脑小血管病与眼底血管网络参数的相关性研究

姬晓昙Benny ZeeJack Lee林晶王迪龙范玉华

脑小血管病与眼底血管网络参数的相关性研究

姬晓昙*Benny Zee△Jack Lee△林晶*王迪龙*范玉华*

目的利用计算机辅助的全自动眼底照相分析技术，研究脑小血管病与眼底血管网络参数的相关性。方法连续性纳入能坐位行眼底照相的脑小血管病患者80例，大动脉粥样硬化性脑梗死患者41例，比较两组患者的一般临床资料和眼底血管网络参数。同时行logistic回归分析脑小血管病患者的危险因素。结果脑小血管病组在男性比例、吸烟史发生率、血尿酸水平方面均低于大动脉粥样硬化性脑梗死组［（55%vs.75.6%）；（20%vs.39%）；（308.33±85.30 vs.367.79±113.60）］，差异均有统计学意义（P＜0.05）。脑小血管病组小静脉分支系数和不对称性指数均小于大动脉粥样硬化性脑梗死组，［（1.37±0.04 vs.1.39±0.05）；（0.80±0.02 vs.0.81±0.02）］，差异均有统计学意义（P＜0.05）。Logistic回归分析显示，调整血管危险因素后，减小的小静脉不对称性指数与脑小血管病相关，是其危险因素（OR值=1.16，95%CI：1.05-1.38，P＜0.05）。结论减小的小静脉不对称性指数与脑小血管病相关，是其危险因素，可作为其早期诊断指标。

脑小血管病眼底照相眼底血管

【Abstract】ObjectiveTo investigate the correlation of cerebral small vessel disease with retinal vascular network parameters using fully automatic retinal image analysis of fundus photographs.Methods A total of 121 patients undertaking fundus photography in a sitting position were included.They were divided into either a cerebral small vessel disease group（n=80）or an artery atherosclerotic cerebral infarction group（n=41）according to their cerebral MRI findings.The clinical data and retinal vascular network parameters were compared between the two groups.We used logistic regression to analyse risk factors of the small vessel disease.Results The percentage of males，the incidence of smoking and serum uric acid level in the small vessel disease group were lower than those in the artery atherosclerotic cerebral infarction group（P＜0.05）.The bifurcation coefficient and asymmetry index of venule in the small vessel disease group were lower than those in the artery atherosclerotic cerebral infarction group（P＜0.05）.Logistic regression analysis showed that after adjusting vascular risk factors，decreased asymmetry index of venule was associated with cerebral small vessel disease （OR=1.16，95%CI：1.05-1.38，P＜0.05）.Conclusions The decreased asymmetry index of venule is associated with small vessel disease which can be used as an early diagnotic indicator.

【Key words】Cerebral small vessel disease Fundus photography Retinal vessel

脑小血管病（cerebral small vessel disease，CSVD）泛指供应脑的小穿支动脉和小动脉（直径40～200 μm）、毛细血管和小静脉的各种病变所导致的临床、认知、影像学及病理学表现的综合征［1］。越来越多的证据表明，CSVD是全身小血管病变在脑部的表现［2］。眼底血管即视网膜血管，它是视网膜中央动脉和中央静脉的终末血管，而视网膜中央动脉与大脑中动脉和脉络丛动脉共同起源于颈内动脉，因此，视网膜动脉和脑小动脉有相似的胚胎学起源、大小（直径40～200 μm）和解剖结构特征（没有吻合的终末动脉）；……