急性腔隙性脑梗死与眼底病变的相关性研究

摘要

Objective To investigate the correlation of acute lacunar infarction and retinopathy. Methods A total of 171 patients whom admitted in the Department of Neurology, General Hospital of Beijing Military Command and could accept fundus examination in a sitting position were collected from January 2011 to October 2011. They were divided into either a lacunar infarction group ( n = 78 ) and a non-lacunar infarction group ( n = 93 ) according to their cerebral MRI findings. The clinical data and retinopathy ( arteriovenous crossing signs, microaneurysms, hard exudates, cotton-wool spots, and blood spots ) were compared between the two groups. Results (T)The incidences of hypertension, stroke and atrial fibrillation history as well as plasma C-reactive protein level in the lacunar infarction group were higher than those in the non-lacunar infarction group. The differences were statistically significant ( P <0. 05 or P <0. 01 ). ?The incidence of arteriovenous crossing signs was 73. 1 % ( 57/78 ) and that of hard exudates was 30. 8% ( 24/78 ) in the lacunar infarction group. They were higher than 58. 1% and 16. 1% in the non-lacunar infarction group ( P <0. 05 ). There were no significant differences in other retinopathies. ?Logistic regression analysis showed that the incidence of lacunar infarction in patients with arteriovenous crossing signs was 1. 96 times of those without arterial crossing signs ( OR = 1. 96, 95% CI: 1. 03 - 3. 75 ). The incidence of lacunar infarction in patients with hard exudates was 2. 31 times of those without hard exudates( OR =2. 31, 95% CI: 1. 11 - 4. 81 ). (4)Multivariate logistic regression analysis showed that hypertension, heart disease, previous stroke history were the independent factors for retinopathy ( OR =4. 22, 95% CI: 1.90-9.36; Ofi=2.33, 95% CI: 1.08-5.02; OR = 2.37, 95% CI: 1.30-4.33). Conclusion The arteriovenous crossing signs and hard exudates in optic fundus lesions are correlated with lacunar infarction.%目的 探讨急性腔隙性脑梗死与眼底病变的相关性.方法 选择2011年1-10月在北京军区总医院神经内科住院、能坐位行眼底照相的急性脑梗死患者171例,将其分为腔隙性脑梗死组(78例)和非腔隙性脑梗死组(93例),比较两组患者的一般临床资料及眼底病变情况(视网膜动静脉交叉征、微血管瘤、硬性渗出、棉絮斑和出血斑).结果 ①腔隙性脑梗死组高血压、既往腔隙性脑梗死史、心房颤动史的发生率及血浆C反应蛋白水平均高于非腔隙性脑梗死组,差异有统计学意义(P<0.05).②在腔隙性脑梗死组中,视网膜动静脉交叉征发生率为73.1%(57/78),硬性渗出的发生率为30.8%(24/78),分别高于非腔隙性脑梗死组的58.1%和16.1%(P<0.05),其他眼底病变差异无统计学意义.③Logistic回归分析显示,存在视网膜动静脉交叉征患者的腔隙性脑梗死的发生率是无视网膜动脉交叉征患者的1.96倍(OR=1.96,95%CI:1.03~3.75),存在硬性渗出的患者腔隙性脑梗死的发生率是无硬性渗出患者的2.31倍(OR=2.31,95%CI:1.11~4.81).④多因素Logistic回归分析显示,高血压、心脏病、既往腔隙性脑梗死史是眼底病变的独立影响因素(OR=4.22,95%CI:1.90~9.36 ;OR=2.33,95%CI:1.08~5.02;OR=2.37,95%CI:1.30~4.33).结论 眼底病变中的动静脉交叉征和硬性渗出与腔隙性脑梗死相关.