不同非接触式角膜内皮镜测量角膜内皮细胞密度临床结果的比较  

Comparison among different noncontact specular microscopes for the detection of corneal endothelial celldensity

作　　者：成拾明[1,2] 黄锦海[1] 李岩[1] 杨欣[1] 高蓉蓉[1] 王勤美[1] 

机构地区：[1]温州医学院眼视光学院温州医学院附属眼视光医院,325027 [2]湖北医药学院附属太和医院,325027

出　　处：《中华实验眼科杂志》2012年第2期150-154,共5页Chinese Journal Of Experimental Ophthalmology

基　　金：卫生部科技教育司卫生行业科研专项资金资助项目（200802114）

摘　　要：背景临床研究已证实，不同的角膜内皮镜所测的角膜内皮细胞密度值有较大差别，但国内外尚未见到关于SP02、TomeyEM-3000和SP3000P等不同非接触式角膜内皮镜测量角膜内皮细胞密度结果的一致性比较。目的评估SP02、TomeyEM-3000和SP3000P非接触式角膜内皮镜测量角膜内皮细胞密度的重复性和一致性。方法收集健康志愿者54人，其中男33人，女21人；年龄17-38岁。均取右眼分别应用SP02、TomeyEM-3000和SP3000P非接触式角膜内皮镜在自动模式下拍摄测量角膜内皮细胞密度，并采集角膜内皮细胞图像，其中SP3000P分析角膜内皮细胞的方法有两种：自动分析和手工校正分析，即SP3000P（A）和SP3000P（M）；SP02和TomeyEM一3000均采用自动分析方法。每种仪器均行3次检测并收集3张彩色照片进行计算和分析，以评价各种仪器测量结果的重复性；分别对每两种仪器检测的结果进行差异检验、相关分析和Bland-Ahman一致性分析。结果年龄〈24岁者平均角膜内皮细胞密度明显较年龄≥24岁者大，差异有统计学意义（t=3．692，P〈0．05）；不同性别间平均角膜内皮细胞密度值差异无统计学意义（t=0．335，P=0．739）。SP02、TomeyEM-3000、SP3000P（A）和SP3000P（M）测量的角膜内皮细胞密度分别为（30584-260）、（2954_＋229）、（2668＋258）、（27344-268）个／mm。，组内相关系数分别为0．957、0．940、0．972、0．972，变异系数分别为0．063、0．061、0．056和0．058。SP02与TomeyEM-3000、SP3000P（A）与SP02、SP3000P（A）与TomeyEM-3000和SP3000P（A）与SP3000P（M）间测量角膜内皮细胞密度值的95％可信区间分别为（-100．8-306．8）、（162．6-617．4）、（109．9-494．1）、（-0．6-132．6）个／mm。。结论SP02、TomeyEM-3000、SP3000P（A）测量角膜内皮细胞密度值的重复性好，但3种仪器检测结果的一致性不理想，因此不可相互替代�Background Clinical research showed that the corneal endothelial cell density value from different corneal speeu｜a microscopies exist diversity. The relevant literature of SP02, Tomey EM-3000 and $P3000P is still seldom up to now. Objective This research was to assess the repeatability of endothelial cell density measurements by SPO2,Tomey EM-3000 and $P3000P respectively and the agreement among 3 kinds of endothelial microscopes. Methods Fifty-four healthy volunteers with the age 17-38 years old were included this research. The written informed consent was obtained from each subjeet before examination. The corneal endothelial cell densities in the right eyes were analyzed with SP02, Tomey EM-3000 and SP3000P respeetively for 3 times under the automatic mode,and the analytical procedure of SP3000P measurement were divided into automatic mode SP3000P （A） and manual correction modes SP3000P（M）. The repeatability of each specula microscopy was analyzed by calculating the intraelass correlation coefficients （ICC） and coefficient of variation （ CV ） , and the 95% confidence intervals and plotting Bland-Altman graphs were used to analyze the agreement among these methods. Results The mean cornealendothelial cell densities in the population 〈24 years were significantly higher than the ones /〉 24 years （ t = 3. 692, P〈0.05 ） , but no statistical difference was found between different gender（ t = 0. 335, P = 0. 739 ）. The mean corneal endothelial cell densities were （ 3058±260 ） , （ 2954 ±229 ） , （ 2668 ± 258 ） , （ 2734 ±268 ） cell/mm2 ; the ICCs were 0. 957,0. 940,0. 972 and 0. 972 and the CV were 0. 063,0. 061,0. 056 ,0. 058 for SP02,Tomey EM-3000,SP3000P （A） and SP3000P（M） respectively. The 95% confidence intervals were（-100.8-306.8）, （162.6-617.4）, （ 109.9-494.1 ） and （ -0.6 - 132.6 ） cell/ramz for between SP02 and Tomey EM-3000, SP3000P （ A ） and SP02, SP3000P（A） and Tomey EM-3000,SP3000P（A） and SP 3000P（M） respectively. Concl

关 键 词：角膜/内皮 内皮细胞密度 生物测量 非接触式角膜内皮镜 重复性 一致性 

分 类 号：R779.6[医药卫生—眼科]