功能裂隙灯生物显微镜对正常成人结膜微血管血流动力学指标的检测和临床应用价值
|
摘要
目的探讨功能裂隙灯生物显微镜(functional slit lamp biomicroscopy,FSLB)对正常成人结膜微血管血流动力学指标的检测和临床应用价值。方法随机抽取南昌大学医学院和中山眼科中心硕士研究生16人,其中男8人,女8人;年龄21~25岁。应用FSLB并使用软件程序(Benoit~(TM),Tru Soft Inc,St.Petersburg,FL,USA)对受试者结膜微血管密度、微血管长度、微血管直径、微动脉血流速度、微静脉血流速度等指标进行检测,并分析受试者各指标特征。结果受试者右眼微血管密度、长度、直径、微动脉血流速度、微静脉血流速度上方和下方、鼻侧和颞侧差异均无统计学意义(均为P>0.05);受试者右眼微血管密度、长度、直径上方、下方均较鼻侧、颞侧减小,差异均有统计学意义(均为P<0.05);受试者微动脉血流速度、微静脉血流速度右眼上方、下方均较鼻侧、颞侧明显增加,差异均有统计学意义(均为P<0.05)。左眼以及总眼数的情况和右眼相一致。结论利用FSLB可以较为清晰地获得正常成人结膜微血管血流动力学指标,有很好的临床价值。
Objective To investigate the detection of hemodynamics param eters of conjunctivalm icrovessels by functional slit lamp biom icroscopy( FSLB) in norm al adult and its clinical application values. Methods R andomly selected 1 6 postgraduate students aged 2 1 to2 5 years from the N anchang U niversity and Zhongshan O phthalm ic C enter,including 8 m ales and 8 fem ales. The density,length and diam eter of conjunctival m icrovessel and the flow velocity of arteriolar and venular blood were m easured by FSLB and softw are program( Benoit~(TM),TruSoft Inc,St. P etersburg,FL,USA),as well as the indicators ' characteristics of the subjects' were analyzed. R esults A s for subjects' right eyes,the m icrovascular density,length,diam eter,and the arteriolar and venular blood flow velocity w ere no significant difference betw een the upper,and low er sides,as w ell as betw een nasal and tem poral sides( all P > 0. 0 5); m eanw hile the microvascular density,length and diam eter of the upper and low er sides w ere both low er than those of the nasal and tem poral sides,and the differences were statistically significant( all P <0. 0 5),w hile the arteriolar and venular blood flow velocity of the upper and low er sides w ere both significantly higher than those of the nasal and tem poral sides,and the differences w ere statistically significant( all P < 0. 0 5). In addition,the changes in hem odynam ics param eters of conjunctival m icrovessels of the left eyes and total eyes in subjects w ere consistent w ith the right eyes. Conclusion FSLB can clearly obtain hemodynamics parameters of conjunctival microvessels in healthy grown-ups,and has a promising clinical value.
Objective To investigate the detection of hemodynamics param eters of conjunctivalm icrovessels by functional slit lamp biom icroscopy( FSLB) in norm al adult and its clinical application values. Methods R andomly selected 1 6 postgraduate students aged 2 1 to2 5 years from the N anchang U niversity and Zhongshan O phthalm ic C enter,including 8 m ales and 8 fem ales. The density,length and diam eter of conjunctival m icrovessel and the flow velocity of arteriolar and venular blood were m easured by FSLB and softw are program( Benoit~(TM),TruSoft Inc,St. P etersburg,FL,USA),as well as the indicators ' characteristics of the subjects' were analyzed. R esults A s for subjects' right eyes,the m icrovascular density,length,diam eter,and the arteriolar and venular blood flow velocity w ere no significant difference betw een the upper,and low er sides,as w ell as betw een nasal and tem poral sides( all P > 0. 0 5); m eanw hile the microvascular density,length and diam eter of the upper and low er sides w ere both low er than those of the nasal and tem poral sides,and the differences were statistically significant( all P <0. 0 5),w hile the arteriolar and venular blood flow velocity of the upper and low er sides w ere both significantly higher than those of the nasal and tem poral sides,and the differences w ere statistically significant( all P < 0. 0 5). In addition,the changes in hem odynam ics param eters of conjunctival m icrovessels of the left eyes and total eyes in subjects w ere consistent w ith the right eyes. Conclusion FSLB can clearly obtain hemodynamics parameters of conjunctival microvessels in healthy grown-ups,and has a promising clinical value.
引文
[1]JUNG F,KORBER N,KIESEWETTER H,PRUNTE C,WOLF S,REIM M.Measuring the microcirculation in the human conjunctiva bulbi under normal and hyperperfusion conditions[J].Graefe Arch Clin Exp,1983,220(6):294-297.
[2]OHTANI N.Laser Doppler flowmetry of the bulbar conjunctiva as a monitor of the cerebral blood flow[J].Nihon Kyobu Geka Gakkai Zasshi,1996,44(9):1721-1728.
