正常眼压性青光眼的24小时眼压测量临床价值  

Clinical study of the 24 hour IOP monitoring in normal tension glaucoma

作　　者：徐育慧[1] 吴良成[1] 周志超[1] 姚大庆[1] 沈平[1] 翁成海[1] 

机构地区：[1]上海市静安区中心医院复旦大学附属华山医院静安分院眼科,上海200040

出　　处：《中国实用眼科杂志》2012年第4期428-430,共3页Chinese Journal of Practical Ophthalmology

基　　金：上海市卫生局课题静安区不可逆视力残疾原因及变化趋势（沪卫科2008-161）

摘　　要：目的评估24h眼压测量在正常眼压性青光眼中的意义，以更好地指导临床应用。方法于2008年1月至2011年2月正常眼压性青光眼（NTG）患者共86例（86只眼）人选本研究，应用非接触眼压计自清晨8：00开始至第二天清晨8：00，每两小时测量一次，共12次；采用A型超声波角膜测厚仪对中央角膜厚度进行测定。结果所有86只眼的24h眼压测量值中，29只眼（33．7％）在正常范围内且昼夜眼压波动小于5mmHg，而57只眼（66．3％）出现异常。所有患者昼夜眼压曲线中眼压低谷值为（13．78＋1．39）mmHg眼压高峰值为（18．52±1．81）mmHg，分别出现于18：00～20：00和夜间2：00。根据24h最高眼压是否高于21mmHg分为高眼压组和低眼压组，两组年龄差异显著有统计学意义，而中央角膜厚度无明显差异。结论24h眼压测量应作为正常眼压性青光眼患者诊断的常规检查，能提高夜间眼压高峰及昼夜波动过大的检出率，避免漏诊误诊的发生。Objective To evaluate the effect of 24-hour IOP measurement in the suspects of normal-tension glaucoma. Methods Eight-six patients （86 eyes） with normal tension glaucoma （NTG） were enrolled in the study from December 2008 to December 2010. Non-contact tonometer was used to measure the IOP once every two hours from 8：00 AM to the next 8：00 AM, with a total of 12 times a day. Central corneal thickness was also measured. Results The IOPs of 29 eyes （33.7%） were within normal range and the diurnal fluctuations of IOP were no more than 5mmHg, while the IOPs of the other 57 eyes （66.3%） were abnormal. The average lowest IOP of all the pa- tients was 13.78 ± 1.39mmHg and the highest was 18.52 ± 1.81mmHg, which appeared during 6：00 PM to 8：00 PM and 2：00 AM, respectively. The patients were divided into two groups according to 24-hour peak IOP （group A≥21mmHg, group B〈21mmHg）. There was an age significant difference between the two groups, but no significant difference in central corneal thickness. Conclusion The 24-hour IOP measurement should be a routine examination in patients with NTG, which can in- crease the the detective rate of nocturnal IOP peak and diurnal fluctuation, and thus prevent the oc- currence of misdiagnosis.

关 键 词：正常眼压性青光眼 24 h眼压测量 中央角膜厚度 

分 类 号：R775[医药卫生—眼科]