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目的探讨青光眼视神经损害与眼局部及全身血流动力学之间的关系。方法对３４例原发开角型青光眼，３１例低压性青光眼及９０名正常人进行彩色超声多普勒图象研究，测量双眼眼动脉、视网膜中央动脉、睫状后动脉的收缩期峰值血流速度（ＰＳＶ）和舒张末期血流速度（ＥＤＶ），通过公式计算阻力指数（ＲＩ），并行甲襞微循环及血液粘度检查。结果两组青光眼的双眼视网膜中央动脉ＰＳＶ和ＥＤＶ均下降，ＲＩ升高。原发开角型青光眼组右眼睫状后动脉ＲＩ升高。两组青光眼微循环主要参数如流态、袢周、形态积分和总积分、血管畸形数均明显高于正常，血流速度却明显低于正常，血浆粘度和全血粘度（低切）明显高于正常。青光眼视神经损害晚期，甲襞微循环及血液粘度等检查中的一些指标异常程度明显高于青光眼早期。对彩色超声多普勒验证结果与甲襞微循环及血液粘度结果进行相关分析，结果显示低压性青光眼组甲襞微循环形态积分与视网膜中央动脉ＥＤＶ呈明显负相关，与视网膜中央动脉ＲＩ呈明显正相关。结论全身微循环和血液粘度与眼局部血流动力学异常密切相关，是造成青光眼视神经损害的重要因素之一。
Objective To investigate the relationship between glaucomatous optic nerve damage and local and systemic hemodynamics in glaucoma. Methods 34 cases of primary open-angle glaucoma, 31 cases of low-pressure glaucoma and 90 normal subjects were studied by color Doppler sonography. Peak systolic blood flow was measured in bilateral ocular artery, central retinal artery and posterior ciliary artery Speed (PSV) and end-diastolic velocity (EDV) were calculated using the formula to calculate the resistance index (RI), and concurrent nail 襞 microcirculation and blood viscosity examination. Results In both groups, the central retinal artery PSV and EDV in both eyes decreased and RI increased. The RI of the right ciliary artery in the primary open angle glaucoma group was increased. The main parameters of glaucoma microcirculation such as flow pattern, circumflex week, shape integral and total score, vascular malformation in both groups were significantly higher than normal, blood flow velocity was significantly lower than normal, plasma viscosity and whole blood viscosity (low cut) were significantly higher Normal. Late glaucoma optic nerve damage, nailfold microcirculation and blood viscosity and other indicators of some abnormalities was significantly higher than early glaucoma. Correlation analysis between color Doppler ultrasound examination and microcirculation and blood viscosity showed that there was a significant negative correlation between the morphological score of formazan microcirculation and EDV of central retinal artery in low pressure glaucoma group and RI of central retinal artery Positive correlation. Conclusions Systemic microcirculation and blood viscosity are closely related to local hemodynamic abnormalities in the eye and are one of the important factors that cause glaucomatous optic nerve damage.