| Objective:Explore the retinal blood vessels and blood oxygen characteristics of blood stasis syndrome,and provide directions for establishing a dynamic,quantitative and objective evaluation index system of blood stasis syndrome based on retinal information.Methods:1.Establish rhesus monkey drug-induced blood stasis syndrome model by injecting 10% high-molecular dextran solvent into the cubital vein,and characterize it with rhesus monkeys such as tongue,lip color,eyeball,fur,and animal behavior,hemorheology,coagulation,blood routine and other indicators to evaluate the blood stasis syndrome model.2.Use Oxymap to collect fundus image information of retinal blood vessels and blood oxygen in the fundus of blood stasis syndrome group and control group,and study the correlation between retinal information and hemorheology,coagulation and other indicators,and establish an evaluation index system for blood stasis syndrome based on retinal information.3.Taking healthy subjects as controls,patients with retinal vein occlusion due to qi stagnation and blood stasis syndrome,and patients with essential hypertension as the research object,the syndrome factors such as tongue quality and pulse,blood rheology,coagulation and other index systems were used to study the characteristics of retinal information such as retinal blood vessels and blood oxygen in patients with stagnation of blood stasis syndrome,and provided a direction for the objectivization of TCM syndromes.Results:1.Establishment and evaluation of rhesus monkey blood stasis model:(1)The scores of the TCM Syndrome Evaluation Scale based on the four diagnostic information showed that the blood stasis group's tongue image score andear blood vessel status score,fur status score,lip color score,and eye status score all increased.In the blood stasis group,slackness in reaction activity,slightly darker lips,dry hair,increased blood vessels in the ear margins,and changes in fecal properties.(2)As far as the blood stasis syndrome model is concerned,compared with the control group,the whole blood reduced viscosity(low-cut),whole blood reduced viscosity(medium-cut),and blood rheology increased(P<0.05),whole blood reduced viscosity(high-cut),red blood cell rigidity index increased significantly(P<0.01)in blood stasis group.The blood viscosity,whole blood viscosity,whole blood reduced viscosity,hematocrit,and red blood cell rigidity index of the blood stasis group were increased(P<0.05),and the red blood cell deformation index was decreased(P<0.05)after modeling in blood stasis group.The systematic cluster analysis method found that the samples in the blood stasis group after modeling were significantly different from other samples(P<0.01),which further verified the successful modeling of the rhesus monkey blood stasis model.The average hemoglobin content,average hemoglobin concentration,and nucleated red blood cell count in the blood stasis group increased(P<0.05),and the average platelet volume,platelet distribution width,and hematocrit after modeling in the blood stasis group increased(P<0.05).This further supported the successful modeling of the blood stasis model.2.Research on characteristics of retinal image information of rhesus monkey fundus based on blood stasis syndrome:(1)Blood stasis syndrome rhesus monkey retinal blood oxygen characteristic study found that blood stasis syndrome group rhesus monkey arterial blood oxygen content was(84.23±18.46)%,venous blood oxygen content was(72.30±11.84)%;control group rhesus monkey arterial blood oxygen content was(96.57±15.41)%,the venous blood oxygen content was(67.23 ± 7.23)%,and the blood oxygen saturation content of rhesus retinal veins in the blood stasis syndrome group increased,and the difference was statistically significant(P<0.05).In the blood stasis syndromegroup,the content of retinal vein oxygen saturation(72.30±11.84)% after modeling was higher than that before modeling(59.46±7.52)%(P<0.01).Compared with the control group's lower main vein oxygen saturation content(66.35±7.42)% and the blood oxygen saturation content of the upper main vein(68.11±7.25)%,the blood oxygen saturation content of the lower main vein of rhesus monkeys in the blood stasis group was(64.73±11.77)%,and the blood saturation content of the upper main vein was(79.27 ± 6.78)%,both quadrants increased(P<0.05).In the blood stasis group,the blood oxygen saturation content of the upper main vein(79.27±6.78)%was significantly higher than that before(60.76±5.36)%(P<0.01),but the difference in the remaining quadrants was not obvious.The blood stasis syndrome rhesus monkey retinal vascular characteristics study found that the blood stasis group rhesus monkey overall retinal artery diameter is(128.56 ± 29.31)? m,the venous diameter diameter is(191.79 ± 35.42)? m;the control group rhesus monkey overall retinal artery diameter was(117.04±20.64)?m,and the mean venous diameter was(189.79±25.09)?m.Compared with the control group,the diameter of the whole retinal artery and the diameter of the retinal vein in rhesus monkeys in the blood stasis group were increased(P<0.05).In the blood stasis group,the diameter of the whole retinal artery increased after modeling(P<0.05).The difference between the quadrants was not significant(P>0.05).The characteristics of the retinal arteriovenous diameter ratio showed that the mean diameter of the retinal superior nasal artery diameter / upper main vein diameter of the macaque monkeys in the blood stasis group was(0.84±0.33);in the control group was(0.61±0.16),the difference was statistically significant(P<0.05).In the blood stasis group,the diameter of the superior temporal artery / superior main vein diameter(0.65±0.10)and the diameter of the superior nasal artery / superior main vein diameter(0.61±0.08)were higher than before(P<0.05).