2型糖尿病非增殖期黄斑水肿患者眼球后动脉血流动力学的超声评价

目的探讨彩色多普勒超声评价糖尿病视网膜病变非增殖期黄斑水肿患者眼球后动脉血流动力学的价值。方法选取2型糖尿病非增殖期黄斑水肿患者30例(46只眼)为病例组,2型糖尿病非增殖期视网膜病变患者30例(60只眼)为对照组,应用彩色多普勒超声检测两组视网膜中央动脉(CRA)、眼动脉(OA)、睫状后短动脉(PCA)的血流参数,并对其结果进行对比分析。绘制受试者工作特征(ROC)曲线分析各血流参数对糖尿病黄斑水肿的诊断价值。结果病例组CRA、PCA血流频谱均较对照组低平、圆钝,病例组OA血流频谱与对照组相似。病例组CRA的收缩期峰值流速(PSV)、舒张末期流速(EDV)及阻力指数(RI)均较对照组减低,差异均有统计学意义(均P<0.05);病例组PCA的PSV、EDV均较对照组减低(均P<0.05),RI与对照组比较差异无统计学意义;病例组OA的各血流参数与对照组比较差异均无统计学意义。以CRA的PSV 7.655 cm/s、EDV 2.925 cm/s及RI 0.645为截断值,诊断黄斑水肿的敏感性分别为80.0%、60.7%及63.8%,特异性分别为76.1%、76.1%及70.0%,曲线下面积分别为0.783、0.720及0.692。以PCA的PSV8.75 cm/s、EDV 2.56 cm/s为截断值诊断黄斑水肿的敏感性分别为75.0%、81.3%,特异性分别为61.4%、60.9%,曲线下面积分别为0.536、0.533。结论彩色多普勒超声可以监测糖尿病非增殖期黄斑水肿患者眼球后动脉血流动力学的改变,为临床早期治疗提供可靠依据。     

Orbital blood flow velocities in patients with rheumatoid arthritis

PURPOSE: To assess orbital blood flow changes in patients with rheumatoid arthritis using Doppler sonography. PATIENTS AND METHODS: The study comprised 35 patients who were diagnosed with RA and were treated at the Department of Physical Therapy and Rehabilitation at Duzce Medical School. A control group consisted of 35 healthy volunteers. Color Doppler imaging was used to measure peak systolic velocity (PSV) and end diastolic velocity (EDV), from which the resistance index (RI) was calculated in the ophthalmic artery (OA), central retinal artery (CRA), and posterior ciliary arteries (PCAs). RESULTS: In the OA, PSV, EDV, and RI were, respectively, 36.7 +/- 0.6 cm/sec, 9.7 +/- 0.2 cm/sec, and 0.73 in the control group versus 34.7 +/- 3.0 cm/sec, 9.1 +/- 1.1 cm/sec, and 0.74 in the patient group. In the CRA, they were, respectively, 11.8 +/- 1.7 cm/sec, 3.6 +/- 0.7 cm/sec, and 0.66 in the control group versus 11.1 +/- 1.7 cm/sec, 3.4 +/- 0.7 cm/sec, and 0.68 in the patient group. In the PCAs, they were, respectively, 13.2 +/- 1.2 cm/sec, 4.7 +/- 0.6 cm/sec, and 0.65 in the control group versus 12.4 +/- 1.2 cm/sec, 4.2 +/- 0.6 cm/sec, and 0.66 in the PCAs. PSV, EDV, and RI of the PCAs and OA and RI of the CRA were significantly different between patients and controls, whereas there was no difference in the serum levels of glucose, triglyceride, low-density lipoprotein cholesterol, and total cholesterol. In the patient group, there was a significant correlation between orbital blood flow and duration of disease. CONCLUSION: Ocular blood flow appears to be slightly lower in RA patients than in healthy controls, suggesting that RA is a systemic inflammatory disease that may also involve ocular vessels.     

