腔隙性脑梗死患者脑血管改变相关因素与眼底动脉硬化分级的临床分析

目的通过分析腔隙性脑梗死(LI)患者眼底动脉硬化分级与部分脑动脉硬化危险因素变化之间的关系,为寻找监测方法提供依据。方法选择北京大学第一医院神经内科2012年6月至2014年2月间急性LI发病的住院患者151例,男105例,女46例,平均年龄(62.11±11.32)岁。分别接受神经影像、眼底照相、颈动脉超声检查,进行眼底动脉硬化分级,并同时测定血压、胆固醇三项、血糖、同型半胱氨酸等指标,资料分析通过SPSS 18.0统计软件完成。结果在受检的302只眼中,有动脉硬化改变的占96.03%,Ⅰ级占52.98%,Ⅱ、Ⅲ级分别为23.84%、19.21%。眼底动脉硬化分级与颈动脉内-中膜厚度、斑块面积、收缩压、LI病灶数、LI受累部位数之间存在较高相关性(r=0.222、0.260、0.214、0.332、0.221,均P0.05),轻度硬化组和中重度组各项指标存在统计学差异(t/z=2.617、2.425、2.124、3.416、2.200,均P0.05),同时血糖水平在两组中比较也有统计学意义(t=3.427,P=0.001)。结论眼底动脉硬化的程度与颅内其他血管相比具有一致性,其分级可以间接反映颅内血管病变程度,可以作为脑小血管变化的临床观察窗口。

Analysis of the correlation between some relevant factors for changes of cerebral small vessels and retinal atherosclerotic classification in patients with lacunar infarct

Objective To explore an effective monitoring way of intracranial atherosclerosis and observe the correlation between the risk factors and retinal atherosclerotic classification. Methods One hundred and fifty-one hospitalized patients with lacunar infarct（LI） from June 2012 to February 2014 were retrospectively analyzed,male 105, female 46, and mean age was （ 62. 11± 11.32 ） years. All patients were examined with CT/MRI, fundoscopy, color vascular ultrasonograph, laboratory tests, respectively. Retinal atherosclerotic grades were assessed, blood pressure, blood sugar, cholesterol, homocysteine and other indicators were measured. All data were dealt statistically via SPSS 18.0 software package. Results Data showed that incidence of retinal atherosclerosis was 96. 03% in checked 302 eyes, retinal atherosclerotic grades were 52. 98%, 23.84, 19. 21% in grade Ⅰ ,Ⅱ ,Ⅲ, and retinal atherosclerotic arteriole had significantly higher correlated with systolic blood pressure, intima-media thickness, carotid plaque area, LI loci,and LI suffered regions respectively（r =0. 222,0. 260,0. 214,0. 332,0. 221 ,all P 〈0.05）. The above indices including blood glucose had indicated remarkably differences between mild atherosclerotic group and severe one （ t/z = 2. 617,2. 425,2. 124,3.416,2. 200, all P 〈 0.05 ）. Conclusion Retinal atherosclerotic grade is well-coherent with intracranial atherosclerosis, which could be used as an effectively monitoring evaluation for pathological retinal arteriole.