【摘要】 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。更多还原

【Abstract】 Objective To explore the relationship between the optic nerve lesion in glaucoma and ocular and systemic heamodynamic disturbance. Methods The color Doppler imaging was used to study blood velocity in the ophthalmic, the central retinal and the short posterior ciliary arteries in 34 patients with primary open angle glaucoma , 31 patients with low tention glaucoma and 90 healthy controls. The peak systolic velocity(PSV), the end diastolic velocity (EDV) and resistive index (RI) in each artery were measured, moreover the nailfold microcirculation and blood viscosity in each patient were examined. Results Compared with the control group, the PSV and EDV of the central retinal arteries were significantly lower while the RI of the central retinal arteries was significantly higher in both POAG and LTG patients. The RI of the short posterior ciliary arteries however was significantly higher in POAG. Nailfold microcirculation shows that some important parameters, including flow pattern, loop surrounding, morphological weighted value, total weighted value and capillary deformity rate in the two glaucoma groups were higher, whereas the flow velocity was lower than in the control group. The plasm viscosity and the whole blood viscosity (low spear) were higher than normal. According to our measurements, the nailfold microcirculation and blood viscosity was worse at the end stage of glaucoma than at early stage. The correlative analysis between measurement results of color doppler imaging and microcirculation and heamorrheology showed that nailfold microcirculation morphological weighted value was negatively correlated with the EDV of the central retinal artery and positively correlated with the RI of the central retinal artery in LTG patients. Conclusions The abnormity of ocular haemodynamics and systemic microcirculation and blood viscosity is one important factor of optic nerve damage in glaucoma.更多还原