高度近视眼血流多普勒研究

目的：探讨高度近视的眼血流动力学变化及其在高度近视病理改变机制中的作用。方法：应用彩色多普勒超声,对比观测42例高度近视和30例正常人眼动脉,睫状后动脉和视网膜中央动物的血流速度及阻力指数。结果：高度近视眼的眼动脉,睫状后动脉舒张末期血流速度减低,阻力指数上升,视网膜中央动脉收缩期,舒张末期血流速度明显减低,结论：高度近视患者脉络膜及视网膜存在血液灌注不良,睫状后动脉及视网膜中央动脉血供不足可能是高度近视患者视网膜,脉络膜退行性变的原因之一。     

尼莫地平对缺氧缺血性脑病患儿脑血流动力学及脑实质密度的影响

目的探讨缺氧缺血性脑病（HIE）患儿脑血流动力学和脑实质密度改变及尼莫地平的干预作用。方法将58例中、重度HIE随机分成常规组28例,尼莫地平组30例,20例正常新生儿为对照组,尼莫地平组在常规治疗基础上给予尼莫地平,连用10～14d。HIE患儿于治疗前及治疗10～14d后用多普勒超声仪检测脑血流动力学。并于生后第3—5天及第10—14天行CT检查。结果①HIE患儿PSFV、EDFV及Vm低于对照组（P〈0．01）;RI高于对照组（P〈0．05）。治疗10—14d后,尼奠地平组PSFV、EDFV及Vm较常规组明显增高（P〈0．01）,尼莫地平组RI元统计学意义,尼莫地平组大脑中动脉血流速度明显改善;②尼莫地平组在额叶皮质处CT值变化有统计学意义（P〈0．01）。结论HIE患儿脑血流动力学出现明显紊乱,检测脑血流动力学有助于HIE早期诊断和预后判断,并指导治疗;尼莫地平具有改善HIE患儿脑血液循环的作用,减轻脑损伤,且额叶皮质处脑实质密度恢复明显,提示尼莫地平对缺氧缺血性脑损伤具有保护作用。     

彩色多普勒超声对高度近视眼血流动力学研究

目的:研究高度近视眼血流动力学及其在近视眼病理改变机制中的作用。方法:应用ATL超9型彩色多普勒诊断仪对26例高度近视眼、17例轻中度近视眼及26例正常对照眼的眼动脉(OA)、视网膜中央动脉(CRA)、睫状后动脉(PCA)进行检测。结果:高度近视组、轻中度近视组与正常对照组血流参数比较:OA血流参数无显著性差异(P>0.05)。CRA、PCA的收缩期(PSV)、舒张期(EDV)、平均血流速度(AV)流速均减低, CRA的阻力指数(RI)升高(P<0.05)。轻中度近视组与对照组比较,无显著性差异(P>0.05)。结论:高度近视眼患者CRA、PCA血流速度减低,表明视网膜及睫状血管系统血液灌注不足,可能是引起其病理性眼底改变的因素之一。彩色多普勒超声用于研究眼底血管、高度近视眼血流动力学变化具有临床意义。     

Cerebral blood flow velocity: the influence of myocardial contractility on the velocity waveform of brain supplying arteries.

Indices of Doppler-derived velocity waveforms of arteries perfusing the brain are used as relative measures of neonatal brain blood flow. Using a dog model, we investigated the influence of changes in myocardial contractility, induced by dobutamine, on the blood flow velocity waveform of the vertebral artery. The following indices of the velocity waveform were investigated during control states and during 5 or 10 micrograms/kg/min dobutamine infusion: peak systolic flow velocity (PSFV), temporal mean flow velocity (TMFV), end-diastolic flow velocity (EDFV) and acceleration time (ACC-time). PSFV and ACC-time of the vertebral artery showed a strong relationship with myocardial contractile state. These results indicate that PSFV of an artery supplying the brain or indices which combine PSFV with MFV or EDFV should not be used for noninvasive assessment of brain blood flow or cerebral vascular resistance. ACC-time may prove to be very useful in assessing changes in myocardial contractile state.     

彩色多普勒成像对裂孔源性视网膜脱离后眼血流动力学的研究

目的：应用彩色多普勒成像（CDI）观察视网膜脱离后眼血流动力学的改变。方法：采用CDI对54例单眼视网膜脱离患者的眼动态（OA）,视网膜中央动脉（CRA）的收缩期峰值流速（Vmax)、舒张末期流速（Vmin)及阻力指数（RI）进行测量,以对侧正常眼作对照。结果：网脱眼CRA的Vmax降低,RI升高;网脱眼OA的Vmax降低,并随年龄增长明显下降,而网脱眼CRA和OA的Vmin以及OA的AI与对照组比较,差异无显著性。结论：视网膜脱离后眼动脉、视网膜中央动脉的血流速度下降,眼动脉血流速度与年龄呈负相关。     

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。     

Normal reference intervals and ranges of side-to-side and day-to-day variability of ocular blood flow Doppler parameters

