正常眼压性青光眼与睡眠呼吸事件的相关性研究  

Relationship between normal-tension glaucoma and sleep-breathing events

作　　者：冬雪川[1] 张纯[1] 黄萍[1] 陈杰[1] 仇福成[1] 沈扬[1] 古雅兰[1] 李涛[1] 杜晨[1] 

机构地区：[1]北京大学第三医院北京大学眼科中心,100191

出　　处：《中华实验眼科杂志》2014年第2期172-177,共6页Chinese Journal Of Experimental Ophthalmology

摘　　要：背景正常眼压性青光眼（NTG）是原发性开角型青光眼中的一个重要类型，非眼压依赖因素对本病的影响已受到广泛关注，而近期一些研究发现睡眠呼吸暂停综合征患者青光眼发病率较高，提示两者之间有一定的内在联系。目的探讨NTG患者睡眠呼吸事件的发生频率和强度及其与青光眼进展的关系。方法采用前瞻性病例对照研究设计，纳入2011—2012年于北京大学第三医院眼科就诊的NTG患者20例作为NTG组，纳入同期年龄和性别匹配的18名健康志愿者作为正常对照组，所有受试者进行视野、海德堡共焦激光眼底断层扫描仪（HRT）检查、OCT检查以及多导睡眠监测（PSG），采用SPSS17．0统计学软件对两组之间受试者的各睡眠呼吸参数测量值的差异进行Mann—WhitneyU检验或独立样本t检验，对受试者睡眠呼吸事件参数测量值与平均视网膜神经纤维层（RNFL）厚度及视杯容积的关系进行Spearman秩相关分析和Pearson相关分析，确定NTG患者睡眠呼吸事件与青光眼相关指标的关系。结果两个组间受试者的临床基线特征，包括年龄、性别、身高、体质量及体质量指数（BMI）的差异均无统计学意义（P〉0．05）。NTG组受试者测量的呼吸暂停低通气指数（AHI）、低通气指数（HI）和呼吸暂停指数（AI）均明显高于正常对照组，差异均有统计学意义（U=89．000，P=0．007；U=91．000，P=0．008；U=89．000，P=0．007），睡眠呼吸事件中关于时间的相关参数均明显长于正常对照组（P〈0．05），而睡眠觉醒期和睡眠中动脉血氧饱和度均低于正常对照组，差异均有统计学意义（t=-3．480，P=0．001；t=-3．255，P=0．002）。两个组间受试者睡眠平均心率、睡眠最低心率、睡眠最高心率的差异均无统计学意义（t=-0．133，P=0．895；t=-0．906，P=0．371；t=-0．164，P=0．871）。HRT测量的NTG患者平均RNFL厚度�Background Normal-tension glaucoma （NTG） is a common form of open-angle glaucoma throughout the world and additional intraoeular pressure （IOP）-independent factors take increasing importance in NTG. Some recent studies found that patients with obstructive sleep apnea syndrome had a high prevalence of NTG. Objective The aim of this study was to determine the relationship between NTG and sleep-breathing events. Methods A prospective cases-controlled trial was designed. This trial protocol was approved by the Ethic Committee of Peking University Third Hospital. Written informed consent was obtained from each subject prior to entering into the study cohort. Twenty NTG patients were included in Peking University Third Hospital in 2011-2012, and 18 normal volunteers were enrolled in the same duration. Perimetry,retinal nerve fibrous layer （RNFL） thickness by Heidelberg confocal laser scanner （HRT）,volume of optical disc by OCT and polysomnography （PSG） in night were performed on all the subjects. The difference of all the PSG sleep parameters were compared using Mann-Whitney U test or independent sample t test, and the correlations of PSG sleep parameters with RNFL and volume of optical disc in the NTG patients were analyzed by Spearman rank correlation and Pearson correlation analysis of SPSS 17.0 software. Results The demographic baseline of the subjects was no significant difference between the NTG group and the normal control group, including age, gender, height, weight and body mass index（BMI） （all at P〉0.05 ）. Apnea hypopnea index （AHI） ,hypopnea index （HI） and apnea index （AI） were significantly higher （ U = 89. 000, P = 0. 007; U= 91. 000, P = 0. 008; U= 89. 000 ,P = 0, 007 ） , and the time-related parameters of apnea sleep events were longer in the NTG group than those in the normal control group （all at P〈0.05 ）. In the NTG group ,lowest sleep SaO2 of both waking and sleeping states was significant declined in comparison with the normal control group （ t =

关 键 词：正常眼压性青光眼 诊断 多导睡眠描记术 睡眠呼吸暂停综合征 血气分析 体层摄影术 神经纤维 病理 视盘 病理 视野 

分 类 号：R775[医药卫生—眼科]