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目的探讨彩色多普勒血流显像(CDFI)检测阻塞型睡眠呼吸暂停综合征(OSAS)患者眼底动脉血流的变化。方法按照呼吸低通气指数(AHI)将OSAS患者分成轻度组(AHI<20,15例)和重度组(AHI≥20,15例);选取年龄相近的20例作为对照组。应用CDFI分别测量眼动脉(OA)、视网膜中央动脉(CRA)及睫状后动脉(PCA)。检测指标:收缩期峰值血流速度(PSV)、舒张末血流速度(EDV)及阻力指数(RI)。其结果与正常组对照,并与OSAS患者的血氧饱和度(SaO2)作相关性分析。结果①OSAS组(轻、重度)的CRA血流速度(PSV、EDV)显著高于对照组(P<0.01);②OSAS重度组的PCA血流速度(PSV、EDV)显著高于正常组(P<0.01);③OSAS重度组的MSpO2与PCA(PSV、EDV)呈负相关(r=-0.973,P=0.000;r=-0.96,P=0.000)。结论 OSAS患者眼底动脉血流存在显著改变,间接反映了OSAS患者全身中小动脉病变状况及硬化程度,应用CDFI检测OSAS眼底血流是一种良好的方法,具有重要的临床参考价值。
Objective To investigate the changes of fundus artery blood flow in patients with obstructive sleep apnea syndrome (OSAS) by color Doppler flow imaging (CDFI). Methods OSAS patients were divided into mild group (AHI <20,15) and severe group (AHI> 20,15) according to AHI. Twenty patients with similar ages were selected as control group. The ocular artery (OA), central retinal artery (CRA) and posterior ciliary artery (PCA) were measured by CDFI. Test indicators: peak systolic blood flow velocity (PSV), end diastolic blood flow velocity (EDV) and resistance index (RI). The results were compared with those in the normal group and were correlated with SaO2 in OSAS patients. Results ① The CRA blood flow velocity (PSV, EDV) in OSAS group was significantly higher than that in control group (P <0.01); ② The PCA blood flow velocity (PSV, EDV) in OSAS severe group was significantly higher than that in normal group (P < 0.01). (3) MSpO2 in OSAS severe group was negatively correlated with PCA (r = -0.973, P = 0.000; r = -0.96, P = 0.000) Conclusion There is a significant change of fundus arterial blood flow in patients with OSAS, which indirectly reflects the status of systemic small and medium arterial disease and the degree of sclerosis in OSAS patients. Using CDFI to detect OSAS blood flow is a good method and has important clinical reference value.