作者;武淑玲，王玮玲，王金星，孙海峰
［摘要］ 目的 探讨宁夏回族原发性青光眼患者眼部血流动力学改变特点。方法 研究对象为我院确诊的回族原发性青光眼组患者29例58眼，男11例，女18例。另外31例（62眼）正常人作为对照组。采用美国MULTIGON 500M型TCD仪器，探头频率2.0MHz，超声强度10%，取样位置：眶窗；取样深度：50mm，采用单盲法，由同一熟练操作者实施。检测病例组及对照组眼动脉（OA）、视网膜中央动脉（CRA）和睫状后动脉（PCA）。检测指标为：收缩期峰值流速（Vp）、舒张期末流速（Vd）、平均流速（Vm）、搏动指数（PI）、阻力指数（RI），频谱形态，监听频声。结果 青光眼组患者的CRA及SPCA的收缩期峰值流速（PSV）分别为（7.55±2.43）cm/s、（9.37±1.14）cm/s，舒张期血流速度（EDV）分别为（2.10±0.93）cm/s、（2.89±0.79）cm/s，平均流速（MV）分别为（4.54±1.44）cm/s、（5.87±1.23）cm/s，均低于正常对照组，阻力指数（RI）［均为（0.69±0.07）～（0.74±0.05）］明显高于正常对照组。搏动指数（PI，PI=PSV-EDV/mV）青光眼组显著高于正常对照组。慢性开角型青光眼（COAG）与正常组比较，除CRA的平均血流速度（Vm）外，OA及CRA的血流速度均明显减慢。慢性开角型青光眼（COAG）的眼动脉舒张末期血流速度（Vd）、视网膜中央动脉峰速（Vs）较慢性闭角型青光眼（CCAG）明显减慢。结论 青光眼患者血流动力学改变无种族特异性。青光眼患者眼血管血流动力学有明显改变，强调血管性因素可能在青光眼视神经的损伤中发挥了重要作用。球后血管的血流速度下降是影响青光眼患者房水循环，致眼压增高的一个重要因素，从而认为缺血是视盘视野损害的另一因素。多普勒血流的成像研究为正常眼球球后血管血流动力学特点及其病理状态下的改变提供了一种直观、无创伤、可重复的检查方法，此将逐步成为临床青光眼诊断的一个重要方法。
［关键词］ 青光眼；彩色多普勒超声；血流速度
Eye blood vessel hemodynamic study in primary glaucoma of Muslin popular in Ningxia
［Abstract］ Objective To approach the feature of eye blood vessel hemodynamic change in the patients with primary glaucoma of Muslin popular in China.Methods Studied subjects are 29 patients(58 eyes)with primary glaucoma of Muslin popular in China'who have been admitted in our hospital.The patients are 11 famales and 18 males.The instrument we used is TCD of the type MULTIGON 500 which is made in USA.The frequency of detecting head is 2.0 MHz.The power of supersound is 10 percent'taking of samples is a single blind method made by only one person who can practiced use the instrument.We detect the arteria ophthalmica(OA)arteria centralis retinae and posterior ciliary arteries of case group and control group.The index of detect are the crest value flow number of the period of contraction'the flow number of the end stage of diastolis phase'mean flow velocity(VM)'pulsatility index(PI)'resistant index(RI)'the shape of spectra and the frequency of monitor.Otherwise'we have made a control group of 31 persons(62 eyes)who are health adulds.Results In the patients with primary glaucoma'date of CRA and SPCA are (7.55±2.43)cm/s and (9.37±1.14)cm/s in PSV'(2.10±0.93)cm/s and (2.89±0.79)cm/s in EDV'(4.54±1.44)cm/s and (5.87±1.23)cm/s in MV.All these parameters are lower than normal control.In RI［(0.69±0.07）～（0.74±0.05)］'glaucoma group obvious top than normal control.Except in the VM of CRA'the blood flow rate of OA and CRA are all step down obviously.The blood flow rate of enddiastole in arteria opthalmica'and hump rate of artery central retinal in the patients with COAG(chronic openangle glaucoma)'lower than those in the patients with CCAG(chronic angleclosure glaucoma).Conclusion The patients with glaucoma whose hemodynamic change of eye blood vessel have no group specificity.The eye blood vessel of patients with glaucoma has manifest change'so we can recive a conclusion that blood vessel perhaps is an important factor in the damage of optical nerve of patients with glaucoma.Decrease of postbulbar vessel of blood flow rate is a important factor in the circulation of aqu