[3]SCHASER KD,SETTMACHER U,PUHL G,ZHANG L,MITTLMEIER T,STOVER JF,et al.Noninvasive analysis of conjunctival microcirculation during carotid artery surgery reveals microvascular evidence of collateral compensation and stenosis-dependent adaptation[J].J Vasc Surg,2003,37(4):789-797.
[4]DUENCH S,SIMPSON T,JONES LW,FLANAGAN JG,FONN D.Assessment of variation in bulbar conjunctival redness,temperature,and blood flow[J].Optom Vis Sci,2007,84(6):511-516.
[5]KOUTSIARIS AG,TACHMITZI SV,PAPAVASILEIOU P,BATIS N,KOTOULA MG,GIANNOUKAS AD,et al.Blood velocity pulse quantification in the human conjunctival pre-capillary arterioles[J].Microvasc Res,2010,80(2):202-208.
[6]SHAHIDI M,WANEK J,GAYNES B,WU T.Quantitative assessment of conjunctival microvascular circulation of the human eye[J].Microvasc Res,2010,79(2):109-113.
[7]WANEK J,GAYNES B,LIM JI,MOLOKIE R,SHAHIDI M.Human bulbar conjunctival hemodynamics in hemoglobin SS and SC disease[J].Am J Hematol,2013,88(8):661-664.
[8]CHEUNG AT,HARMATZ P,WUN T,CHEN PC,LARKIN EC,ADAMS RJ,et al.Correlation of abnormal intracranial vessel velocity,measured by transcranial Doppler ultrasonography,with abnormal conjunctival vessel velocity,measured by computer-assisted intravital microscopy,in sickle cell disease[J].Blood,2001,97(11):3401-3404.
[9]CHEUNG AT,TOMIC MM,CHEN PC,MIGUELINO E,LI CS,DEVARAJ S.Correlation of microvascular abnormalities and endothelial dysfunction in Type-1 Diabetes Mellitus(T1 DM):a real-time intravital microscopy study[J].Clin Hemorheol Microcirc,2009,42(4):285-295.
[10]TO WJ,TELANDER DG,LLOYD ME,CHEN PC,CHEUNG AT.Correlation of conjunctival microangiopathy with retinopathy in type-2 diabetes mellitus(T2 DM)patients[J].Clin Hemorheol Microcirc,2011,47(2):131-141.
[11]CHEUNG AT,HU BS,WONG SA,CHOW J,CHAN MS,TO WJ,et al.Microvascular abnormalities in the bulbar conjunctiva of contact lens users[J].Clin Hemorheol Microcirc,2012,51(1):77-86.
[12]JIANG H,ZHONG J,DEBUC DC,TAO A,XU Z,LAM BL,et al.Functional slit lamp biomicroscopy for imaging bulbar conjunctival microvasculature in contact lens wearers[J].Microvasc Res,2014,92(3):62-71.
[13]DENEUX T,TAKERKART S,GRINVALD A,MASSON GS,VANZETTA I.A processing work-flow for measuring erythrocytes velocity in extended vascular networks from wide field high-resolution optical imaging data[J].Neuroimage,2012,59(3):2569-2588.
[14]MCNALLY JJ,CHALMERS RL,MCKENNEY CD,ROBIRDS S.Risk factors for corneal infiltrative events with 30-night continuous wear of silicone hydrogel lenses[J].Eye Contact Lens,2003,29(1Suppl):S153-156.
[15]SZCZOTKAFLYNN L,JIANG Y,RAGHUPATHY S,BIELEFELD RA,GARVEY MT,JACOBS MR,et al.Corneal inflammatory events with daily silicone hydrogel lens wear[J].Optom Vis Sci,2014,91(1):3-12.
[16]TAGLIAFERRI A,LOVE TE,SZCZOTKA-FLYNN LB.Risk factors for contact lens-induced papillary conjunctivitis associated with silicone hydrogel contact lens wear[J].Eye Contact Lens,2014,40(3):117-22.
[17]TSUCHIYA M,ASANO M,ODA M.Basic aspects of microcirculation[C]//Organizing Committee.eds.Proceedings of the Tokyo international symposium on microcirculation.Amsterdam,Oxford,Princeton:Elsevier Science Publisher,1981:85.
[18]李娟,丁小艳,王亚虹,叶鳞泓,叶蕾,姜楠,等.PM2.5对小鼠泪膜功能和角膜上皮组织结构的影响[J].眼科新进展,2017,37(3):201-204LI J,DING XY,WANG YH,YE LH,YE L,JIANG N,et al.Effects of PM2.5 on tear film function and corneal epithelial structure in mice[J].Rec Adv Ophthalmol,2017,37(3):201-204
[19]容蓉,石颖颖,邵毅.视网膜功能影像检查技术在视网膜疾病中的临床应用[J].眼科新进展,2017,37(4):388-391.RONG R,SHI YY,SHAO Y,Application of retinal functional imager in retinal diseases[J].Rec Adv Ophthalmol,2017,37(4):388-391.
[2]OHTANI N.Laser Doppler flowmetry of the bulbar conjunctiva as a monitor of the cerebral blood flow[J].Nihon Kyobu Geka Gakkai Zasshi,1996,44(9):1721-1728.
