重复性最好的血流参数指标。方法彩色多普勒超声检查55例原发性高血压病患者110只眼及50例正常对照组100只眼的眼动脉、视网膜中央动脉的血流参数,并对照分析。结果与对照组比较,高血压病患者眼动脉收缩期峰值流速（Vs）、舒张末期血流速度（Vd）降低,阻力指数升高（均P〈0．05）;视网膜中央动脉Vs、Vd降低,阻力指数、搏动指数升高（P〈0．05）;视网膜中央动脉与眼动脉血流速度比值降低（P〈0．01）。结论高血压病高眼球后动脉血流变化的多普勒超声参数为眼部病变的诊断和治疗提供可靠数据。     

Evaluation of ocular arterial changes in glaucoma with color Doppler ultrasonography.

The purpose of this study was to evaluate hemodynamic changes of the retrobulbar vasculature caused by different intraocular pressures with color Doppler ultrasonography. Fifty normal eyes in 25 patients, 13 patients with normal tension glaucoma, and 19 patients with acute glaucoma and increased intraocular pressure (greater than 30 mm Hg) were enrolled in this study. In 15 of 19 patients with acute glaucoma patients, follow-up color Doppler ultrasonography was also undertaken after laser peripheral iridectomy when the intraocular pressure had returned to normal. The peak systolic velocity, end diastolic velocity, resistive index, time average maximum velocity, and pulsatility index were compared in different vessels, including the central retinal artery, lateral posterior ciliary artery, medial posterior ciliary artery, and ophthalmic artery in each orbit. The peak systolic velocity, end diastolic velocity, and time average maximum velocity of the central retinal artery were significantly lower (P<0.01) in acute glaucoma patients than in the control group. The resistive index and pulsatility index of the central retinal artery were significantly higher (P<0.01) in acute glaucoma patients than in the control group. The end diastolic velocity of the lateral and medial posterior ciliary arteries was significantly lower in patients with acute glaucoma than in the control group, and the resistive index and pulsatility index of both of these arteries were significantly higher (P<0.001) in patients with acute glaucoma than in the control group. However, no statistical significantly differences were found in the peak systolic velocity or time average maximum velocity in either of the posterior ciliary arteries; similarly, no statistically significant differences were noted in any of the parameters in the ophthalmic artery between the control group and the group with acute glaucoma. The pulsatility index of the central retinal artery and of the lateral and medial posterior ciliary arteries was significantly lower (P<0.01) in acute glaucoma patients after laser therapy than in acute glaucoma patients before laser therapy. The resistive index of both posterior ciliary arteries was also significantly lower (P<0.004) in acute glaucoma patients after laser therapy than before laser therapy. All parameters for all vessels examined among the normal subjects, the patients with normal tension glaucoma, and the patients with acute glaucoma after laser therapy when the intraocular pressure had returned to normal showed no statistically significant differences. Color Doppler ultrasonography is a good modality for both imaging and studying the hemodynamics of the perioptic nerve vessels.     

糖尿病患者视网膜中央动脉血流动力学的研究

目的探讨糖尿病患者视网膜中央动脉的血流动力学变化规律。方法用彩色多普勒超声检测66例糖尿病患者和30例正常对照者的视网膜中央动脉收缩期最高血流速度(Vmax)、舒张末期最低血流速度(Vmin)、阻力指数(RI)、搏动指数(PI);用免疫凝集抑制法测定全部病人的糖化血红蛋白。结果糖尿病患者视网膜中央动脉的Vmax,Vmin均低于正常组(p<0.05),RI高于正常组(p<0.05)。糖化血红蛋白与糖尿病患者视网膜中央动脉的血流速度呈负相关,与RI呈正相关。结论糖尿病患者存在视网膜中央动脉血流动力学异常,且发生在视网膜血管形态学改变之前,与血糖水平有关。     

彩超对视网膜中央静脉阻塞血流动力学改变的诊断价值

目的分析彩色多普勒超声在视网膜中央静脉阻塞(CRVO)分期的视网膜中央动脉血流动力学改变,评价视网膜中央动脉流速曲线参数的超声征象及诊断价值。方法应用彩超分别对CRVO非缺血型组48例(病变眼49只),缺血型组44例(病变眼48只)行视网膜中央动脉流速曲线参数的检测。另选择动脉硬化患者85例为对照组进行对比研究。结果CRVO组与对照组各项血流参数比较,舒张末期流速(EDV)下降(p<0.01)。视网膜中央动脉阻力指数(RI)增高(p<0.01),收缩期流速峰值(PSV)无明显差异(p>0.05)。缺血型组与非缺血型组各项血流参数比较,两组间的血流参数,经X2检验(p<0.01)有显著差异。结论随着CRVO的程度增加,视网膜中央动脉RI增高,视网膜缺血状态越明显,两者呈正相关。而EDV降低,呈较明显的低灌注、高回流状态。应用彩超评价CRVO对视网膜中央动动脉血流动力学改变,对诊断提供了可靠的依据。     

