眼底动脉硬化与脑梗死牛津郡社区卒中项目分型亚型的关系
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摘要
目的探讨眼底动脉硬化及程度与脑梗死牛津郡社区卒中项目(OCSP)分型亚型的关系。方法选取186例急性脑梗死患者,全部行眼底照相检查,根据眼底照相结果明确有无眼底动脉硬化,并对硬化眼底动脉进行分级。根据临床症状进行OCSP分型,分析眼底动脉硬化及程度与脑梗死牛津郡社区卒中项目(OCSP)分型亚型的关系。结果 (1)186例急性脑梗死患者中,完全前循环梗死(TACI)型20例(10.8%),其中眼底动脉硬化者10例(50.0%),无眼底动脉硬化者10例(50.0%);部分前循环梗死(PACI)型78例(41.9%),其中眼底动脉硬化者75例(96.2%),无眼底动脉硬化者3例(3.8%);后循环梗死(POCI)型45例(24.2%),其中眼底动脉硬化者30例(66.7%),无眼底动脉硬化者15例(33.3%);腔隙性梗死(LACI)型43例(23.1%),其中眼底动脉硬化者39例(90.7%),无眼底动脉硬化者4例(9.3%)。PACI型及LACI型眼底动脉硬化形成所占比例较大,差异有统计学意义(χ~2=25.597、10.833,P<0.00833)。(2)比较OCSP各亚型眼底动脉硬化程度,PACI型较LACI型眼底动脉硬化程度更严重,差异有统计学意义(Z=-3.203,P=0.001)。结论眼底动脉硬化与PACI型及LACI型有关,PACI型眼底动脉硬化程度更重。
Objective To investigate the relationship between fundus arteriosclerosis and its extent with subtypes of Oxfordshire Community Stroke Project(OCSP).Methods Totally 186 cases of acute cerebral infarction were examined by fundus photography.The ocular fundus arteriosclerosis was defined and the arteriosclerosis of the fundus arteriosus was classified according to the results of fundus photography.In Oxford County Community Stroke(OCSP)Project,the relationship between the arteriosclerosis,degree of the fundus artery and the subtype was investigated,which was based on clinical symptoms.Results (1)Of 186 cases of acute cerebral infarction patients,total anterior circulation infarction(TACI)was 20 cases(10.8%),including 10 cases of fundus arteriosclerosis(50%),10 cases without fundus arteriosclerosis(50%);partial anterior circulation infarction(PACI)patients with type was 78 cases(41.9%),including 75 cases of fundus arteriosclerosis(96.2%),3 cases without fundus arteriosclerosis(3.8%);posterior circulation infarction(POCI)was45 cases(24.2%),including 30 cases of fundus arteriosclerosis(66.7%),15 cases without fundus arteriosclerosis(33.3%);lacunar infarction(LACI)was 43 cases(23.1%),39 the fundus arteriosclerosis(90.7%),4 cases without fundus arteriosclerosis(9.3%).The proportion of PACI and LACI type of fundus arteriosclerosis was significant,and the difference was statistically significant(2=25.597、10.833,P<0.001).(2)The degree of fundus arteriosclerosis of all subtypes of OCSP was compared,and the degree of PACI type was more severe than that of LACI type fundus arteriosclerosis,and the difference was statistically significant(Z=-3.203,P=0.001).Conclusion The arteriosclerosis of the fundus artery is associated with type PACI and type LACI,and the PACI type of the fundus arteriosclerosis is more severe.
Objective To investigate the relationship between fundus arteriosclerosis and its extent with subtypes of Oxfordshire Community Stroke Project(OCSP).Methods Totally 186 cases of acute cerebral infarction were examined by fundus photography.The ocular fundus arteriosclerosis was defined and the arteriosclerosis of the fundus arteriosus was classified according to the results of fundus photography.In Oxford County Community Stroke(OCSP)Project,the relationship between the arteriosclerosis,degree of the fundus artery and the subtype was investigated,which was based on clinical symptoms.Results (1)Of 186 cases of acute cerebral infarction patients,total anterior circulation infarction(TACI)was 20 cases(10.8%),including 10 cases of fundus arteriosclerosis(50%),10 cases without fundus arteriosclerosis(50%);partial anterior circulation infarction(PACI)patients with type was 78 cases(41.9%),including 75 cases of fundus arteriosclerosis(96.2%),3 cases without fundus arteriosclerosis(3.8%);posterior circulation infarction(POCI)was45 cases(24.2%),including 30 cases of fundus arteriosclerosis(66.7%),15 cases without fundus arteriosclerosis(33.3%);lacunar infarction(LACI)was 43 cases(23.1%),39 the fundus arteriosclerosis(90.7%),4 cases without fundus arteriosclerosis(9.3%).The proportion of PACI and LACI type of fundus arteriosclerosis was significant,and the difference was statistically significant(2=25.597、10.833,P<0.001).(2)The degree of fundus arteriosclerosis of all subtypes of OCSP was compared,and the degree of PACI type was more severe than that of LACI type fundus arteriosclerosis,and the difference was statistically significant(Z=-3.203,P=0.001).Conclusion The arteriosclerosis of the fundus artery is associated with type PACI and type LACI,and the PACI type of the fundus arteriosclerosis is more severe.
