从中风辨证探讨急性脑梗死患者典型眼底改变的证候特点

摘要

目的 观察急性脑梗死患者典型眼底改变的证候特点.方法 对750例患者进行神经功能缺损程度评分、眼底图像采集、中风证候评分,采用X2检验比较中风证候、眼底改变在神经功能缺损程度分型及中风证候在眼底改变中的差异性.结果 视网膜动静脉交叉征在病例中占71.60％,风证在病例中占(81.73％),俱在神经功能缺损程度分型中比较差别均不大(均P＞0.05);跟底改变例数与中风证型例数随神经功能缺损程度分型的加重而有增多的趋势(P＜0.05);眼底改变在中风证型中的比较,蜡样渗出、棉绒状斑以痰证为优势(P＜0.01);出血斑以火证为优势(P＜0.01).结论 视网膜动静脉交叉征、风证为急性脑梗死的基础病变,神经功能缺损程度分型越重,眼底改变及中风证型越复杂,蜡样渗出、棉绒状斑多痰证,出血斑多火证.%Objective:To investigate the syndrome characteristics of typical fundus changes in patients with acute cerebral infarction.Methods:750 cases of acute cerebral infarction patients were collected and involved as the object of this research to evaluate NFD (Neurological Function Defect) scale and HSS (Health Stroke Scale) and to perform fundus image acquisition.The chi-square criterion was used to compare the difference between fundus changes and stroke syndromes in NFD classification and to compare the difference of stroke syndromes in fundus changes.Results:Among all the cases,retinal arteriovenous crossing signs was accounted for 71.60％ and the wind syndromes 81.73％,both of which had no significant difference in NFD classification (P＞0.05);with the aggravation of NFD classification,the number of fundus change cases and stroke syndrome cases had the tendency of increasing,with significant difference (P ＜ 0.05);through comparison of fundus changes in stroke syndromes,phlegm syndromes in waxy exudate and cotton-wool patches were taken as the advantage,with significant difference(P＜ 0.01);fire syndromes in bleeding spots were taken as the advantage,with significant difference (P＜ 0.01).Conclusion:Retinal arteriovenous-crossing signs and wind syndromes are the basic lesions of acute cerebral infarction.The more NFD classification is aggravated,the more fundus changes and stroke syndromes will be complicated.The phlegm syndromes are commonly seen in waxy exudate and cotton-wool patches;while,fire syndromes are commonly seen in bleeding spots.