[3]SCHASER KD,SETTMACHER U,PUHL G,ZHANG L,MITTLMEIER T,STOVER JF,et al.Noninvasive analysis of conjunctival microcirculation during carotid artery surgery reveals microvascular evidence of collateral compensation and stenosis-dependent adaptation[J].J Vasc Surg,2003,37(4):789-797.
[4]DUENCH S,SIMPSON T,JONES LW,FLANAGAN JG,FONN D.Assessment of variation in bulbar conjunctival redness,temperature,and blood flow[J].Optom Vis Sci,2007,84(6):511-516.
[5]KOUTSIARIS AG,TACHMITZI SV,PAPAVASILEIOU P,BATIS N,KOTOULA MG,GIANNOUKAS AD,et al.Blood velocity pulse quantification in the human conjunctival pre-capillary arterioles[J].Microvasc Res,2010,80(2):202-208.
[6]SHAHIDI M,WANEK J,GAYNES B,WU T.Quantitative assessment of conjunctival microvascular circulation of the human eye[J].Microvasc Res,2010,79(2):109-113.
[7]WANEK J,GAYNES B,LIM JI,MOLOKIE R,SHAHIDI M.Human bulbar conjunctival hemodynamics in hemoglobin SS and SC disease[J].Am J Hematol,2013,88(8):661-664.
[8]CHEUNG AT,HARMATZ P,WUN T,CHEN PC,LARKIN EC,ADAMS RJ,et al.Correlation of abnormal intracranial vessel velocity,measured by transcranial Doppler ultrasonography,with abnormal conjunctival vessel velocity,measured by computer-assisted intravital microscopy,in sickle cell disease[J].Blood,2001,97(11):3401-3404.
[9]CHEUNG AT,TOMIC MM,CHEN PC,MIGUELINO E,LI CS,DEVARAJ S.Correlation of microvascular abnormalities and endothelial dysfunction in Type-1 Diabetes Mellitus(T1 DM):a real-time intravital microscopy study[J].Clin Hemorheol Microcirc,2009,42(4):285-295.
[10]TO WJ,TELANDER DG,LLOYD ME,CHEN PC,CHEUNG AT.Correlation of conjunctival microangiopathy with retinopathy in type-2 diabetes mellitus(T2 DM)patients[J].Clin Hemorheol Microcirc,2011,47(2):131-141.
[11]CHEUNG AT,HU BS,WONG SA,CHOW J,CHAN MS,TO WJ,et al.Microvascular abnormalities in the bulbar conjunctiva of contact lens users[J].Clin Hemorheol Microcirc,2012,51(1):77-86.
[12]JIANG H,ZHONG J,DEBUC DC,TAO A,XU Z,LAM BL,et al.Functional slit lamp biomicroscopy for imaging bulbar conjunctival microvasculature in contact lens wearers[J].Microvasc Res,2014,92(3):62-71.
[13]DENEUX T,TAKERKART S,GRINVALD A,MASSON GS,VANZETTA I.A processing work-flow for measuring erythrocytes velocity in extended vascular networks from wide field high-resolution optical imaging data[J].Neuroimage,2012,59(3):2569-2588.
[14]MCNALLY JJ,CHALMERS RL,MCKENNEY CD,ROBIRDS S.Risk factors for corneal infiltrative events with 30-night continuous wear of silicone hydrogel lenses[J].Eye Contact Lens,2003,29(1Suppl):S153-156.
[15]SZCZOTKAFLYNN L,JIANG Y,RAGHUPATHY S,BIELEFELD RA,GARVEY MT,JACOBS MR,et al.Corneal inflammatory events with daily silicone hydrogel lens wear[J].Optom Vis Sci,2014,91(1):3-12.
[16]TAGLIAFERRI A,LOVE TE,SZCZOTKA-FLYNN LB.Risk factors for contact lens-induced papillary conjunctivitis associated with silicone hydrogel contact lens wear[J].Eye Contact Lens,2014,40(3):117-22.
[17]TSUCHIYA M,ASANO M,ODA M.Basic aspects of microcirculation[C]//Organizing Committee.eds.Proceedings of the Tokyo international symposium on microcirculation.Amsterdam,Oxford,Princeton:Elsevier Science Publisher,1981:85.
[18]李娟,丁小艳,王亚虹,叶鳞泓,叶蕾,姜楠,等.PM2.5对小鼠泪膜功能和角膜上皮组织结构的影响[J].眼科新进展,2017,37(3):201-204LI J,DING XY,WANG YH,YE LH,YE L,JIANG N,et al.Effects of PM2.5 on tear film function and corneal epithelial structure in mice[J].Rec Adv Ophthalmol,2017,37(3):201-204
[19]容蓉,石颖颖,邵毅.视网膜功能影像检查技术在视网膜疾病中的临床应用[J].眼科新进展,2017,37(4):388-391.RONG R,SHI YY,SHAO Y,Application of retinal functional imager in retinal diseases[J].Rec Adv Ophthalmol,2017,37(4):388-391.