Huang K K, Huang S, Yun W W, Zhang Z X, Jia Y W, Zhang M
Department of Neurology, Changzhou Second People's Hospital Affiliated to Nanjing Medical University,Changzhou 213004, China.
Department of Ophthalmology, Changzhou Second People's Hospital Affiliated to Nanjing Medical University, Changzhou 213004, China.
Zhonghua Yi Xue Za Zhi. 2021 Jan 5;101(1):62-67. doi: 10.3760/cma.j.cn112137-20200405-01088.
To explore the relationship between the total cerebral small vessel disease (CSVD) score and retinal vessel diameters in patients with mild stroke. The patients with mild stroke who were hospitalized in the Second People's Hospital of Changzhou, Nanjing Medical University from March to December 2019 were continuously collected (National Institutes of Health Stroke Scale score≤3 points). All patients completed the head magnetic resonance imaging and retinal fundus photography examination, and then the retinal arteriovenous diameter was measured semi-automatically based on the pictures. According to the total CSVD score (0-4 points), the patients were divided into 5 groups. The baseline characteristics of the patients were compared. Moreover, the correlation of total CSVD with retinal blood vessel diameters were analyzed by spearman and linear regression. A total of 206 patients were enrolled. There were 69, 51, 41, 30, and 15 patients with 0, 1, 2, 3, and 4 points, respectively. In CSVD subgroups, there were significant differences in age, duration of hypertension and diabetes (all 0.05). The central retinal artery equivalent (CRAE), (CSVD scores 0-4 were (126±12) μm, (118±11) μm, (108±11) μm, (99±8) μm, (90±7) μm, <0.001) and arteriole-to-venule ratio (AVR) (CSVD scores 0-4 were 0.65±0.05, 0.60±0.04, 0.56±0.04, 0.49±0.03, 0.44±0.02, <0.001) were different in CSVD subgroups. With the increase of CSVD score, the diameter of artery and AVR became smaller. The total CSVD was significantly correlated with AVR by Spearman correlation analysis (= 0.818, <0.001). By constructing a linear regression equation model, the coefficient of determination of the total CSVD score (=0.694) was higher than that of lacunes, white matter hyperintensities, cerebral microbleeds and enlarged perivascular space. After adjusting for age, course of hypertension and diabetes, and different types of CSVD, further multiple linear regression analysis revealed that the total CSVD score was still an independent related factor of AVR (β=-0.039, <0.001, 95%=-0.051--0.028). Total CSVD score is negatively correlated with retinal artery diameters and AVR. Additionally, the total CSVD score can better reflect the degree of cerebral microvascular lesions than single type CSVD.
探讨轻度卒中患者全脑小血管病（CSVD）评分与视网膜血管直径之间的关系。连续收集2019年3月至12月在南京医科大学附属常州第二人民医院住院的轻度卒中患者（美国国立卫生研究院卒中量表评分≤3分）。所有患者均完成头部磁共振成像和视网膜眼底摄影检查，然后根据图像半自动测量视网膜动静脉直径。根据CSVD总分（0 - 4分）将患者分为5组。比较患者的基线特征。此外，采用Spearman法和线性回归分析CSVD总分与视网膜血管直径的相关性。共纳入206例患者，CSVD评分为0分、1分、2分、3分和4分的患者分别有69例、51例、41例、30例和15例。在CSVD亚组中，年龄、高血压病程和糖尿病病程存在显著差异（均P<0.05）。视网膜中央动脉等效直径（CRAE）在CSVD评分为0 - 4分时分别为（126±12）μm、（118±11）μm、（108±11）μm、（99±8）μm、（90±7）μm（P<0.001），动静脉比（AVR）在CSVD评分为0 - 4分时分别为0.65±0.05、0.60±0.04、0.56±0.04、0.49±0.03、0.44±0.02（P<0.001），在CSVD亚组中不同。随着CSVD评分增加，动脉直径和AVR变小。Spearman相关性分析显示CSVD总分与AVR显著相关（r = 0.818，P<0.001）。通过构建线性回归方程模型，CSVD总分的决定系数（R²=0.694）高于腔隙灶、白质高信号、脑微出血和血管周围间隙增宽。在调整年龄、高血压病程、糖尿病病程及不同类型CSVD后，进一步多元线性回归分析显示CSVD总分仍是AVR的独立相关因素（β=-0.039，P<0.001，95%CI=-0.051--0.028）。CSVD总分与视网膜动脉直径和AVR呈负相关。此外，CSVD总分比单一类型的CSVD能更好地反映脑微血管病变程度。
