视神经疾病患者颅内压与眼内压变化的相关性  

Correlation of intracranial pressure and intraocular pressure changes in patients with optic nerve disease

作　　者：王大江[1] 田磊[1] 赵军 秦丽敏[1] 

机构地区：[1]解放军总医院眼科,北京100853 [2]辽河油田总医院眼科,辽宁盘锦124010

出　　处：《解放军医学院学报》2014年第10期993-995,999,共4页Academic Journal of Chinese PLA Medical School

基　　金：全国博士后特别资助项目(201104781)~~

摘　　要：目的 探讨视神经疾病患者腰椎穿刺前后颅内压（intracranial pressure,ICP）与眼内压（intraocular pressure,IOP）变化的相关性。方法 前瞻性分析2013年1-5月解放军总医院眼科诊断视神经疾病12例（24眼）患者的相关资料。对诊断视神经疾病的12例入院患者的相关资料进行研究。所有患者住院期间通过腰椎穿刺留取定量脑脊液行脑脊液常规检查并测定ICP,同时采用回弹式眼压计测量腰椎穿刺前后双眼眼压变化,并计算其平均值。所有患者腰椎穿刺术后每2 h测量1次眼压,共12次,并绘制24 h眼压曲线。结果 共有12例（24眼）纳入本次研究,其中男7例,女5例,诊断为视神经炎6例,缺血性视神经病变5例,未明确诊断1例。患者年龄16～55（38.125±12.438）岁。所有患者全身状况良好,无高血压、糖尿病等常见全身疾病。腰椎穿刺前后ICP与双眼平均IOP之间无明显的相关性（r=0.126,P=0.697）。腰椎穿刺前后双眼IOP的差异（t=8.002,P〈0.001）、ICP的差异（t=7.936,P〈0.001）均有统计学意义。结论 IOP与ICP虽然有一定相关性,但是两者变化之间没有规律,以眼压推测颅压或者反之目前还不能得出有意义的结论。Objective To investigate the correlation of intracranial pressure （ICP） and intraocular pressure （IOP） changes in patients with optic nerve disease. Methods Clinical data about 12 patients with optic nerve disease admitted to our hospital from January to May in 2013 were retrospectively analyzed. The quantitative cerebrospinal fluid of all patients during hospitalization were extracted by lumbar puncture, and after that routine inspection of cerebrospinal fluid, the measurement of ICP were performed. The changes of before and after lumbar puncture were measured using spring back tonometer and the average value were calculated. 24-hour intraocular pressure curve was described with all patients undergoing the lumbar puncture once every 2 hours. Results Of the 12 cases （24 eyes）, 7 cases were male and 5 cases were female with the average age of （38.125 ± 12.438） years old （range, 16-55 years old）. 6 cases were diagnosed as optic neuritis, 5 cases were ischemic optic neuropathy, and 1 case was undefined diagnosis. All patients were in good condition with no high blood pressure, diabetes or any other common systemic disease. There was no significant correlation between before and after lumbar puncture ICP and eyes mean IOP （r=0.126, P=0.697）. The differences of before and after lumbar puncture in IOP （t=8.002, P 〈 0.001） and ICP （t=7.936, P 〈 0.001） were statistically significant. Conclusion There is a certain correlation between IOP and ICP, but no regularity is found between the changes of them. Meaningful conclusion about presuming the lOP basing on the ICP or presuming the ICP basing on the IOP is yet to be educed.

关 键 词：青光眼 颅内压 眼内压 

分 类 号：R778.1[医药卫生—眼科]