彩色多普勒血流显像检测阻塞型睡眠呼吸暂停综合征患者的眼底血流变化

目的探讨彩色多普勒血流显像（CDFI）检测阻塞型睡眠呼吸暂停综合征（OSAS）患者眼底动脉血流的变化。方法按照呼吸低通气指数（AHI）将OSAS患者分成轻度组（AHI〈20,15例）和重度组（AHI≥20,15例）;选取年龄相近的20例作为对照组。应用CDFI分别测量眼动脉（OA）、视网膜中央动脉（CRA）及睫状后动脉（PCA）。检测指标：收缩期峰值血流速度（PSV）、舒张末血流速度（EDV）及阻力指数（RI）。其结果与正常组对照,并与OSAS患者的血氧饱和度（SaO2）作相关性分析。结果①OSAS组（轻、重度）的CRA血流速度（PSV、EDV）显著高于对照组（P〈0.01）;②OSAS重度组的PCA血流速度（PSV、EDV）显著高于正常组（P〈0.01）;③OSAS重度组的MSpO2与PCA（PSV、EDV）呈负相关（r=-0.973,P=0.000;r=-0.96,P=0.000）。结论 OSAS患者眼底动脉血流存在显著改变,间接反映了OSAS患者全身中小动脉病变状况及硬化程度,应用CDFI检测OSAS眼底血流是一种良好的方法,具有重要的临床参考价值。

Doppler Measurement of Blood Flow Velocities in Extraocular Orbital Vessels in Patients with Obstructive Sleep Apnea Syndrome

Objective We used color Doppler flow imaging to determine blood in the extraocular orbital vessels of patients with obstructive sleep apnea syndrome（OSAS）.Methods The study comprised 30 patients（15 with mild and 15 with severe OSAS） who were classified according to the apean-hypopnea index（AHI） as having mild OSAS（AHI〈20） or severe OSAS（AHI≥20） and 20 healthy control subjects.The peak systolic velocity（PSV）,end-diastolic velocity（EDV）,and resistance index were measured in the ophthalmic artery（OA）,central retinal artery（CRA）,short posterior ciliary artery（PCA） using color Doppler flow imaging.The blood flow velocities and resistance index of patients with OSAS and those of control subjects were compared.The blood flow velocities and The oxyhemoglobin saturation were compared with correlation analysis.Results The PSVs and EVDs in the CRA were higher in patients with OSAS than they were in the control subjects（P 〈0.01）,Among patients with severe OSAS,the PSVs and EDVs in the short posterior ciliary arteries were higher than those of the control group（P 〈0.01）,The statistically significant correlations were found between the mean O2 saturation values and the blood flow velocity in the PCA of patients with severe OSAS（r=-0.973,P=0.000;r=-0.96,P=0.000）.Conclusions Color Doppler sonographic measurements of blood flow parameters in the orbital vessels may differ significantly between patients with OSAS and those without the syndrome.It may indirectly reflect the situation of arterioles in patients with OSAS,Color Doppler flow imaging is a good method in the eyes blood test and of geat value in the clinical.