The study presents normal reference intervals and ranges of "normal" side-to-side and day-to-day variability of ocular blood flow Doppler parameters. Peak-systolic (PSV), end-diastolic velocity (EDV) and impedance indices in the ophthalmic artery (OA), the central retinal artery (CRA) and the short posterior ciliary artery (SPCA) of both orbits were determined with color-coded duplex sonography in 140 healthy volunteers (range 18 to 83 y; 68 men and 72 women). Decreases in flow velocities and concomitant increases in impedance indices were found in all arteries with advancing age. The PSV and the EDV values for the OA, the CRA and the SPCA in the age group less than 40 yr-old were 40.6 +/- 8.9 and 11.2 +/- 3.7, 9.9 +/- 1.8 and 3.7 +/- 0.9, 13.8 +/- 2.6 and 5.7 +/- 1.5 cm/s (mean +/- SD), respectively. In the 40 to 60 yr-old age group, the values were 35 +/- 7.9 and 10.7 +/- 4.3, 9.7 +/- 2 and 3.5 +/- 0.8, 13.5 +/- 2.9 and 5.3 +/- 1.5 cm/s. In the age group over 60 yr-old, the values were 34 +/- 8 and 8.4 +/- 3.3, 9.3 +/- 2 and 3 +/- 0.9, 12.8 +/- 2.4 and 4.3 +/- 1.2 cm/s. In the youngest age group, the EDV in the CRA and the SPCA was higher in women, while in the OA the PSV and the EDV were higher in men. Ranges of side-to-side variability in the OA, the CRA and the SPCA, determined with repeatability coefficient for the PSV and the EDV, were 24, 5.4, 7.5 cm/s and 11, 2.5, 4.2 cm/s, respectively, whereas the values for day-to-day variability were 16.8, 4.3, 6.7 cm/s and 5.6, 1.7 and 3.9 cm/s. Ocular blood flow Doppler parameters range widely and are significantly age and sex dependent. Ranges of "normal" side-to-side and day-to-day variability of the parameters can help to determine abnormal flow pattern.     

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。     

2型糖尿病非增殖期黄斑水肿眼球后动脉血流动力学分析

目的 研究彩色多普勒超声对糖尿病视网膜病变非增殖期黄斑水肿患者球后动脉血流动力学的价值。方法 收集内蒙古自治区人民医院自 2016 年10月—2018年10月期间诊断为2型糖尿病非增殖期视网膜病变患者30例（60眼）和2型糖尿病非增殖期黄斑水肿患者30例（46眼）,采用彩色多普勒超声诊断仪检测两组患者的视网膜中央动脉（CRA）、眼动脉(OA)、睫状后短动脉(PCA)的血流参数指标并进行分析。结果 病例组CRA、PCA血流频谱较对照组低平、圆钝,病例组OA血流频谱与对照组相似;病例组CRA和PCA的最大收缩期血流速度（PSV）、舒张末期血流速度（EDV）及CRA的阻力指数（RI）均较对照组减低,差异有统计学意义 （P＜0.05）;CRA的ROC曲线下面积（AUC）分别为0.783、0.720及0.692。截断值分别为7.655、2.925、0.645,对应的灵敏度、特异度分别为80.0%、60.7%、63.8%及76.1%、76.1%、70.0%。结论 超声彩色多普勒技术可以监测DME球后动脉血流动力学的改变,为治疗早期DME提供有价值的信息。     

彩色多普勒超声对肝硬化患者眼血流动力学研究

目的应用彩色多普勒超声观察肝硬化患者眼动脉和视网膜中央动脉的血流动力学改变。方法检测35例正常对照组3、0例早期肝硬化患者和31例晚期肝硬化患者眼动脉(OA)和视网膜中央动脉(CRA)的收缩期峰值流速(Vs)、舒张末期流速(Vd)和阻力指数(RI)。结果与正常对照组比较,早期肝硬化患者眼动脉和视网膜中央动脉Vs升高(P0.05),RI降低(P0.05);晚期肝硬化患者眼动脉和视网膜中央动脉Vs升高(P0.01),RI升高(P0.05)。结论肝硬化患者眼血管血流动力学改变符合全身高动力循环状态,但随病程进展有不同的表现。     

