[急性缺血性视网膜病变与非动脉炎性前部缺血性视神经病变的临床特征]

[Clinical characteristics of acute ischemic retinopathy and nonarteritic anterior ischemic optic neuropathy].

作者信息

Tian Guo-hong, Jia Nan, Wang Ying, Lu Ning, Wang Qian, Zhang Xiao-jun

机构信息

Department of Neurology, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China.

出版信息

Zhonghua Yan Ke Za Zhi. 2011 Dec;47(12):1076-9.

PMID:22336115

Abstract

OBJECTIVE

To compare the vascular risk factors between acute ischemic retinopathy (AIR) and nonarteritic anterior ischemic optic neuropathy (NAION).

METHODS

Single center retrospective study. Patients diagnosed of AIR and NAION from Jan 2008 to Jan 2009 in Beijing Tongren hospital were enrolled in this study. The demographical data, the results of blood tests, cardiac examinations, carotid vascular ultrasound and brain MRI were analyzed by Chi-square test.

RESULTS

Ninety-one AIR patients and 143 NAION patients were enrolled. The mean age of the NAION patients (51.4 ± 8.9) was lower than that of the AIR group (55.4 ± 15.8) (t = 2.514, P = 0.013). There was no significant difference in the gender, smoking status, hypertension and fasting blood glucose levels between these two groups (χ(2) = 0.023, 2.727, 0.217, 0.012; all P > 0.05). The percentage of hypercholesterolemia (total cholesterol > 5.17 mmol/L) was 46.2% (66/143) in the NAION group and 26.4% (24/91) in the AIR group (χ(2) = 9.193, P = 0.002). Prevalence of carotid artery disease and ischemic heart disease was 13.2% (12/91) in the AIR group and 4.9% (7/143) in the NAION group (χ(2) = 5.125, P = 0.024). Carotid artery stenosis was present in 34.5% (30/87) patients in the AIR group, whereas none in the NAION group (χ(2) = 44.370, P = 0.000). Among 57 AIR patients and 127 NAION patients who finished brain MRI, the percentage of cerebral infarction was 47.4% (27/57) in the AIR group and 0.8% (1/127) in the NAION group (χ(2) = 66.210, P = 0.000). Cerebral white matter hyperintensities (WMH) were present in 66.9% (85/127) of the NAION group and 36.8% (21/57) in the AIR group (χ(2) = 66.46, P = 0.000).

CONCLUSIONS

The mean age of NAION patients was lower than that of the AIR patients. Carotid artery stenosis and stroke, which might indicate large-middle vessel disease, are common in ischemic retinopathy. WMH with small vascular atherosclerosis, possibly caused by hypercholesterolemia, is more common in the NAION group.

摘要

目的

比较急性缺血性视网膜病变（AIR）与非动脉炎性前部缺血性视神经病变（NAION）之间的血管危险因素。

方法

单中心回顾性研究。纳入2008年1月至2009年1月在北京同仁医院诊断为AIR和NAION的患者。通过卡方检验分析人口统计学数据、血液检查结果、心脏检查、颈动脉血管超声和脑部MRI结果。

结果

纳入91例AIR患者和143例NAION患者。NAION患者的平均年龄（51.4±8.9）低于AIR组（55.4±15.8）（t=2.514，P=0.013）。两组在性别、吸烟状况、高血压和空腹血糖水平方面无显著差异（χ²=0.023、2.727、0.217、0.012；均P>0.05）。NAION组高胆固醇血症（总胆固醇>5.17 mmol/L）的比例为46.2%（66/143），AIR组为26.4%（24/91）（χ²=9.193，P=0.002）。AIR组颈动脉疾病和缺血性心脏病的患病率为13.2%（12/91），NAION组为4.9%（7/143）（χ²=5.125，P=0.024）。AIR组34.5%（30/87）的患者存在颈动脉狭窄，而NAION组无（χ²=44.370，P=0.000）。在完成脑部MRI的57例AIR患者和127例NAION患者中，AIR组脑梗死的比例为47.4%（27/57），NAION组为0.8%（1/127）（χ²=66.210，P=0.000）。NAION组66.9%（85/127）的患者存在脑白质高信号（WMH），AIR组为36.8%（21/57）（χ²=66.46，P=0.000）。