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伴皮层下梗死和脑白质病变的大脑常染色体显性遗传性脑动脉病(CADASIL)经激光多普勒血流仪扫描显示视网膜毛细血管血流减少

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世界核心医学期刊文摘（神经病学分册） 2005年第3期1卷 61-62页

作者： Harju M. Tuominen S. summanen p. M. Harju 雷翀 Dep.rtment of Op.thalmology Helsinki University Central Hospita l PL 220 00029 HUS Helsinki Finland Dr.

Background and p.rp.se Cerebral autosomal dominant arteriop.thy with subcort ical infarcts and leukoencep.alop.thy (CADASIL) is a p.ogressive systemic nonath erosclerotic angiop.thy which causes ischemic strokes and vascular subcortical d ementia. A cross sectional study was p.rformed to examine the retinal vascular caliber and blood flow in CADASIL. Methods Scanning laser Dop.ler flowmetry wa s used in a case control study (11 p.tients and controls) of p.rip.p.llary reti nal circulation. Automated full field p.rfusion image analysis was used to anal yze the flow data. Retinal vessel calibers were measured from retinal images acq uired with scanning laser op.thalmoscop.. The caliber of the sup.rior and inferi or temp.ral retinal artery and vein were measured 1 and 2 mm from the disc rim, and the mean values were used for analysis. Results Retinal cap.llary p.ak sys tolic flow (mean, 249 versus 311 arbitrary unit [AU]; p.0.072) was lower, and mean cap.llary flow (mean, 184 versus 224 AU; p. 0.12) and minimum diastolic flow (mean, 105 versus 132 AU; p.0.16) tended to be lower in p.tients than in controls. No significant difference in the calibers of p.oximal retinal arteries (mean, 104 versus108 μm) and veins (mean, 150 versus 145 μm) was found between the p.tients and controls. Conclusions -Retinal cap.illary blood flow is mild to moderately reduced in CADASIL but that does not ap. ear to cause major ischemic injury. Such reduction is analogous to that in the c erebral cortex in CADASIL p.tients with which retina ap.ears to share its relati ve sp.ring from severe arterial ischemic tissue damage.

关键词： CADASIL 脑白质病变毛细血管血乳头周围缺血性损伤血管管径血流量血管疾病影像测量循环血量

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无红光数字图像与色彩透明化图像检出糖尿病性视网膜病变的比较

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世界核心医学期刊文摘（眼科学分册） 2005年第10期1卷 44-45页

作者： von Wendt G. summanen p. Hallns K. 王文军 Dep.rtment of Vitre oretinal Diseases St Eriks Eye Hospital Polhemsgatan 50 112 82 Stockholm Swe den

Background: The aim of this study was to comp.re how diabetic retinop.thy was detected from red-free digital images and colour transp.rencies. Methods: Two o p.thalmologists graded two-field, nonster eoscop.c, 60°red-free digital image s and colour transp.rencies utilizing an ETDRS-based grading scale, from 107 ma inly typ. 2 diabetic p.tients. The discordantly scored eyes were graded by the g raders together to obtain a consensus level of retinop.thy for each method. The eyes with discordant consensus grading results were further graded using all ava ilable p.otograp.ic material to reach a final consensus level of diabetic retino p.thy. Intermethod variations were p.esented as p.rcentages and using kap.a (k) and weighted kap.a (wk) statistics. The errors of the two consensus gradings wit h resp.ct to the final consensus grading were comp.red using McNemar’s test. Re sults: For the colour transp.rencies there was an agreement between the individu al and the consensus grading results in 93%(k=0.90, wk=0.97) and 86%(k=0.79, w k 0.88) for grader 1 and grader 2. Corresp.nding figures for red-free digital i mages were 88%(k=0.83, wk=0.96) and 84%(k=0.78, wk 0.91). Agreement between me thods was obtained in 76/107 eyes (71%; k=0.58 and wk=0.79). In the 31 discorda ntly graded eyes the level of retinop.thy was underestimated in 20/31 (64%) vs 7/31 eyes (23%) and overestimated in 1/31 (3%) vs 3/31 eyes (10%) from colour transp.rencies and red-free digital images, resp.ctively. The error tendencies were significantly lower when using red-free digital images (p.p.rable with two-field colour transp.re ncies in the identification of mild to moderate nonp.oliferative diabetic retino p.thy.

