甲状腺相关眼病球后血管血流动力学分析
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摘要
目的：研究甲状腺相关眼病患者球后血管血流动力学的变化及其与临床活动性评分(clinical activity score, CAS)的关系。方法：选择31例(56眼)甲状腺相关眼病(Thyroid-associated ophthalmopathy, TAO)患者,按CAS将其分为2组,1-2分为TAO1组(32眼),≥3分为TA02组(24眼)。利用彩色多普勒超声诊断仪(color doppler flow imaging, CDFI)测定两组患者球后血管的血流状态,并与正常人15例(30只眼)进行对照。检测指标包括眼动脉、视网膜中央动脉、睫状后动脉的收缩期峰值血流速度(PSV)、舒张末期血流速度(EDV)、搏动指数(PI)和阻力指数(RI),以及视网膜中央静脉的最大血流速度(Vmax)和最小血流速度(Vmin)。结果：TAO1组与正常对照组相比,各指标之间无统计学差异；TA02组与正常对照组相比,眼动脉的PSV、EDV, PI、RI,视网膜中央动脉的PSV、EDV、RI,睫状后动脉的PSV、EDV,视网膜中央静脉的Vmax、Vmin均有统计学差异(P<0.05)；TAO1组与TA02组相比,眼动脉的PSV、EDV,视网膜中央动脉的PSV、EDV、RI,睫状后动脉的、PSV、EDV,视网膜中央静脉的Vmax和Vmin均有统计学差异。结论：CDFI可直接检测TAO患者球后血管的血流速度,并评价其活动性,为临床治疗提供重要依据。
Objective:TOstudy the changes of post-ocular vascular hemodynamics of patients with thyroid-associated ophthalmopathy (TAO) and the relation with CAS。Methods:TOchoose 31 patients (56 eyes) with TAO, and divided them intOtwOgroups according CAS:1-2scores is TAO1(32eyes),≥3scores is TAO2(24eyes)oThe retrobulbar hemodynamics of these patients were determined by color doppler flow imaging (CDFI), and 15 normal people (30 eyes) without TAOwere contrasted。The indexes included peak systolic velocity (PSV), end diastolic velocity (EDV), pulsatility index (PI), resistance index(RI) of ocular artery, the central retinal artery and posterior ciliary artery, alsOincluded maximum velocity (Vmax) and minimum velocity (Vmin) of the central retinal vein. Results:There were not statistically significance between TAO1 and normal people. There were statistically significance between TAO2 and normal people in PSV, EDV, PI, RI of the ocular artery, PSV, EDV, RI of the central retinal artery, PSV, EDV of the posterior ciliary artery, Vmax and Vmin of the central retinal vein (P<0.05)o There were statistically significance between TAO1 and TAO2 in PSV, EDV of the ocular artery, PSV, EDV, RI of the central retinal artery, PSV, EDV of the posterior ciliary artery, Vmax and Vmin of the central retinal vein。Conclusions:CDFI can detect the velocity of post-ocular vascular in patients with thyroid-associated ophthalmopathy and evaluate its activity, alsOcan offer important basis for clinical treatment。
Objective:TOstudy the changes of post-ocular vascular hemodynamics of patients with thyroid-associated ophthalmopathy (TAO) and the relation with CAS。Methods:TOchoose 31 patients (56 eyes) with TAO, and divided them intOtwOgroups according CAS:1-2scores is TAO1(32eyes),≥3scores is TAO2(24eyes)oThe retrobulbar hemodynamics of these patients were determined by color doppler flow imaging (CDFI), and 15 normal people (30 eyes) without TAOwere contrasted。The indexes included peak systolic velocity (PSV), end diastolic velocity (EDV), pulsatility index (PI), resistance index(RI) of ocular artery, the central retinal artery and posterior ciliary artery, alsOincluded maximum velocity (Vmax) and minimum velocity (Vmin) of the central retinal vein. Results:There were not statistically significance between TAO1 and normal people. There were statistically significance between TAO2 and normal people in PSV, EDV, PI, RI of the ocular artery, PSV, EDV, RI of the central retinal artery, PSV, EDV of the posterior ciliary artery, Vmax and Vmin of the central retinal vein (P<0.05)o There were statistically significance between TAO1 and TAO2 in PSV, EDV of the ocular artery, PSV, EDV, RI of the central retinal artery, PSV, EDV of the posterior ciliary artery, Vmax and Vmin of the central retinal vein。Conclusions:CDFI can detect the velocity of post-ocular vascular in patients with thyroid-associated ophthalmopathy and evaluate its activity, alsOcan offer important basis for clinical treatment。
引文
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[3]Braverman LE, Utiger RD, Werner and Ingbar's thyroid:A fundamental and clinical Text (7 th ed.) philadelphia:lippicott-raven Phblishers,1996,52-577
[4]Teng CS, YeOPP. Ophthalmic Graves'disease:natural history on detailed thyroid func-tions studies. Br Med J,1997,1:273
[5]Weetman Ap. Update:thyroid-associated ophthalmopathy. Autoimmunity,1992, 12:215-222
[6]Perros P, Kendall-Taylor P. Pathogenetic mechanisms in thyroid-associated ophthalm-opathy. J intern Med,1992,231:05-211
[7]Wall JR, Salvi M, Bernared NF, et al. Thyroid-associated ophthalmopathy。A model for tha assocition of organ-specific autoimmune disorders. Immunology Today,1991, 12:150-153
[8]Wiersinga WM, Prummel MF. An evidence2based approach tOthe treatment of Graves'ophthalmopathy. Endocrinol Metab Clin North Am,2000,29 (2):297.
[9]Perros P, Kenendal12Taylor. Natural history of thyroid eye disease. Thyroid,1998, 8:423.
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[11]谢秦,安振梅,魏松全Graves(?)病活动性评判方法研究进展。国外医学内分泌学分册,2000,20(2)：76-78
[12]甲状腺相关眼病活动性评判及病情的影响因素.国外医学内分泌学分册,2005,25(1)：39-41
[13]Mourits MP, Prummel MF,Wiersinga WM. [J]. J Clin Endocrinol,1997,47:9-14.
[14]Kahaly G,Hansen C,Beyer J, et al. Plasma glycosaminogly cans in endocrine ophthalmopathy [J]. J Endocrinol Invest,1994,17:45-50.
[15]Kulig G, Pilarska K, Kulig J, et al. Usefulness of soluble ICAM-1 measurements for the evaluation of the disease activity and efficiency of therapy in patients with infiltrative Graves'ophthalmopathy. Pol Arch Med Wewn,2002,108:116121169.
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[17]Hoh HB, Lalltt RD, Wakeley C, et al. The stir sequence MRI in the assessment of extraocular muscles in thyroid eye disease. Eye,1994,8,506
[18]Burggasser G, Hurtl I, Hauff W, et al. Orbital scintigraphy with the somatostatin receptor tracer 99mTc2P829 in patients with Graves' disease. J Nucl Med,2003, 44:154721555.
[19]罗清礼主编.甲状腺相关眼病.北京：人民卫生出版社,2005,270
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