肺動脈高壓( pulmonary artery hypertension, PAH) 是右心衰竭的首要原因, 而右心衰竭又是 PAH 患者的重要致命因素, 及時而準確地對肺動脈高壓患者的右心室功能做出評價, 對其病情評估、治療決策和預后判斷有重要的意義。近年來新發展的超聲心動圖二維應變及應變率技術、實時三維成像技術、Tei 指數及三尖瓣環收縮期位移等新技術彌補了傳統超聲評價右心功能的不足。本文就超聲新技術在評價PAH 患者右心功能的應用做一綜述。
Objective To observe the effect of laser-Doppler retinal blood flowmeter in diabetic retinopathy. Methods The blood flow volume (VOL), the blood flow velocity (FLW) and the erythrocyte flow velocity (VEL) of peri-papillary retina were measured with the non-invasive Heidelberg Retinal Flowmeter (HRF) in 108 patients (216 eyes) with diabetes and 32 patients (64 eyes) in normal control group. The patients with diabetes were divided into non-diabetic retinopathy (NDR) group (27 patients, 54 eyes) and non-proliferative diabetic retinopathy (NPDR) group (81 patients, 162 eyes). NPDR group were subdivided into 3 groups: 26 patients (52 eyes) in mild group, 24 patients (48 eyes) in moderate group, and 31 patients (62 eyes) in severe group. The foveal avascular zone area (FAZ) was measured by fundus flourescein angiography (FFA) in patients with diabetes and some in the control group. The data in each group were statistically analyzed. Results The parameter of retinal blood flow of temporal and nasal peri-papillary retina in NDR and NPDR group was significantly lower than that in the control group (Plt;0.05). With the degree of retinopathy becoming more severe, the FLW and VEL of temporal and nasal peri-papillary retina in NDR and mild NPDR group presented ascending tendency, reached the peak in moderate NPDR group, and then decreased. The change tendency of the FLW was more obviously. The VOL of temporal and nasal peri-papillary retina in moderate NPDR group was obviously higher than that in the other groups (Plt;0.01).The FLW and the VEL of temporal and nasal peri-papillary retina in moderate NPDR group were significantly higher than that in mild NPDR and NDR group (Plt;0.01). The FLW and the VEL of temporal peri-papillary retina in severe NPDR group were obviously higher than that in NDR group (Plt;0.01). Blood sugar value positively correlated with degree of diabetic retinopathy (r=0.172，P=0.046). The FLW and the VEL of temporal peri-papillary retina positively correlated with FAZ area in patients with diabetes (r=0.268, P=0.000；r=0.275, P=0.000). The FAZ area positively correlated with the degree of macular degeneration in patients with diabetes (r=0.559, P=0.000). Conclusion As a non-invasive method for measurement of retinal blood flow, HRF has important value in revealing the mechanism and degree of pathological changes and choice of treatment for diabetic retinopathy. (Chin J Ocul Fundus Dis,2007,23:256-259)