彩色多普勒超声监测斜视手术对眼血流动力学影

目的 :探讨斜视手术对眼血流动力学影响 ,评价多普勒超声监测眼动脉血供的临床价值。方法 :筛选斜视患者 51例 51只眼行 1或 2条水平直肌后徙 -截腱术。术前、术后 1周、 1个月分别用彩色多普勒超声诊断仪测量眼动脉 (OA)、睫状后动脉 (PCA)、视网膜中央动脉 (CRA)的收缩期血流速度峰值 (Vs)、舒张末期血流速度 (Vd)及阻力指数 (RI) ,比较血流改变并与 3 0例正常人对照。结果 :1.斜视眼术前患眼 OA、 PCA、 CRA血流参数与正常组比较无显著性意义 (P>0 .0 5) ;2 .斜视眼术后 1周眼动脉 Vs明显升高、 PI、 RI升高 (P<0 .0 5) ;3 .斜视眼术后 1个月 OA、PCA、 CRA各血流参数与术前比较 ,无显著性意义 (P>0 .0 5)。结论 :手术可以引起短期眼组织缺血 ,但随着手术激惹的消失及广泛侧枝循环的建立 ,1条或 2条水平直肌截断手术不会引起眼前节缺血 ,多普勒超声是评价眼血流动力学变化的敏感方法     

高度近视眼彩色多普勒血流显像检测价值

目的　研究高度近视眼的眼血流动力学变化。方法　采用ＨＰＳｏｎｏｓ１０００ 型彩色多普勒血流显像仪, 对２３例高度近视眼患者、２０例轻中度近视眼患者及１８例正常对照者的眼动脉、后睫状短动脉、视网膜中央动脉血流进行彩色多普勒超声测定。结果　高度近视眼组与正常组及轻中度近视眼组血流参数比较： 眼动脉血流参数无显著性差异（Ｐ＞ ０．０５）; 后睫状短动脉舒张末期血流速度低于其它两组, 有显著性差异（Ｐ＜ ０．０５）; 视网膜中央动脉收缩期血流峰值速度、平均血流速度、舒张末期血流速度均降低,有显著性差异（Ｐ＜ ０．０５）, 轻中度近视组与正常组比较无显著性差异（Ｐ＞ ０．０５）。结论　高度近视眼视网膜中央动脉血流速度与后睫状短动脉舒张末期血流速度均明显降低, 彩色多普勒超声有可能应用于研究其病理改变的形成机制。     

彩色多普勒血流显像对高度近视眼的血流动力学研究

为研究高度近视眼的眼血流动力学变化，对２３例高度近视眼组，２０例轻中度近视眼组及１８例正常对照组进行眼动脉、后睫状动脉、视网膜中央动脉血流的彩色多普勒超声测定。结果表明：高度近视眼组与正常组及轻中度近视眼组血流参数比较：眼动脉血流参数无显著性差异（Ｐ＞０．０５）；后睫状动脉舒张末期血流速度低于其它两组，有显著性差异（Ｐ＜０．０５），余参数差异无显著性（Ｐ＞０．０５）；视网膜中央动脉收缩期血流峰值速度、平均血流速度、舒张末期血流速度均降低，有显著性差异（Ｐ＜０．０５），轻中度近视组与正常组比较无显著性差异（Ｐ＞０．０５）。研究结果表明：高度近视眼视网膜中央动脉血流速度与后睫状动脉舒张末期血流速度均明显降低，彩色多普勒超声有可能应用于研究其病理改变的形成机制。     

糖尿病视网膜病变的彩色多普勒研究

本文应用彩色多普勒技术检测72例Ⅱ型糖尿病（DM）患者的球后血流动力学改变，包括眼动脉（OA）、视网膜中央动脉（CRA）。结果显示在糖尿病性视网膜病变（DR）发生过程的极早期阶段、眼底荧光造影尚未发现明显病变时，CRA血流速度较对照组增高（P＜0．05），背景型DR早期阶段接近对照组（p＞0．05），增殖前期、增殖期低于对照组（p＜0．05）并伴有OA舒张未期血流速度下降及阻力指数增高；DM不伴DR者或DR早期CRA血流速度与空腹血糖水平呈正相关，视网膜病变越重血糖水平对CRA血流速度的影响越小。提示DM患者的眼部血流动力学变化与DR发生、发展之间的关系是相当复杂的；它反映了视网膜微循环对高血糖等全身与局部代谢异常的代偿与失代偿变化。     

彩色多普勒超声对正常眼压性青光眼血流动力学的研究

目的研究正常眼压性青光眼视神经的血液供应状况。方法用彩色多普勒超声检测正常眼压性青光眼和正常眼眼动脉、视网膜中央动脉和睫状后短动脉的收缩期峰值血流速度（PSv）、舒张末期血流速度（EDV）、阻力指数（RI）。结果正常眼压性青光眼组中眼动脉（OA）、视网膜中央动脉（CRA）、睫状后短动脉（SPCA）的PSV、EDV较正常对照组减慢,差异具有统计学意义（t分别=2．83、4．57、2．94、3．17、6．69、5．22,P均〈0．05）;OA、CRA、SPCA的RI较正常对照组增高,差异具有统计学意义（t分别=2．75、2．94、2．89,P均〈0．05）。结论正常眼压性青光眼的视神经存在缺血因素,彩色多普勒超声对其早期诊断有重要价值。     

