| Objective1. Based on the incidence of hypertensive retinopathy and stroke in patients with hypertension, and the correlation between cerebral and ocular blood flow, explore the relationship between the degree of retinopathy and risk of stroke in hypertensive patients, and provide a theoretical way to predict or early detect intervene stroke.2. Classify the patients with stroke or hypertensive retinopathy, explore the relations between severity of disease and syndromes, analyze the pathological process of TCM and similarity of the two diseases. Provide a theoretical basis for the "treatment before onset" of stroke.3. Based on the correlation between brain blood flow and ocular blood flow in the hypertension patients with two kinds of complications of hypertensive retinopathy and ischemic stroke, investigate the common hemodynamic characteristics related to the hypertensive retinopathy and stroke.Method1. Cross-sectional study on incidence of stroke in patients with hypertensive retinopathy.According to the method of Cross-sectional study and diagnostic criteria of hypertensive retinopathy level II and above,300 patients are collected from three clinical centers and 100 cases for each, which excluding the ones with diabetes, hyperlipidemia and other complications. After asking the history of stroke, taking fundus color photos, measuring the diameter of retinal vessels, calculating ratio of retinal artery diameter/retinal vein diameter(AVR), and grading hypertensive retinopathy and retinal arteriosclerosis clinical stages, the TCM syndrome of the patients in accordance with hypertensive retinopathy is identified. And the correlation among risk of stroke and hypertensive retinopathy clinical classification, clinical grading of retinal arteriosclerosis, retinal vessel diameter and the TCM syndrome is studied.2. Correlation among the hemodynamic parameters of hypertensive retinopathy and ischemic stroke.120 patients with hypertensive retinopathy and ischemic stroke from inpatients in Wangjing hospital are collected. After taking fundus color photos, measuring the diameter of retinal vessels, calculating ratio of retinal artery diameter/retinal vein diameter, grading hypertensive retinopathy and retinal arteriosclerosis clinical stages, Identifing the TCM syndrome of the patients in accordance with hypertension, Measuring the blood flows of ophthalmic artery(OA), central retinal artery(CRA), anterior cerebral artery(ACA), middle cerebral artery(MCA), posterior cerebral artery (PCA), vertebral artery (VA) and basilar artery(BA). The correlation among ocular blood flow, brain blood flow and hypertensive retinopathy clinical classification, clinical grading of retinal arteriosclerosis is analyzed. The correlation among ocular blood flow, brain blood flow and retinal vessel diameter is analyzed. The correlation between ocular blood flow and brain blood flow is analyzed. The distribution of the TCM syndrome types of the patients is analyzed.Result1. In the cross-sectional study, test cycle was from January 1,2015 to January 31,2016. We collected 291 cases from three clinical centers.2. There were correlations between the incidence of stroke and clinical classification of hypertensive retinopathy and retinal arteriosclerosis clinical classification. The higher levels of retinopathy, the more incidences of stroke. With level III of retinopathy, the incidence of stroke (65.71%) is 3.56 times than the incidence (18.45%) with level II of retinopathy.3. Compared with non-stroke group, the stroke group has smaller retinal arteriolar diameter, smaller AVR and larger retinal vein diameter.4. There were correlations among the TCM syndrome types and incidence of stroke, the TCM syndrome types and clinical classification of hypertensive retinopathy. The blockage of phlegm syndrome was most likely to occur stroke and has the heaviest hypertensive retinopathy.5. In the study on correlation between hypertensive retinopathy and ischemic stroke, test cycle was from Januaryl,2015 to December 31,2015. 120 cases were collected at the end. The phlegm-dampness syndrome type was the majority, accounting for 50%, followed by the syndrome of deficiency of liver yin and hyperactivity of liver yang and the liver fire hyperactivity syndrome.6. Of the cerebral blood flow velocity between different levels of hypertensive retinopathy and retinal arteriosclerosis, the RI, PI,S/D make differences. With the aggravation of retinopathy, RI, PI and S/D all increased.7. There were positive correlation among the PI and RI of the blood flow parameters of ACA, MCA and OA.Conclusion1. Hypertensive retinopathy clinical classification can predict risk of stroke. The higher levels of retinopathy, the higher risk of stroke. With retinal bleeding or exdute, the incidence of stroke (65.71%) is 3.56 times than the incidence with purely Arteriovenous crossing sign (18.45%).2. There are correlations between the risk of stroke and retinal vascular morphology for the patients with hypertension. The patients with small retinal artery diameter, large retinal vein diameter, small AVR have the high risk of stroke occurrence. The risk of stroke will be very high when the AVR reduce to 0.5 for patients with hypertension.3. There are correlations between the TCM syndrome types of hypertensive retinopathy and incidence of stroke for the patients with hypertension. The blockage of phlegm syndrome most likely to occur stroke and have the heaviest hypertensive retinopathy.4. There are correlations between ocular blood flow and cerebral blood flow. RI and PI are the most sensitive indicator of the hemodynamic parameters that evaluating the influence of hypertension to the blood vessels of brain and eye. |
