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目的揭示糖尿病伴高血压患者的眼和视网膜中央动脉血流动力学改变的特点。方法应用彩色多普勒血流成像技术,测量高血压、糖尿病、糖尿病高血压及正常对照者眼动脉和视网膜中央动脉的血流参数。结果高血压组的眼动脉血流速度和搏动指数,糖尿病组的眼动脉舒张末期血流速度、血管内径、和血管横断面积,糖尿病高血压组的眼动脉平均血流速度,均明显高于对照组;糖尿病高血压组的视网膜中央动脉舒张末期血流速度比高血压组显著下降,而视网膜中央动脉阻力指数明显增加;眼动脉血流速度及血流量比糖尿病组显著增加。结论糖尿病高血压患者的眼和视网膜中央动脉血流动力学改变,既呈现血流速度明显加快,又有血流灌注阻力增加的特征。糖尿病所致的视网膜循环阻力增加和高血压所致的视网膜血流灌注压下降,二者作用叠加模式使视网膜循环血量降低,早期就出现视网膜缺血性改变。糖尿病未发生视网膜病变前应用血管扩张药预防性治疗,比较治疗前后视网膜中央动脉的舒张末期血流速度和血管阻力指数来观察疗效。糖尿病伴高血压或动脉硬化者,可考虑用治疗前后视网膜中央动脉的收缩期峰值血流速度和血管搏动指数,和首次提出的视网膜中央动脉与眼动脉血流速度比值,作为疗效观察指标。
Objective To reveal the characteristics of hemodynamics of central retinal and central retinal artery in diabetic patients with hypertension. Methods Color Doppler flow imaging was used to measure the blood flow parameters of the ophthalmic artery and the central retinal artery in hypertension, diabetes mellitus, diabetic hypertension and normal controls. Results Compared with the control group, the ophthalmic arterial blood flow velocity and pulsatility index, the diastolic arterial blood flow velocity, the vascular diameter and the vascular cross-sectional area in diabetic group and the average arterial blood flow velocity in diabetic hypertensive group were significantly higher than those in control group Group. The diastolic blood flow velocity in the central retinal artery in diabetic hypertension group was significantly lower than that in the hypertensive group, while the central retinal artery resistance index was significantly increased. The ophthalmic artery blood flow velocity and blood flow were significantly higher than those in the diabetic group. Conclusion The changes of hemodynamics of central retinal and central retinal artery in diabetic hypertensive patients are characterized by markedly accelerated blood flow and increased resistance to perfusion. Increased retinal circulation resistance caused by diabetes and decreased retinal perfusion pressure caused by hypertension, the role of the two superimposed mode of retinal blood volume decreased retinal ischemic changes early. Diabetic retinopathy before application of vasodilator prophylactic treatment, compared before and after treatment of central retinal end-diastolic blood flow velocity and vascular resistance index to observe the effect. Diabetes with hypertension or atherosclerosis, can be considered before and after treatment with the central retinal artery systolic peak blood flow and vascular beats index, and the first proposed central retinal artery and ophthalmic artery blood flow velocity ratio, as the efficacy of indicators.