超声评价血糖控制不良对糖尿病视网膜病变的影响

目的探讨糖尿病（DM）患者血糖控制不良在视网膜病变（DR）发生发展中的作用。方法应用彩色多普勒血流显像（CDFI）检测72例DM患者和26例正常对照组眼动脉（OA）、视网膜中央动脉（CRA）的各项参数。结果在DR发生过程中的不伴DR组，眼底荧光造影尚未发现明显病变时，CRA血流速度较对照组增高（P〈0．05），非增殖期DR组接近对照组（P〉0．05），增殖期DR组低于对照组（P〈0．05）并伴有OA舒张末期血流速度下降及阻力指数增高；DM不伴DR者或DR早期CRA血流速度与糖化血红蛋白（HbA1c）水平呈正相关，DR越重血糖水平对CRA血流速度的影响越小。结论CDFI是评价DR时OA、CRA的血流动力学变化的有效方法，持续而有效地血糖控制是DR治疗的首要措施。     

彩色多普勒成像技术对近视眼眼部血流动力学研究

目的:观察近视眼的血流动力学改变,及与眼轴、眼压等的关系。方法:应用彩色多普勒超声诊断仪对中度近视(26例,52只眼)、高度近视(23例,44只眼)患者和正常人(25例,50只眼)的眼动脉、睫状后短动脉、视网膜中央动脉的收缩期峰值流速(PSV)、舒张期最小流速(EDV)和阻力指数(RI)以及眼轴、眼压等进行检测。结果:近视眼患者眼动脉的PSV、EDV及RI与正常人相比无显著性差异(P>0.05);视网膜中央动脉和睫状后短动脉的PSV、EDV比正常人低(P<0.05),RI比正常人高(P<0.05);中度近视眼组与高度近视眼组比较,睫状后短动脉的EDV、视网膜中央动脉的EDV、RI有显著性差异(P<0.05);近视眼眼轴、眼压与正常人相比亦有显著性差异(P<0.05)。结论:近视眼眼底血管视网膜中央动脉、睫状后短动脉血流动力学改变是屈光度进一步加深、视功能损害的重要原因之一。     

Haemorheological disturbances in hypertensive type 2 diabetic patients--influence of antihypertensive therapy

Haemorheological changes have been described in hypertension as well as in diabetes mellitus. Antihypertensive treatment improves rheology in hypertensive patients. The aim of this study was to describe the haemorheological profile and its impact on shear stress in hypertensive type 2 diabetes mellitus patients (HT + DM) and to investigate the effect of antihypertensive therapy on blood rheology using a double-blind randomized protocol, comparing the calcium antagonist amlodipine with the angiotensin-converting enzyme (ACE) inhibitor enalapril. A total of 144 patients with hypertension and type 2 diabetes (64 of transversal study and 80 of randomized clinical trial) were compared with 92 controls belonging to a transversal study. Secondarily, in a separate analysis, therapeutic effects of calcium antagonist amlodipine and ACE inhibitor enalapril were compared in a longitudinal, randomized trial in the patients. We assessed whole-blood viscosity, plasma viscosity, partial and total disaggregation times, haematocrit and fibrinogen. Radial artery systolic flow velocity was measured by pulsed Doppler. Shear stress was calculated as the product of flow velocity x whole-blood viscosity. Compared with controls, patients had significantly higher whole-blood viscosity for all shear rates (P < 0.001) as well as higher arterial diameter and systolic blood flow velocity (2.8 +/- 0.3 vs. 2.6 +/- 0.3 mm, P < 0.001; and 50.8 +/- 11.6 vs. 45.6 +/- 9.8 cm/s, P = 0.01, respectively). Whole-blood viscosity at shear rate gamma = 128/s tended to increase with amlodipine (+1.13%) and decrease with enalapril (-2.47%) (P = 0.028 for inter-group difference). In hypertensive diabetic patients, hyperviscosity contributes to increased shear stress. Haemorheological disturbances in these patients are not significantly influenced by blood pressure lowering with antihypertensive therapy by ACE inhibitor enalapril or calcium antagonist amlodipine. Other factors potentially contributing to rheology and arterial changes may be more critical in HT + DM patients and need further investigation.