青光眼患者动态轮廓眼压计眼压及眼脉动幅度昼夜波动趋势调查  

Diurnal variation curve of intraocular pressure and ocular pulse amplitude with dynamic contour tonometer in primary open-angle glaucoma and normal tension glaucoma patients

作　　者：贠洪敏[1] 傅培[1] 袁劲松[1] 张斌[1] 黎晓新[2] 

机构地区：[1]北京大学深圳医院眼科,518036 [2]北京大学人民医院眼科

出　　处：《中华医学杂志》2006年第48期3401-3404,共4页National Medical Journal of China

摘　　要：目的使用动态轮廓眼压计(DCT)研究原发性开角型青光眼(POAG)患者、正常眼压性青光眼(NTG)患者及正常人双眼眼压及眼脉动幅度(OPA)的昼夜波动趋势,并比较双眼的波动趋势是否一致。方法POAG患者18例,NTG患者17例及正常对照30名均来自于北京大学深圳医院眼科,使用DCT测量获得眼压及OPA波动的日曲线,统计3组OPA日波动幅度,比较3组的眼压、OPA的波动情况和差异,并观察双眼的日眼压、OPA波动模式及其峰值分布。结果POAG患者、NTG患者和正常对照的DCT眼压的波动模式不同,且部分个体的双眼眼压波动趋势不同。在所观察的65人中,眼压峰值出现于非办公时段的正常人为右眼4例(13·3%)、左眼6例(20·0%),NTG患者为右眼4例(23·5%)、左眼5例(29·4%),POAG患者为右眼5例(27·8%)、左眼4例(22·2%)。POAG患者、NTG患者和正常对照的OPA存在日波动,且波动模式不同,左右眼之间也有区别。OPA的波动幅度,正常人:右眼(1·1±0·5)mmHg(1mmHg=0·133kPa),左眼(1·2±0·5)mmHg;NTG患者:右眼(1·1±0·8)mmHg,左眼(1·0±0·5)mmHg;POAG患者:右眼(2·1±1·3)mmHg,左眼(2·4±1·9)mmHg,波动幅度差异有统计学意义。POAG患者表现出较大的OPA波动范围。结论POAG、NTG患者和正常人的OPA存在差异,OPA存在日波动,且不同的人群波动幅度有差异,POAG患者表现出更大的OPA日波动;POAG、NTG患者和正常人有着不同的眼压和OPA波动模式,且双眼的波动趋势不尽相同;办公时段多次眼压测量不能完全代替1d眼压监测。Objective To observe the diurnal variations of intraocular pressure （IOP） measured with dynamic contour tonometer （DCT） in primary open angle glaucoma （POAG） patients, normal tension glaucoma （NTG） patients, and healthy controls, and to compare the differences of diurnal variation curves between the two eyes of each subject and define the distribution of the peak of IOP ; to analyze the diurnal variation range of ocular pulse amplitude （OPA） and compare the differences among the POAG and NTG patients and healthy controls. Methods DCT was used to measure the diurnal variations of IOP and OPA in the two eyes of 18 POAG patients, 17 NTG patients and 30 normal controls at 5：00,7：00,10：00,14：00, 18：00,and 22：00 and the distribution of the peak IOP was observed. The range of the diurnal variation of OPA was identified. Results The diurnal variation curves of IOP were different among the POAG patients, NTG patients, and normal people, and also between the two eyes of each subject. Four right eyes（ 13.3% ） and 6 left eyes （20.0%）of the healthy controls, 4 right eyes（23.5% ） and 5 left eyes（29.4% ）of the NTG patients, and 5 right eyes（27.8% ） and 4 left eyes（22.2% ）of the POAG patients reached the peak IOP values in out-office period. Diurnal variation of OPA was detected in both the patients and controls, and the variation curves were different within different groups sampled and between the two eyes of each subject. The diurnal OPA range of the right and left eyes of the POAG group were （2.1 ± 1.3） mm Hg, and（2.4 ± 1.9） mm Hg respectively, significantly larger than those of the normal controls [ （ 1.1 ± 0.5） mm Hg and 1.2 ± 0. 5 ）mm Hg respectively ], and those of the NTG group [ （ 1.1 ± 0.8 ）mm Hg and （ 1.0 ± 0.5 ） mm Hg） respectively ] （all P 〈 0.01 ）. Conclusion OPA has diurnal variatiori. The diurnal variation of the POAG patients is the largest. NTG patients and normal controls have asymmetric IOP and OPA diurnal variations.

关 键 词：眼压测量法 青光眼 开角型 脉动流 日曲线 

分 类 号：R775[医药卫生—眼科]