引文
[1]London A,Benhar I,Schwartz M.The retina as a window to the brain-from eye research to CNS disorders[J].Nature Reviews Neurology,2013,9(1):44-53
[2]马丽芳,张微微,王国强,等.急性腔隙性脑梗死与眼底病变的相关性研究[J].中国脑血管病杂志,2012,9(3):113-117
[3]Henderson A D,Bruce B B,Newman N J,et al.Hypertension-related eye abnormalities and the risk of stroke[J].Reviews in Neurological Diseases,2011,8(1-2):1
[4]Ong YT,Wong TY,Klein R,et al.Hypertensive retinopathy and risk of stroke[J].Hypertension,2013,62(4):706-711
[5]宋伟琼,周小平,邝国平,等.脑梗死患者颈动脉病变与眼底动脉硬化的相关性研究[J].国际眼科杂志,2017,17(11):2151-2153
[6]中华医学会神经病学分会,中华医学会神经病学分会脑血管病学组.中国急性缺血性脑卒中诊治指南2014[J].中华神经科杂志,2015,48(4):246-257
[7]Bamford,J,Sandercock,P,Dennis,M,et al.Classification and natural history of clinically identifiable subtypes of cerebral infarction[J].Lancet,1991,337(8756):1521-1526
[8]罗晶晶,衷弘熙,刘冉,等.脑梗死患者颈动脉病变与眼底动脉硬化的相关性分析[J].中华老年心脑血管病杂志,2015,17(11):1137-1139
[9]Tei H,Uchiyama S,Ohara K,et al.Deteriorating Ischemic Stroke in 4 Clinical Categories Classified by the Oxfordshire Community Stroke Project[J].Stroke,2000,31(9):2049-2054
[10]刘斌,任伯,毛文静,等.急性脑梗死患者牛津郡社区卒中项目亚型脑侧支循环的形成及其对近期预后的影响[J].中国医药导报,2017,14(11):64-68
[11]王竞男,曹利民,李红琴,等.眼底动脉硬化与脑梗死复发的关系研究[J].浙江医学2017,39(7):545-548
[12]Jeppesen P,Gregersen P A,Bek T.The age-dependent decrease in the myogenic response of retinal arterioles as studied with the Retinal Vessel Analyzer.[J].Graefes Arch Clin Exp Ophthalmol,2004,242(11):914-919
[13]Hilal S,Ong Y T,Cheung C Y,et al.Microvascular network alterations in retina of subjects with cerebral small vessel disease[J].Neuroscience Letters,2014,577:95-100
[14]Liu J,Kou Z,Tian Y.Diffuse axonal injury after traumatic cerebral microbleeds:an evaluation of imaging techniques[J].Neural Regeneration Research,2014,9(12):1222-1230
[15]Miwa K,Tanaka M,Okazaki S,et al.Multiple or mixed cerebral microbleeds and dementia in patients with vascular risk factors[J].Neurology,2014,83(7):646-653
[16]Wardlaw J M,Smith C,Dichgans M.Mechanisms of sporadic cerebral small vessel disease:insights from neuroimaging[J].Lancet Neurology,2013,12(5):483-497
[2]马丽芳,张微微,王国强,等.急性腔隙性脑梗死与眼底病变的相关性研究[J].中国脑血管病杂志,2012,9(3):113-117
[3]Henderson A D,Bruce B B,Newman N J,et al.Hypertension-related eye abnormalities and the risk of stroke[J].Reviews in Neurological Diseases,2011,8(1-2):1
[4]Ong YT,Wong TY,Klein R,et al.Hypertensive retinopathy and risk of stroke[J].Hypertension,2013,62(4):706-711
[5]宋伟琼,周小平,邝国平,等.脑梗死患者颈动脉病变与眼底动脉硬化的相关性研究[J].国际眼科杂志,2017,17(11):2151-2153
[6]中华医学会神经病学分会,中华医学会神经病学分会脑血管病学组.中国急性缺血性脑卒中诊治指南2014[J].中华神经科杂志,2015,48(4):246-257
[7]Bamford,J,Sandercock,P,Dennis,M,et al.Classification and natural history of clinically identifiable subtypes of cerebral infarction[J].Lancet,1991,337(8756):1521-1526
[8]罗晶晶,衷弘熙,刘冉,等.脑梗死患者颈动脉病变与眼底动脉硬化的相关性分析[J].中华老年心脑血管病杂志,2015,17(11):1137-1139
[9]Tei H,Uchiyama S,Ohara K,et al.Deteriorating Ischemic Stroke in 4 Clinical Categories Classified by the Oxfordshire Community Stroke Project[J].Stroke,2000,31(9):2049-2054
[10]刘斌,任伯,毛文静,等.急性脑梗死患者牛津郡社区卒中项目亚型脑侧支循环的形成及其对近期预后的影响[J].中国医药导报,2017,14(11):64-68
[11]王竞男,曹利民,李红琴,等.眼底动脉硬化与脑梗死复发的关系研究[J].浙江医学2017,39(7):545-548
[12]Jeppesen P,Gregersen P A,Bek T.The age-dependent decrease in the myogenic response of retinal arterioles as studied with the Retinal Vessel Analyzer.[J].Graefes Arch Clin Exp Ophthalmol,2004,242(11):914-919
[13]Hilal S,Ong Y T,Cheung C Y,et al.Microvascular network alterations in retina of subjects with cerebral small vessel disease[J].Neuroscience Letters,2014,577:95-100
[14]Liu J,Kou Z,Tian Y.Diffuse axonal injury after traumatic cerebral microbleeds:an evaluation of imaging techniques[J].Neural Regeneration Research,2014,9(12):1222-1230
[15]Miwa K,Tanaka M,Okazaki S,et al.Multiple or mixed cerebral microbleeds and dementia in patients with vascular risk factors[J].Neurology,2014,83(7):646-653
[16]Wardlaw J M,Smith C,Dichgans M.Mechanisms of sporadic cerebral small vessel disease:insights from neuroimaging[J].Lancet Neurology,2013,12(5):483-497