目的:探讨轻型卒中患者的脑小血管病（CSVD）总负荷与视网膜血管直径之间的关系。方法:连续收集2019年3—12月在南京医科大学附属常州市第二人民医院住院治疗的轻型卒中的患者（美国国立卫生研究院卒中量表评分≤3分）。所有患者均完成头颅磁共振成像和眼底照相检查，然后根据眼底照相图片半自动测量视网膜动静脉直径。按CSVD总负荷评分（0~4分）分成5等级，比较患者的基线资料，并采用Spearman线胜相关和多因素线性回归分析CSVD总负荷与视网膜血管直径之间的关系。结果:共纳入了206例患者，年龄（66±12）岁，根据CSVD评分分组，0、1、2、3和4分的患者分别有69、51、41、30和15例。患者的年龄、高血压及糖尿病病程在CSVD评分各组之间差异存在统计学意义（均n P<0.05）。在不同CSVD评分分组中，中央动脉等效值（CRAE）［CSVD评分0~4分组分别为（126±12）μm，（118±11）μm，（108±11）μm，（99±8）μm，（90±7）μm，n P<0.001］、视网膜动静脉比值（AVR）［CSVD评分0~4分组分别为0.65±0.05，0.60±0.04，0.56±0.04，0.49±0.03，0.44±0.02，n P<0.001］明显不同，随着CSVD评分的增加，动脉直径、动静脉的比值变小。Spearman相关分析发现，CSVD总负荷与AVR具有相关性（n r=0.818，n P<0.001），构建线性回归方程模型，CSVD总负荷决定系数n R2=0.694，高于腔隙、白质高信号、脑微出血及扩大的血管周围间隙的决定系数。进一步使用多重线性回归模型校正年龄、高血压和糖尿病病程，以及不同类型CSVD后，CSVD总负荷仍然是AVR的独立相关因素（β=-0.039，n P<0.001，95n %CI：-0.051~-0.028）。n 结论:CSVD总负荷评分与视网膜动脉直径和AVR呈负相关，CSVD总负荷评分等级比单一类型CSVD能更好地反映脑微血管的病变程度。“,”Objective:To explore the relationship between the total cerebral small vessel disease (CSVD) score and retinal vessel diameters in patients with mild stroke.Methods:The patients with mild stroke who were hospitalized in the Second People′s Hospital of Changzhou, Nanjing Medical University from March to December 2019 were continuously collected (National Institutes of Health Stroke Scale score≤3 points). All patients completed the head magnetic resonance imaging and retinal fundus photography examination, and then the retinal arteriovenous diameter was measured semi-automatically based on the pictures. According to the total CSVD score (0-4 points), the patients were divided into 5 groups. The baseline characteristics of the patients were compared. Moreover, the correlation of total CSVD with retinal blood vessel diameters were analyzed by spearman and linear regression.Results:A total of 206 patients were enrolled. There were 69, 51, 41, 30, and 15 patients with 0, 1, 2, 3, and 4 points, respectively. In CSVD subgroups, there were significant differences in age, duration of hypertension and diabetes (alln P<0.05). The central retinal artery equivalent (CRAE), (CSVD scores 0-4 were (126±12) μm, (118±11) μm, (108±11) μm, (99±8) μm, (90±7) μm, n P<0.001) and arteriole-to-venule ratio (AVR) (CSVD scores 0-4 were 0.65±0.05, 0.60±0.04, 0.56±0.04, 0.49±0.03, 0.44±0.02,n P<0.001) were different in CSVD subgroups. With the increase of CSVD score, the diameter of artery and AVR became smaller. The total CSVD was significantly correlated with AVR by Spearman correlation analysis (n r= 0.818, n P<0.001). By constructing a linear regression equation model, the coefficient of determination of the total CSVD score (n Rn 2=0.694) was higher than that of lacunes, white matter hyperintensities, cerebral microbleeds and enlarged perivascular space. After adjusting for age, course of hypertension and diabetes, and different types of CSVD, further multiple linear regression analysis revealed that the total CSVD score was still an independent related factor of AVR (β=-0.039, n P<0.001, 95%n CI=-0.051--0.028).n Conclusions:Total CSVD score is negatively correlated with retinal artery diameters and AVR. Additionally, the total CSVD score can better reflect the degree of cerebral microvascular lesions than single type CSVD.