(2)Analysis of the correlation between retinal indexes and blood indexes based on blood stasis syndrome suggests that retinal arterial oxygen saturation is related towhole blood viscosity(mid-cut)(high-cut),whole blood reduced viscosity(mid-cut)(high-cut),erythrocyte rigidity(P<0.05)and the average red blood cell volume(P<0.01).The retinal vein blood oxygen saturation is correlated with the number of red blood cells,and the hemoglobin content is positively correlated(P<0.05).The diameter of retinal vein vessels is correlated with whole blood viscosity(medium-cut),whole blood reduced viscosity(low-cut),and red blood cell electrophoresis index(P<0.05).3.Research on the characteristics of fundus retinal image information in patients with qi stagnation and blood stasis syndrome:(1)Qi stagnation and blood stasis syndrome RVO group and EH group according to the disease location,etiology,disease status and information of the four diagnosis groups showed that the disease position of RVO group is mainly in liver and spleen,the disease position of EH group is mainly in liver and meridian,except the main clinical manifestations of each disease are different,both of which have red tongue with petechiae(79%,83%),upset(91%,90%),chest flank or breast pain(70%,86%),fine pulse and late(61%,60%),and the proportion of these certificates is high,which is consistent with the characteristics of this syndrome.(2)As for the biochemical indicators of blood stasis syndrome,compared with the normal group,the blood rheology erythrocyte aggregation index of the RVO group and the EH group of Qi stagnation and blood stasis syndrome increased(P<0.01).The total cholesterol,low-density lipoprotein and triglyceride in the RVO group of qi stagnation and blood stasis syndrome were significantly higher(P<0.05),and the total cholesterol,low-density lipoprotein and high-density lipoprotein in the EH group of qi stagnation and blood stasis syndrome were significantly increased(P<0.01),triglycerides increased(P<0.05).The coagulation indexes of the RVO group,EH group of Qi stagnation and blood stasis and normal group showed that the measurement of thrombin time in the RVO group was relatively longer than that of the normal group(P<0.05).(3)Retinal information characteristics of Qi stagnation and blood stasis syndrome showed that the retinal artery oxygen saturation content was(87.73 ± 21.35)%,venous blood oxygen saturation content was(62.91 ± 18.92)%,arteriovenous difference was(24.81 ± 25.41)% in RVO group;retinal artery oxygen saturation content is(86.83 ± 10.44)%,venous blood oxygen saturation content is(68.81 ±11.13)%,arteriovenous difference was(18.02±25.41)% in normal group;the retinal arterial oxygen saturation content in the EH group of Qi stagnation and blood stasis syndrome was(92.39±13.03)%,the venous oxygen saturation content was(72.15±10.61)%,and the arteriovenous difference was(20.24±16.05)%.Compared with the normal group,the retinal arterial oxygen saturation content of the RVO group of Qi stagnation and blood stasis syndrome increased slightly,the vein slightly decreased,and the arteriovenous difference increased(P<0.01).In the EH group of Qi stagnation and blood stasis syndrome,the retinal artery oxygen saturation content increased(P<0.05).Compared with the EH group,the difference in overall retinal arterial oxygen saturation,venous oxygen saturation,and arteriovenous oxygen saturation was significantly statistically significant in the RVO group(P<0.01).The characteristics of retinal arterial and venous oxygen saturation in different quadrants of RVO group and EH group of Qi stagnation and blood stasis syndrome showed that compared with the normal group,the oxygen saturation content of subnasal retinal artery and the oxygen saturation content of superior temporal vein in RVO group was significance(P<0.05),the oxygen saturation of supratemporal artery was increased(P<0.01),the oxygen saturation of supratemporal artery in EH group was increased(P<0.05).Compared with EH group,the content of oxygen saturation in the upper vein was lower(P<0.05),and the content of oxygen saturation in the superior temporal retinal vein was lower(P<0.01).The retinal vessel diameter characteristics of the RVO group and the EH group of Qi stagnation and blood stasis syndrome showed that the average retinal artery diameter of the RVO group in the Qi stagnation and blood stasis syndrome was(108.17±24.47)?m,and the average venous vessel