彩色多普勒血流显像对青光眼血流动力学研究

本文用美国Ａｃｕｓｏｎ－１２８ＸＰ彩色多普勒检测２４例原发开角青光眼（ＰＯＡＧ）、２７例低压青光眼（ＬＴＧ）及２０例正常人的眼动脉、视网膜中央动脉及睫状后短动脉的血流参数，测定收缩期血流峰值速度（Ｖｍａｘ）、舒张末期血流速度（Ｖｍｉｎ）平均血流速度（Ｖｍｅａｎ）及阻力指数（ＲＩ）、同时测血压及眼压。结果显示，ＰＯＡＧ和ＬＴＧ患者视网膜中央动脉的Ｖｍａｘ、Ｖｍｅａｎ及睫状后短动脉的Ｖｍａｘ、Ｖｍｉｎ、Ｖｍｅａｎ均显著降低，与对照组有显著差异（Ｐ＜０．０５）；而ＰＯＡＧ与ＬＴＧ两组间差异无显著性（Ｐ＞０．０５）。眼动脉的４个血流参数，ＰＯＡＧ、ＬＴＧ与对照组均无显著差异（Ｐ＞０．０５）；收缩压、舒张压三组间亦无显著差异（Ｐ＞０．０５）；而ＰＯＡＧ患者的眼压均值显著高于ＬＴＧ及对照组（Ｐ＜０．０１）。本文结果提示，ＰＯＡＧ和ＬＴＧ患者视网膜中央动脉、睫状后短动脉均存在血流动力学异常。使视盘的血液供应不良，从而导致结构和功能改变。     

超声诊断右房、下腔静脉内巨大癌栓1例

患者,男性,５５岁,进行性消瘦,腹胀腹痛一月,加重伴双下肢肿胀一周来诊。体检：慢性消耗病容,精神差,皮肤巩膜黄染,双下肢肿胀,肝肋下４ｃｍ,腹部移动性浊音阳性。腹部Ｂ超及肝脏ＣＴ检查,均诊断为肝硬化合并肝癌、腹水。化验血ＡＦＰ明显升高。临床诊断肝硬化...     

Effects of hypertension and antihypertensive treatment on retrobulbar circulation detected on Doppler sonography.

OBJECTIVE: To study the effect of antihypertensive drugs in essential hypertension and in the central retinal, posterior ciliary, and ophthalmic arteries by using Doppler sonography. METHODS: Thirty patients with essential hypertension and 32 control subjects were enrolled in the study. The pulsatility and resistive indices were evaluated in the central retinal, posterior ciliary, and ophthalmic arteries before and 2 months after treatment with antihypertensive drugs as well as in the control group. The pulsatility and resistive index values for each artery in each group were compared statistically. RESULTS: There were significant differences in the retrobulbar pulsatility and resistive index values in each artery among the patients with initially diagnosed hypertension and the control group (P < .05). There were significant reductions in the resistive and pulsatility index values of the posterior ciliary and ophthalmic arteries after treatment (P < .05). For the ophthalmic artery, posttreatment pulsatility and resistive index values did not reach the level of flow measured in the control subjects. CONCLUSIONS: The alteration of Doppler parameters of medication-free patients with hypertension may result from a peripheral vasospasm in the retrobulbar circulation, and the improvement in the Doppler parameters with oral antihypertensive drugs may indicate the importance of early diagnosis in ameliorating hypertension-induced retrobulbar circulation changes.     

彩色多普勒超声对糖尿病患者视网膜中央动脉和睫状动脉血流动力学的研究

目的:研究糖尿病患者视网膜中央动脉(CRA)、睫状动脉(PCA)的血流变化规律以及视网膜中央动脉血流参数与糖化血红蛋白(GHb)间的相关性。材料与方法:彩色多普勒超声检测67例(67只右眼)糖尿病患者和40例正常对照者的CRA、PCA的收缩期血流峰值速度(PSV)、舒张末期血流速度(EDV)、阻力指数(RI),同时检测患者GHb水平,分析CRA血流参数与GHb的关系。结果:糖尿病各组随病情的加重,CRA、PCA的血流速度呈逐渐减低趋势,RI呈增高趋势;且在无视网膜病变时就存在眼血流动力学的异常,CRA改变明显于PCA;GHb与CRA血流速度呈负相关,与RI呈正相关。结论:在无视网膜病变时,糖尿病患者不仅视网膜而且脉络膜都表现出血流动力学的异常,GHb水平与CRA血流参数有密切的相关性。     

彩色多普勒超声对原发性高血压患者视网膜中央动脉血流动力学的检测

目的 了解高血压患者视网膜中央动脉血流动力学变化,为临床高血压病分期提供辅助诊断指标。方法 采用美国ＡＴＬ公司ＨＤＩ３０００彩色多普勒超声仪测量６８例原发性高血压患者视网膜中央动脉的收缩期峰值血流速度、舒张末期血流速度、阻力指数。结果 随病程的进展,原发性高血压视网膜中央动脉阻力指数增高,血流速度降低,以舒张末期流速改变明显。结论 视网膜中央动脉数量化参数,对于高血压眼病变的检测,较以传统的血管形态描述赤主的检查方法,更为客观主直接。     

Color Doppler imaging of the eye: normal ranges,reproducibility, and observer variation.

Color Doppler ultrasonography has numerous potential applications in the diagnosis and monitoring of many ocular disease processes. One of its advantages over other investigative and diagnostic tests is its safety and repeatability. To be able to fully assess this technique it is important to have good control data and to know the reproducibility of the technique for each of the retrobulbar vessels. Color Doppler ultrasonography was performed on 80 volunteers, and normal ranges of blood velocity were calculated for the ophthalmic artery and for the central retinal artery and vein. Reduction in the peak systolic and end diastolic velocities in the ophthalmic artery and an increase in resistive index in the central retinal artery and vein were noted with advancing age. With regard to reproducibility of the retrobulbar vessels, 15 healthy persons were chosen at random and intra- and interobserver studies performed. The most reliable and reproducible vessels were the ophthalmic artery and central retinal artery and vein. Greater variation was noted in the posterior ciliary vessels, whereas the superior ophthalmic and vortex veins were unreliable in both detection and velocity measurement. The results provide normal ranges for future studies and demonstrate that reproducible results can be obtained for the orbital vasculature using color Doppler imaging.