HRT-Ⅱ指标体系的分析及其在正常眼压青光眼的应用  

Analysis of HRT-Ⅱ stereometric parameters and the application to normal pressure glaucoma

作　　者：任泽钦[1] 乔荣华[1] 刘丽娜[1] 

机构地区：[1]北京大学第一医院眼科,北京100034

出　　处：《中国实用眼科杂志》2004年第10期783-787,共5页Chinese Journal of Practical Ophthalmology

摘　　要：目的　探讨正常眼压青光眼 (NPG)患者HRT -Ⅱ检查的临床特征 ,分析HRT -Ⅱ视乳头立体测量指标的变量分类、相互关系和临床病理意义 ,评价不同指标的诊断性能 ,简化指标体系。方法　对两组NPG患者 (5 3例 )和一组正常受试者 (2 2例 )进行HRT -Ⅱ检查 ,对HRT -Ⅱ推荐的盘沿面积 (RA )、盘沿容积 (RV )、视杯形状测度 (CSM )、轮廓线高度变异 (HVC)和视网膜神经纤维层平均厚度 (RNFLT)等 5项指标和本文提出的视杯容积指数 (CVI)及其有关的视杯容积 (CV )、视盘面积 (DA)和视杯平均深度 (MCD)等 4项指标进行分组间和指标间的比较 ,对指标体系及其正常范围做临床病理意义和正态分布理论的分析 ,对不同指标做诊断性能的评价。结果　NPG组在CSM、RA、RNFLT、RV、MCD、CV和CVI上与正常组间差异有显著性 (P <0 0 1,F =10 0 0～ 3 7 77) ,其中CSM、RA、RV、MCD和CVI的差异出现于早期患者组 (P <0 0 5 ,Q =3 5 0或P <0 0 1,Q =4 13～ 12 2 1)。各指标在变量关系上被分为基础变量和导出变量 ,在临床意义上除视盘面积可视作双侧指标外 ,其余指标均为单侧有意义指标 ,仪器提供的“正常范围”的显著性水平分别为 0 3 173和 0 15 86。CVI是一包含 5个变量的复合指标 ,其诊断性能仅次于CSM。结论　NPG患者在HRT -Objective To investigate the clinical characteristics of the stereometric parameters obtained with the HRT-Ⅱ from patients with normal pressure glaucoma(NPG) and normal controls.To analyze the variable interrelationships and the clinical implications,evaluate the diagnostic performance of the each parameter,and furthermore simplify the parameter system.Methods 51 patients with NPG and 22 normal controls were recruited in this case-control study.All subjects were examined with the HRT-Ⅱ.Five top parameters and cup volume index(CVI) as well as its relative parameters were compared,and a system of parameters and their “normal ranges”were evaluated through normal distribution and diagnostic test theories.Results The differences in CSM,RA,RNFLT,RV,MCD,CV and CVI were found between NPG patients and normal controls( P <0 01,F=10 00～37 77),but there occurred the differences in CSM,RA,RV,MCD and CVI in patients with early glaucomatous damage( P <0 05,Q=3 50 or P <0 01,Q=4 13～12 21).Furthermore,the areas under ROC curves were equal to 0 7823 for CSM,0.7764 for CVI,0.7486 for MCD,0.7019 for RA and 0.6950 for RV,respectvely,when the false negative rates were equalized to the false positive rates according to the diagnostic requirements.All the parameters listed in stereometric analysis ONH were re-grouped as basic and deduced based ont heir variabler interrelationships,and as one-sided except the DA as two-sided concerning to their clinical implications.CVI was a composite norm and contained 5 other variables.Its diagnostic performance was secondary only to CSM.Conclusions NPG had abnormal changes in several variables on the HRT-Ⅱ,and in patients with early glaucoma were only CSM,RA and RV of top five parameters recommended by the HRT-Ⅱ.The norm CVI and the variable classification advanced herein in this study could simplify the original parametric system.

关 键 词：HRT 诊断 RA 正常范围 正常眼 CSM 眼压 NPG 指标 面积 

分 类 号：R775[医药卫生—眼科] G633[医药卫生—临床医学]