视网膜微血管改变在脑微出血患者中的临床参考价值

目的:研究视网膜微血管改变在脑微出血(CMBs)患者中临床参考价值并讨论其意义。方法:收集2012-01/2013-12住院患者125例,男81例,女44例,年龄76.3±11.2岁。全部患者进行肝肾功及血脂和血糖等血生化检查,进行双眼数字眼底照相和头颅MRI检查。根据双眼眼底照相确定视网膜动脉直径(RAE)、静脉直径(RVE)、视网膜动静脉直径比值(AVR)和动静脉交叉征(AVN),根据头颅MRI对CMBs进行分级。全部数据用SPSS 16.0软件进行统计学分析。结果:双眼视网膜中央动脉直径(CRAE)、视网膜中央静脉直径(CRVE)和AVR值之间无统计学差异(P<0.05)。CMBs分级中,0级75例,1级27例,2级9例,3级14例,CMBs不同等级与视网膜RVE,AVR和AVN之间具有显著相关性(P<0.01),CMBs级别越高视网膜血管改变越明显。在分别控制年龄、性别、血糖、血压等危险因素后,AVR和AVN仍然是影响CMBs分级的相关因素。结论:视网膜微血管改变,特别是视网膜小静脉增宽和出现动静脉交叉征更易可能伴发CMBs。在去除性别、年龄、高血压和高血糖等传统心脑血管危险因素,视网膜微血管改变仍可作为CMBs发生参考指标。

Clinical reference value of retinal microvascular changes in patients with cerebral microbleeds

AIM: To study clinical reference value of retinal microvascular changes in patients with cerebral microbleeds(CMBs)and discuss its clinical significance.

METHODS:From January 2012 to December 2013, 125 hospitalized patients were collected, including 81 cases were male, 44 cases were female, mean age 76.3±11.2 years old. For all patients, functions of liver and kidney, blood-lipoids, blood sugar and blood biochemical examination were tested, and fundus photography and cerebral MR was done. According to the fundus camera eyes, retinal arteriolar equivalent(RAE), retinal venular equivalent(RVE), retinal vein diameter ratio(AVR)and arteriovenous crossing sign(AVN)were identified, CMBs were classified with cerebral MRI. All the data were processed by SPSS statistical software.

RESULTS: The central retinal arteriolar equivalent(CRAE), central retinal venular equivalent(CRVE)and AVR values in the eyes were found no statistical difference(P<0.05). Of CMBs classification, the grade 0 in 75 cases, 1 in 27 cases, 2 in 9 cases and 3 in 14 cases were included. The RVE, AVR and AVN and the different grades of CMBs had statistically significant correlation(P<0.01). The higher CMBs classification, the more obvious retinal microvascular changes were found. In respectively to eliminate risk factors such as age, sex, blood glucose and blood pressure, AVR and AVN were still influencing factors for CMBs classification.

COCLUSION: The results show that retinal microvascular changes, especially small retinal vein arteriovenous cross width, and arteriovenous crossing phenomenon, in which CMBs will happen more likely. After sex, age, hypertension and hyperglycemia in patients with traditional cardiovascular risk factors being ruled out, the retinal microvascular changes are still relatively factors of CMB's occurrence.