【摘要】：目的：采用增強(qiáng)型血流顯像（eFlow）及頻譜多普勒研究高尿酸血癥患者眼動(dòng)脈（ophthalmic artery，OA）和視網(wǎng)膜中央動(dòng)脈（central retinalartery CRA）的內(nèi)徑及血流動(dòng)力學(xué)改變，并探討血流動(dòng)力學(xué)指標(biāo)和尿酸值的關(guān)系，旨在了解高尿酸血癥和外周血管疾病的關(guān)系。 方法：選擇確診為高尿酸血癥的患者101名作為實(shí)驗(yàn)組，20名原發(fā)性高血壓患者和30名健康成年人作為對(duì)照組。eFlow觀察眼動(dòng)脈、視網(wǎng)膜中央動(dòng)脈在眶內(nèi)的走形情況及內(nèi)徑，頻譜多普勒檢測眼動(dòng)脈及視網(wǎng)膜中央動(dòng)脈的收縮期峰值血流速度（peak of systolic velocity PSV）、舒張末期血流速度（end of diastolic velocity EDV）、血流阻力指數(shù)（resistanceindex RI）和搏動(dòng)指數(shù)（pulsatility index PI）。根據(jù)確診高尿酸血癥的年限將實(shí)驗(yàn)組分為≤5年組和＞5年組，采用獨(dú)立樣本t檢驗(yàn)比較兩組樣本均數(shù)；再根據(jù)有無高血壓分為高尿酸血癥伴高血壓組和不伴高血壓組，，所得數(shù)據(jù)和健康對(duì)照組做單因素方差分析,各組間比較采用SNK法，再采用獨(dú)立樣本t檢驗(yàn)比較高尿酸血癥伴高血壓組和原發(fā)性高血壓組的樣本均數(shù)；用person，s相關(guān)分別分析高尿酸血癥伴高血壓組和高尿酸血癥不伴高血壓組的血流動(dòng)力學(xué)指數(shù)和尿酸值的相關(guān)性。 結(jié)果：(1)確診高尿酸血癥＞5年組眼動(dòng)脈的RI（0.68±0.09）、PI(1.3±0.4)較≤5年組(RI：0.63±0.09, PI：1.1±0.3)明顯升高（t=3.504,P=0.001;t=3.164,P=0.002），眼動(dòng)脈的舒張末期血流速度(EDV)＞5年組（6.4±3.4） cm/s,較≤5年組(7.5±4.9cm/s)明顯降低（t=1.988,P=0.049）；(2)高尿酸血癥伴高血壓組CRA的PSV（11.5±3.5）cm/s,、 EDV(3.7±1.1)cm/s較高尿酸血癥不伴高血壓組[(PSV：(13.5±4.0)cm/s，EDV：(4.1±1.2)cm/s.)明顯降低，RI明顯升高(伴高血壓組：0.88±1.40，不伴高血壓組：0.67±0.08,P＜0.05)；（3）高尿酸血癥伴高血壓組眼動(dòng)脈的RI、PI(0.73±0.68、1.62±0.37)均較原發(fā)性高血壓組（0.67±0.73、1.48±0.27）升高（t=2.05,P=0.043;t=2.08,P=0.041）；（4）RI實(shí)驗(yàn)組眼動(dòng)脈及視網(wǎng)膜中央動(dòng)脈內(nèi)徑和對(duì)照組無明顯統(tǒng)計(jì)學(xué)差異（P＞0.05）。（5）高尿酸血癥不伴高血壓組眼動(dòng)脈的RI (r=0.274, P=0.007)，PI（r=0.318, P=0.001）和血清尿酸值具有相關(guān)性，CRA的各項(xiàng)指標(biāo)和血清尿酸值無明顯相關(guān)，而高尿酸血癥伴高血壓組的眼動(dòng)脈及視網(wǎng)膜中央動(dòng)脈的各項(xiàng)指標(biāo)和血尿酸均無明顯相關(guān)性。 結(jié)論：eFlow結(jié)合多普勒技術(shù)對(duì)研究高尿酸血癥所致眼動(dòng)脈血流動(dòng)力學(xué)改變具有較高的臨床價(jià)值，并提示高尿酸血癥可加速眼動(dòng)脈及視網(wǎng)膜中央動(dòng)脈的粥樣硬化改變，而高尿酸血癥合并高血壓可進(jìn)一步加速終末小血管的粥樣硬化改變。eFlow結(jié)合多普勒技術(shù)對(duì)預(yù)測外周終末小動(dòng)脈的硬化性改變具有一定的臨床價(jià)值。
[Abstract]:Objective: to study the internal diameter and hemodynamic changes of ophthalmic artery (ophthalmic artery,OA) and central retinal artery (central retinalartery CRA) in patients with hyperuricemia by enhanced blood flow imaging (eFlow) and spectral Doppler. In order to understand the relationship between hyperuricemia and peripheral vascular diseases, the relationship between hemodynamic parameters and uric acid value was discussed. Methods: 101 patients with hyperuricemia were selected as experimental group, 20 patients with essential hypertension and 30 healthy adults as control group. EFlow was used to observe the shape and inner diameter of ophthalmic artery and central retinal artery in orbit. Measurement of peak systolic velocity (peak of systolic velocity PSV), end diastolic velocity (end of diastolic velocity EDV), flow resistance index (resistanceindex RI) and pulsatility index (pulsatility index PI). Of ophthalmic artery and central retinal artery by spectral Doppler According to the years of diagnosis of hyperuricemia, the experimental group was divided into two groups: 鈮

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