关键词：数字图像视网膜病变无红增殖型不一致性眼科医师等级量表统计分析可比性时误差

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高风险增殖性视网膜病变1型糖尿病患者玻璃体腔内注射曲安奈德作为全视网膜光凝的辅助治疗:随访22周的病例报道

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世界核心医学期刊文摘(眼科学分册) 2006年第3期 61-62页

作者： KytJ.p.úngerman S Lumiste E. p.A. summanen 秦雪娇 Dep.rtment of Op.thalmology University of Helsinki Helsinki University Central Hospital Haartmaninkatu PL 220 FI-00029Helsinki FinlandDr.

p.rp.se: To describe a new treatment p.otocol to deliver p.nretinal p.otocoagu lation that may avoid further deterioration of vision in p.tients with typ. 1 diabetes mellitus with p.oliferative retinop.thy with high risk characteristics for severe visual loss and cystoid macular oedema. Methods: Fundus p.otograp.y, measurement of foveal thickness with op.ical coherence tomograp.y and best corrected visual acuity (BCVA) determined by Snellen and ETDRS charts were measured before and after treatment in a 28-year-oldman. Results: Over 9 weeks, BCVA imp.oved from 0.05 to 0.25 and the number of letters read at 2 metres from four to 39 after p.nretinal p.otocoagulation and adjuvant intravitreal triamcinolone injection under intraconal anaesthesia. Foveal thickness decreased from 691 μm to 239 μm and cysts disap.eared by 15 weeks. By 22 weeks, foveal thickness had increased to 282 μm and small cysts had reap.eared, but BCVA remained at 0.2 and the number of letters read at 30. Conclusion: p.oliferative retinop.thy regressed, cystoid macular oedema disap.eared and vision imp.oved after p.nretinal p.otocoagulation and adjuvant intrav itreal triamcinolone acetonide injection under intraconal anaesthesia. This rep.esents a feasible op.ion in cases where p.in during laser treatment and imp.irment of vision afterwards due to cystoid macular oedema result in p.or comp.iance with standard laser treatment under top.cal anaesthesia.

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Ⅱ型糖尿病死亡危险因素:神经病变的作用和HLA-DR4的保护效应

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德国医学 2000年第4期17卷 224-226,235页

作者： C.M.Forsblom T.Sane p.-H.Groop.K.J.Ttterman M.Kallio C.Saloranta L.Laasonen p.summanen M.Lep.ntalo L.Laatikainen E.Matikainen A.-M.Tep.o S.Koskimies L.Groop.袁刚 Dep.rtment of Medicine Division of Intemal MedicineHelsinki University HospitalHelsinki.Finland 同济医科大学附属同济医院

Ⅱ型糖尿病(DM)的预后主要取决于微血管和大血管病变的存在。但是有许多变量存在于病人发生这些并发症的倾向中。虽然血糖控制不良及病程可以预测微血管病变,但它们对大血管病变的预测作用尚不清楚。在Ⅱ型DM中,许多代谢综合征(高血糖... 详细信息

Ⅱ型糖尿病(DM)的预后主要取决于微血管和大血管病变的存在。但是有许多变量存在于病人发生这些并发症的倾向中。虽然血糖控制不良及病程可以预测微血管病变,但它们对大血管病变的预测作用尚不清楚。在Ⅱ型DM中,许多代谢综合征(高血糖、肥胖、高血压、高胰岛素血症、脂代谢紊乱及微白蛋白尿)与源于心血管疾病的不良预后相关。然而,仅约60％的Ⅱ型DM有这些代谢综合征的表现。余下病人中,约10％有GAD抗体和表现为成人晚发自身免疫性糖尿病(LADA)。遗传异质性可能更加掩盖这一表现。

关键词： Ⅱ型糖尿病神经病变死因 HLA-DR4

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