diameter was(155.19±32.17)?m;the average retinal artery diameter of the normal group was(130.95±110.35)?m,and the average venous diameter was(159.40±24.30)?m;the average retinal artery diameter of the EH group was(113.17±22.14)?m,the mean value of venous vessel diameter is(158.73 ± 25.91)? m.Compared with the normal group,the venous diameter value of the RVO group was increased(P<0.05).The retinal arteriovenous vessel diameter characteristics in different quadrants of RVO group and EH group showed that,compared with the normal group,the diameter of the superior nasal artery(111.09±16.56)?m,the diameter of the superior nasal vein(155.42±31.20)?m,the diameter of the inferior nasal vein(152.76±31.81)?m in the RVO group was decreased(P<0.05),the diameter of the superior retinal nasal artery(112.93±20.17)? m,the diameter of the subretinal nasal artery(110.40 ± 26.62)? m,the diameter of the inferior nasal vein(154.63 ± 22.94)? m in the EH group was increased(P<0.01).Compared with the EH group,the diameter of the superior retinal temporal artery was statistically significant(P<0.05),and the diameter of the subretinal nasal artery was statistically significant(P<0.01).The characteristics of the diameter ratio of retinal arteriovenous veins in RVO and EH groups of Qi stagnation and blood stasis syndrome showed that compared with the normal group,the diameter ratio of superior temporal arteriovenous veins in RVO group decreased(P<0.05),and the diameter ratio of supra-nasal arteriovenous veins increased(P<0.01),the diameter ratio of supra-nasal arteriovenous tubes in EH group decreased(P<0.05),and the diameter-diameter ratio of subnasal arteriovenous tubes decreased(P<0.01).Compared with the EH group,the diameter ratio of the superior temporal arteriovenous tube in the RVO group was statistically significant(P<0.01).(4)Correlation analysis of retinal indexes and blood indexes based on blood stasis syndrome showed that Sat-A in the EH group was correlated with whole blood viscosity(low-cut)(mid-cut),plasma viscosity(P<0.05),which has a significant correlation with whole blood viscosity(high-cut)(P<0.01).The RVO group Sat-Vwas correlated with whole blood reduced viscosity(high-cut),erythrocyte rigidity index,erythrocyte deformation index,Fib(P<0.05),and significantly correlated with hemorheology(P<0.01),EH group Sat-V was correlated with whole blood viscosity(high-cut),CHOL,and Glu(P<0.05),and it was significantly correlated with whole blood viscosity(low-cut)(medium-cut)and LDL-C(P<0.01).Correlation analysis of retinal arterial vascular diameter index and blood index showed that Diam-A in RVO group was related to reduced blood viscosity(low-cut)and Fib(P<0.05),and Diam-A and whole blood viscosity in EH group(mid-cut)(high-cut)had significant correlation(P<0.01),and Diam-A in EH group had correlation with PT-SEC and APTT(P<0.05).Correlation analysis of retinal vein vessel diameter index and blood index showed that Diam-V in RVO group was related to reduced blood viscosity(low-cut)in whole blood(P<0.05).and the diameter of retinal vein in EH group of Qi stagnation and blood stasis syndrome was correlated with erythrocyte sedimentation rate and blood rheology(P<0.05).Correlation analysis between retinal arteriovenous tube diameter ratio and blood index showed that Diam-A/Diam-V in EH group was correlated with whole blood viscosity(high-cut),whole blood reduced viscosity(high-cut),TG(P<0.05),and has a significant correlation with prothrombin time(P<0.01).Conclusion:1.Intravenous injection of 10% polymer dextran solvent can cause signs of reactionary fatigue,slightly dark lips,and increased blood vessels in the ear margins of rhesus monkeys,as well as red blood cell agglutination,red blood cell count,hemoglobin content,hematocrit and other hemorheological indicators.The change is consistent with the characteristics of blood stasis syndrome in traditional Chinese medicine,and the blood stasis syndrome model is successfully modeled.2.The change of retinal oxygen saturation in rhesus monkeys in the blood stasis group is mainly reflected in the retinal vein oxygen saturation.The drug-engraved animal blood stasis model in a short period of time cannot cause changes in thediameter of each quadrant.3.Compared with the normal group,the blood oxygen saturation of retinal arteries in the RVO group and EH group of Qi stagnation and blood stasis syndrome were increased,and the increase in the upper temporal quadrant was the most significant;the overall venous diameter of the RVO group increased,but there was no significant difference in the overall arteriovenous caliber value in the EH group,and the arteriovenous caliber diameter ratio decreased.4.Under blood stasis syndrome,retinal blood oxygen saturation and caliber are correlated with multiple indexes of blood rheology.5.A new system of blood stasis syndrome evaluation based on dynamic,quantified and objective retinal blood vessels and blood oxygen characteristics was initially established to provide a reference for further research on blood stasis syndrome evaluation system. |
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