动态轮廓眼压计在非动脉炎性前部缺血性视神经病变患者中的应用  

Dynamic contour tonometer for patients with nonarteritic anterior ischemic optic neuropathy

作　　者：王韧琰[1] 钟勇[1] 董方田[1] 施维[2] 

机构地区：[1]北京协和医学院,北京协和医院眼科,北京市100730 [2]首都医科大学附属北京同仁医院眼科中心,北京市100730

出　　处：《眼科新进展》2010年第1期81-84,共4页Recent Advances in Ophthalmology

摘　　要：目的探讨动态轮廓眼压计(dynamic contour tonometer,DCT)在非动脉炎性前部缺血性视神经病变(nonarteritic anterior ischemic optic neuropathy,NAION)及正常对照人群眼脉动振幅(ocular pulse amplitude,OPA)测量中的临床应用价值及影响因素。方法选取NAION和正常对照组各40眼,分别用Goldmann压平眼压计(Goldmann applanation tonometer,GAT)测量眼压(intraocular pressure,IOP)、DCT测量IOP及OPA值,并测量中央角膜厚度(central corneal thickness,CCT)、中央角膜曲率(corne-al curvature,CCV)以及心率、收缩压、舒张压等指标,以了解这些指标对OPA值的影响。结果DCT测得IOP值为(17.57±2.85)mmHg(1kPa=7.5mmHg),GAT测得IOP值为(16.00±2.78)mmHg,差异无统计学意义(P=0.079)。GAT测得IOP值与CCT、CCV均呈正相关,DCT测得IOP值与CCT、CCV均无相关性。NAION组与正常对照组的OPA平均值分别为(2.28±0.59)mmHg、(3.01±0.64)mmHg。NAION组左右眼配对比较,其中双眼发病者左右眼OPA值差异无统计学意义(P=0.790);单眼发病者差异有显著统计学意义(P=0.002)。正常对照组左右眼OPA值配对比较,差异无统计学意义(P=0.531)。总体OPA值与DCT测得IOP值呈正相关(r=0.236),正常对照组和NAION组的OPA值与DCT测得IOP值均呈正相关(r=0.119、0.349),但NAION组关联性更强。总OPA值与收缩压、舒张压、心率呈正相关,与年龄无相关性。结论DCT测量结果与GAT具有良好的一致性,且受CCT、CCV等干扰因素影响较少,测量结果更为可靠;NAION患者和正常人的OPA值存在差异,提示眼内存在血流动力学差异;正常人和NAION患者的OPA值与DCT测得IOP值分别呈正相关,这可能揭示了NAION的潜在发病原因,对于治疗及预后的判断具有一定的价值。Objective To investigate clinical efficacy and influencing factors of dynamic contour tonometer（DCT） in measuring ocular pulse amplitude（OPA） of patients with nonarteritic anterior ischemic optic neuropathy（NAION） and normal people.Methods There were NAION group and normal control group,40 eyes in each group.Goldmann applanation tonometer（GAT） was used to measure intraocular pressure（IOP）,DCT was used to detect IOP and OPA,central corneal thickness（CCT）,corneal curvature（CCV）,heart rate,systolic pressure,diastolic pressure,etc were also measured,and the effects of these indexes on OPA were also comprehended.Results IOP were （17.57±2.85）mmHg（1 kPa=7.5 mmHg） by DCT and （16.00±2.78）mmHg by GAT（P=0.079）.IOP by GAT was positively correlated with CCT and CCV,while no correlation was found for IOP by DCT with CCT or CCV.The average OPA were （2.28±0.59）mmHg and （3.01±0.64）mmHg in NAION group and normal control group,respectively.With paired comparison between left and right eyes in NAION group,there was no statistical difference in OPA for patients with pathological changes in both eyes（P=0.790）,while significant difference was found in OPA for patients with pathological changes in single eye（P=0.002）.There was no significant difference in OPA between left and right eyes with paried comparison in normal control group（P=0.531）.Positive correlation was found for total OPA,OPA in normal group,OPA in NAION group compared with IOP by DCT（r=0.236,0.119,0.349）,and the correlation was more positive in NAION group.Total OPA was positively correlated with systolic pressure,diastolic pressure and heart rate,while no correlation was found between total OPA and age.Conclusions For IOP measurement,DCT is in concord with GAT,less affected by CCT and CCV and with reliable result.The differences in OPA among NAION group and normal control group indicate different intraocular hemodynamic status.OPA in normal control group and NAION group are positively correlated with

关 键 词：动态轮廓眼压计 压平眼压计 眼压测量法 眼脉动振幅 缺血性视神经病变 

分 类 号：R774.6[医药卫生—眼科]