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通过颈动脉双功扫描和超声心动图评估视网膜中央静脉阻塞患者的动脉粥样硬化:一项前瞻性病例对照研究。

Evaluation of atherosclerosis in patients with central retinal vein occlusion by carotid artery duplex scanning and echocardiography: a prospective case-control study.

作者信息

Rauh G, Fischereder M, Nasemann J, Müller M, Grüterich M, Spannagl M, Spengel F A

机构信息

Medizinische Poliklinik, Ludwig-Maximilians-Universität München, Germany.

出版信息

Eur J Med Res. 1996 Jun 25;1(9):429-32.

PMID:9353243
Abstract

BACKGROUND AND PURPOSE

Central retinal vein occlusion (CRVO) is a common cause of retinal vascular visual loss second to diabetic retinopathy. Atherosclerotic risk factors are thought to affect vascular flow or cause retinal vascular wall abnormalities, thereby contributing to development of CRVO. Previous studies did not fully evaluate the degree of atherosclerotic disease. The purpose of this study was to determine the degree of atherosclerosis of the carotid artery by duplex scanning and to investigate cardiac manifestations of atherosclerotic risk factors by echocardiography in patients with CRVO.

MATERIAL AND METHODS

39 patients (age 63.1 years [50-84 years], 21 men, 18 women) with CRVO were compared with a control group consisting of 39 individuals (age 59.3 years [49-81 years], 19 men, 20 women) in whom echocardiography was performed to rule out endocarditis. Clinical examination, laboratory testing, carotid artery duplex scanning and echocardiography were performed in all patients.

RESULTS

Echocardiography revealed significantly increased prevalence of left ventricular hypertrophy (30.8% in CRVO patients, 5.1% in controls) as a typical sign of hypertensive heart disease in CRVO patients, which is consistent with the increased prevalence of hypertension (HTN) (46.2% in CRVO patients, 15.4% in controls). The prevalence of atherosclerosis of carotid artery and ascending aorta, and all other echocardiographic findings were comparable in CRVO patients and controls: regional wall motion abnormality, left ventricular dilatation, aortic valve calcification, and mitral valve calcification.

CONCLUSION

Our study demonstrates that CRVO is not associated with atherosclerosis of large arteries, such as the carotid artery and the ascending aorta. We propose that the retinal artery atherosclerosis seen in most CRVO patients is caused by HTN.

摘要

背景与目的

视网膜中央静脉阻塞(CRVO)是仅次于糖尿病视网膜病变的导致视网膜血管性视力丧失的常见原因。动脉粥样硬化危险因素被认为会影响血管血流或导致视网膜血管壁异常,从而促使CRVO的发生。既往研究未充分评估动脉粥样硬化疾病的程度。本研究的目的是通过双功扫描确定CRVO患者颈动脉的动脉粥样硬化程度,并通过超声心动图研究动脉粥样硬化危险因素的心脏表现。

材料与方法

将39例CRVO患者(年龄63.1岁[50 - 84岁],男性21例,女性18例)与一个由39名个体组成的对照组(年龄59.3岁[49 - 81岁],男性19例,女性20例)进行比较,对照组进行超声心动图检查以排除心内膜炎。对所有患者进行临床检查、实验室检测、颈动脉双功扫描和超声心动图检查。

结果

超声心动图显示CRVO患者左心室肥厚的患病率显著增加(CRVO患者中为30.8%,对照组中为5.1%),这是CRVO患者高血压性心脏病的典型体征,这与高血压(HTN)患病率的增加一致(CRVO患者中为46.2%,对照组中为15.4%)。CRVO患者和对照组在颈动脉和升主动脉的动脉粥样硬化患病率以及所有其他超声心动图表现方面相当:节段性室壁运动异常、左心室扩张、主动脉瓣钙化和二尖瓣钙化。

结论

我们的研究表明,CRVO与颈动脉和升主动脉等大动脉的动脉粥样硬化无关。我们提出,大多数CRVO患者所见的视网膜动脉粥样硬化是由HTN引起的。

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