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使用光学相干断层扫描血管造影(OCTA)对有症状腔隙性脑梗死患者黄斑微血管变化的研究。

Study of Macular Microvascular Changes in Patients with Symptomatic Lacunar Cerebral Infarction Using Viaoptical Coherence Tomography Angiography (OCTA).

作者信息

Li Meishuang, Xi Huiyu, Guan Rongrong, Liu Yalu, Guan Lina, Zong Dandan, Wang Nuan, Liu Haiyang

机构信息

Department of Ophthalmology, Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University, Xuzhou, People's Republic of China.

Department of Ophthalmology, Lianyungang Eye Hospital, Lianyungang, People's Republic of China.

出版信息

Int J Gen Med. 2025 Sep 9;18:5243-5256. doi: 10.2147/IJGM.S534255. eCollection 2025.

Abstract

OBJECTIVE

To investigate retinal and choroidal vascular density (VD) changes in the macular region of patients with symptomatic lacunar cerebral infarction (LI) and assess whether these changes can predict symptomatic LI.

METHODS

This cross-sectional study included 49 symptomatic LI patients (49 eyes) and 51 healthy controls (51 eyes). OCTA was employed to measure retinal VD in the superficial capillary plexus (SCP) and deep capillary plexus (DCP), as well as the ganglion cell complex (GCC) thickness. Enhanced depth imaging optical coherence tomography (EDI-OCT) was utilized to calculate the choroidal vascular index (CVI).

RESULTS

Significant differences were observed in macular VD of the SCP and DCP, GCC thickness, and CVI, systolic pressure, diastolic pressure, between the symptomatic LI and control groups (p < 0.05). Binary logistic regression analysis indicated that lower VD in the SCP and DCP, along with reduced GCC thickness, elevated diastolic blood pressure, were significantly associated with symptomatic LI (OR < 1, p < 0.05). Receiver operating characteristic (ROC) curve analysis showed that the area under the curve (AUC) was higher for SCP total vessel density and GCC thickness, while the whole VD of SCP+GCC thickness had the highest area under the curve (AUC =0.880, sensitivity =87.80% and specificity =74.50%).

CONCLUSION

In patients with symptomatic LI, reductions in VD within the SCP and DCP, along with decreased GCC thickness and CVI, were observed. These diminished vascular densities in the SCP and reduced GCC thickness may serve as predictive markers for symptomatic LI.

摘要

目的

研究有症状腔隙性脑梗死(LI)患者黄斑区视网膜和脉络膜血管密度(VD)变化,并评估这些变化是否能预测有症状LI。

方法

本横断面研究纳入49例有症状LI患者(49只眼)和51名健康对照者(51只眼)。采用光学相干断层扫描血管造影(OCTA)测量浅表毛细血管丛(SCP)和深部毛细血管丛(DCP)的视网膜VD以及神经节细胞复合体(GCC)厚度。利用增强深度成像光学相干断层扫描(EDI-OCT)计算脉络膜血管指数(CVI)。

结果

有症状LI组与对照组在SCP和DCP的黄斑VD、GCC厚度、CVI、收缩压、舒张压方面存在显著差异(p<0.05)。二元逻辑回归分析表明,SCP和DCP中较低的VD、GCC厚度降低以及舒张压升高与有症状LI显著相关(OR<1,p<0.05)。受试者工作特征(ROC)曲线分析显示,SCP总血管密度和GCC厚度的曲线下面积(AUC)较高,而SCP+GCC厚度的整体VD曲线下面积最高(AUC=0.8×80,敏感度=87.80%,特异度=74.50%)。

结论

在有症状LI患者中,观察到SCP和DCP内的VD降低,以及GCC厚度和CVI降低。SCP中这些血管密度降低和GCC厚度减小可能作为有症状LI的预测标志物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0bc3/12433219/13f3813adf89/IJGM-18-5243-g0001.jpg

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