动态轮廓眼压计的临床应用  

Clinical assessment of dynamic contour tonometer

作　　者：施维[1] 钟勇[1] 董方[1] 田许鹏[1] 王韧琰[1] 

机构地区：[1]中国医学科学院北京协和医院眼科,100730

出　　处：《中华眼科杂志》2008年第5期408-412,共5页Chinese Journal of Ophthalmology

摘　　要：目的 探讨动态轮廓眼压计（DCT）在原发性开角型青光眼（POAG）、高眼压症（OHT）、正常眼压性青光眼（NTG）及正常对照人群眼压和眼压脉动振幅（OPA）测量中的临床应用价值及影响因素。方法 选取POAG、OHT、NTG及正常对照组各30例，分别采用Goldmann压平眼压计（GAT）测量眼压，DCT测量眼压及OPA，并测量中央角膜厚度（CCT）、中央角膜曲率（CCV）以及心率、收缩压、舒张压等指标，以了解这些指标对OPA的影响。各组统计量两两比较采用q检验。各统计量之间的相关分析采用Pearson相关分析，对于多个变量之间的线性关系采用多重线性回归分析。结果 DCT测量POAG、OHT、NTG及对照组的眼压值分别为（21．68±2．02）、（23．37±2．65）、（18．43±3．08）、（17．04±2．07）mmHg（1mmHg=0．133kPa）；GAT测量的眼压值分别为（21．18±2．95）、（23．28±5．95）、（16．39±3．60）、（14．66±2．27）mmHg。两者测量结果的差异无统计学意义（t=1．338，1．445，1．682，1．803；P=0．197，0．151，0．136，0．081）。POAG、OHT、NTG及对照组的OPA值分别为3．03±1．13，3．53±1．43，2．21±O．55，2．87±O．60，组间比较差异有统计学意义（F=21．311，P=0．000）；OPA值与心率、收缩压、舒张压、GAT测量值、CCT均相关，与年龄无明显相关性。结论 DCT测量结果与GAT有良好的一致性，受干扰因素少，可信度高；POAG、NTG、OHT患者和正常人的OPA存在差异，其中NCT患者OPA值明显较低，提示各组间眼内血液动力学状况的差异，OPA可能对青光眼的诊断及治疗具有一定的潜在价值。Objective To assess the applicabihty and reliability of Dynamic Contour Tonometry （DCT） in the measurement of intraocular pressure （IOP） and ocular pulse amplitude（OPA） in patients with primary open-angle glaucoma（ POAG）, ocular hypertension（OHT）, normal tension glaucoma （NTG） and normal controls. Methods 120 subjects were included in the present study as follows： 30 patients in each group, total four groups, i. e. , POAG, OHT, NTG and normal control, lOP measured by DCT was compared to that by Goldmann applanation tonometry （GAT）. OPA, central cornea thickness （CCT）, central cornea curve （CCV）, heart rate （HR）, systolic blood pressure （SBP） and diastolic blood pressure （DBP）, other associated parameters, were also determined for the subjects of each group. Results The lOP of all groups measured byDCTwas （21.68±2.02）,（23.37±2.65）,（18.43 ±3.08）,（17.04±2.07） mm Hg （ 1 mm Hg =0. 133 kPa） ;and the lOP measured by GAT was （21.18±2.95）, （23.28±5.95）, （ 16. 39 ±3.60）, （ 14. 66±2. 27） mm Hg, there was no significant differences between the lOP measured by these two methods （ t = 1. 338,1. 445,1. 682,1. 803 ;P = 0. 197,0. 151,0. 136, 0. 081 ）. Significant differences of OPA levels in different groups were observed （F =21. 311, P =0. 000）. OPA reading was affected by HR,SBP, DBP ,lOP and CCT, while there was no correlation with patients＇ age. Conclusions Regarding to the lOP measurement, DCT was in concord with GAT readings. The differences in OPA among POAG , OHT and the normal groups and the lowest OPA reading in NTG patients indicate different intraocular hemodynamic status among these groups. OPA measurement may be useful to early detection and progression follow-up of glaucoma patients.

关 键 词：眼压测量法 诊断设备 眼内压 血液动力学现象 

分 类 号：R686[医药卫生—骨科学]