目的：探讨心血管危险因素对非动脉炎性前部缺血性视神经病变(NAION)的发生及视功能的影响。

方法：选取2014-06/2018-06于我科就诊的单眼初发NAION患者(NAION组)和与其基本资料匹配的非NAION患者(对照组)各68例68眼，检测两组患者同型半胱氨酸(Hcy)、血脂、叶酸、维生素B₁₂水平，并进行颈动脉多普勒超声检查，NAION组患者同时进行视功能检查。

结果：与对照组相比，NAION组患者Hcy(24.8±13.9μmol/L vs 11.1±8.2μmol/L)、血浆中总胆固醇(4.5±1.0mmol/L vs 3.8±0.7mmol/L)、甘油三酯(2.0±0.9mmol/L vs 1.5±0.5mmol/L)、低密度脂蛋白(2.9±0.8mmol/L vs 2.3±0.5mmol/L)水平均升高(P<0.05)，维生素B₁₂水平明显下降(315.6±214.5pg/mL vs 467.9±198.2pg/mL，P<0.05)，但两组患者颈内动脉阻力指数和内径无差异。NAION组患者患眼视野缺损值为16.6±7.5dB，Hcy、维生素B₁₂、叶酸及血脂水平以及是否存在全身疾病均不是NAION视野损害的危险因素，而图形视觉诱发电位P₁₀₀波幅和潜伏期峰值均与视野缺损值相关。

结论：高同型半胱氨酸、高血脂和低维生素B₁₂水平是NAION发生的危险因素，但与NAION的视野损害程度无关； 视觉诱发电位的波幅和潜伏期峰值可一定程度上反映视野损害的程度。

METHODS: Sixty-eight patients diagnosed as initial ipsilateral NAION(68 eyes)in NAION group and another 68 patients(68 eyes)matched in age, gender and systemic diseases in Control group were selected from June 2014 to June 2016 were enrolled in this study and evaluated for their levels of homocysteine(Hcy), blood lipids, folic acid and vitamin B₁₂, as well as carotid Doppler ultrasonography. The visual functions were also examined in patients with NAION.

RESULTS: The levels of Hcy(24.8±13.9μmol/L), total plasma cholesterol(4.5±1.0mmol/L), triglyceride(2.0±0.9 mmol/L)and low-density lipoprotein(2.9±0.8mmol/L)in NAION patients were significantly higher(P<0.05)than those in Control group(11.1±8.2μmol/L, 3.8±0.7mmol/L, 1.5±0.5mmol/L and 2.3±0.5mmol/L)while the level of vitamin B₁₂ decreased significantly(315.6 ±214.5pg/mL, P<0.05)in NAION group in comparison with those(467.9±198.2pg/mL)in Control group. However, no significant differences in the artery resistance and inner diameter of the internal carotid were detected between the two groups. The mean deviation(MD)of the visual field was 16.6±7.5dB in NAION group. The levels of Hcy, vitamin B₁₂, folic acid and blood lipid and the presence of systemic diseases were not the risk factors for the visual field damage in NAION patients. MD value was associated with the amplitude and peak latency of P₁₀₀ waves.

CONCLUSION: Hyperhomocysteinemia, hyperlipidemia and low vitamin B₁₂ are the risk factors of in NAION patients. These risk factors, however, are not related to the extent of visual field damage. To some extent, the amplitude and peak latency of visual evoked potentials can reflect the extent of visual field damage.