目的探讨眼底指标改变与脑卒中患病风险的相关性。设计病例对照研究。研究对象北京同仁医院、北京天坛医院年龄(63.6±10.2)岁的脑卒中患者450例,对照组为年龄(62.5±8.7)岁“北京眼病研究”非脑卒中受检者566例。方法所有受试者单张45度眼底数码照相。两位眼科医师盲法评价眼底指标改变。应用Logistic回归分析眼底指标与脑卒中患病的相关性及脑卒中发病风险性,应用Orange 2软件统计图对分析结果进行可视化。主要指标视网膜神经纤维层缺损(RNFLD)、视网膜动脉缩窄、动静脉交叉压迫征、视网膜静脉迂曲扩张、视盘改变、黄斑病变的构成比及与脑卒中患病的OR值。结果非脑卒中组、脑卒中组视网膜动脉管径缩窄出现率分别为46.3%、65.1%(P<0.05),视网膜静脉扩张出现率分别为12.5%、38.0%(P<0.05),RNFLD出现率分别为12.7%、38.0%(P<0.05),视网膜棉絮斑出现率分别为1.6%、4.4%(P<0.05),视网膜出血出现率分别为4.6%、11.3%(P<0.05),视盘病变出现率分别为7.1%、16.9%(P<0.05),黄斑病变出现率分别为6.4%、13.1%(P<0.05)。Logistic回归分析显示,RNFLD(OR=4.163,95%CI 2.792-6.208)和视网膜静脉扩张(OR=3.443,95%CI 2.333-5.082)与脑卒中患病高度相关。除性别对于脑卒中患病有负向影响(男性更易罹患脑卒中)外,RNLFD、视网膜静脉扩张、黄斑病变对脑卒中患病有正向影响。在眼底组合指标中,视网膜动脉缩窄、静脉扩张、RNFLD同时存在与脑卒中患病相关性最大。结论眼底RNLFD、视网膜动脉缩窄、静脉扩张三项指标联合对脑卒中发病预警有重要提示作用,眼底血管变化与RNFLD改变可为脑血管病变的筛查提供简易方法。 Objective To investigate the correlation between fundus changes and the risk of stroke. Design a case-control study. Subjects Beijing Tongren Hospital, Beijing Tiantan Hospital, aged 450 (63.6 ± 10.2) years of stroke patients, the control group was aged 62.5 ± 8.7 years 566 cases of Beijing Eye Research non-stroke subjects. Methods All subjects were single 45-degree fundus digital photography. Two ophthalmologists blind evaluation of fundus changes. Logistic regression analysis was used to analyze the correlation between fundus index and the prevalence of stroke and the risk of stroke. The results of the analysis were visualized using the Orange 2 software statistical chart. The main indicators of retinal nerve fiber layer defect (RNFLD), retinal artery narrowing, arterial and venous cross compression syndrome, retinal vein tortuous dilation, optic disc change, macular degeneration and composition ratio and stroke prevalence of OR. Results The incidences of retinal artery diameter narrowing were 46.3% and 65.1% in non-stroke group and stroke group (P <0.05), and the incidence of retinal vein dilatation was 12.5% ​​and 38.0% (P <0.05) respectively. RNFLD appeared The rates of retinal hemorrhage were 1.6%, 4.4% (P <0.05), and retinal hemorrhage rates were 4.6%, 11.3% (P <0.05) The incidence of pathological changes was 7.1% and 16.9% respectively (P <0.05). The incidence of macular degeneration was 6.4% and 13.1% respectively (P <0.05). Logistic regression analysis showed that RNFLD (OR = 4.163, 95% CI 2.792-6.208) and retinal vein dilatation (OR = 3.443, 95% CI 2.333-5.082) were highly correlated with the prevalence of stroke. In addition to the negative effects of gender on the prevalence of stroke (men are more susceptible to stroke), RNLFD, retinal vein dilatation, and macular degeneration have a positive effect on the prevalence of stroke. In the fundus combination of indicators, narrowing of the retina, venous dilatation, RNFLD coexistence and stroke prevalence of the most relevant. Conclusions The combination of fundus RNLFD, retinal artery narrowing and venous dilatation is an important indicator of early warning of stroke. The change of fundus and RNFLD may provide a simple method for the screening of cerebrovascular disease.