甲状腺相关眼病患者角膜生物力学研究  

The corneal biomechanical properties of patients with Graves＇ orbitopathy

作　　者：张赟[1] 余相均[1] 余心洁 陈立锋[1] 沈丽君[1] 

机构地区：[1]温州医学院附属眼视光医院,325000

出　　处：《中华眼科杂志》2016年第4期263-267,共5页Chinese Journal of Ophthalmology

基　　金：温州市科技计划（Y20140153）;浙江省医药卫生平台计划（2016ZDA016）;国家科技支撑计划（2012BA108800）

摘　　要：目的 观察甲状腺相关眼病（TAO）患者角膜生物力学性能的特点及相关因素分析.方法 回顾性系列病例研究.收集2013年12月至2014年6月在温州医科大学附属眼视光医院确诊为TAO患者的临床资料.包括静止期患者（静止期组）20例（34只眼）,其中单眼患病6例;活动期患者（活动期组）14例（25只眼）,其中单眼患病3例.纳入与之年龄、性别相符的健康人28例（30只眼）作为对照组.A超测量角膜中央厚度（CCT）,采用眼反应分析仪测量角膜滞后量（CH）、角膜阻力因子（CRF）、角膜补偿眼压（IOPcc）、模拟Goldmann眼压值（IOPg）,眼球突出计测量眼球突出度.用单因素方差分析ANONA或非参数检验的统计方法对3组参数进行比较.结果 静止期组平均年龄为（47.3±12.8）岁（女性23只眼,男性11只眼）,活动期组平均年龄为（51.9±9.6）岁（女性16只眼,男性9只眼）,正常组年龄为（47.2±10.4）岁（女性19只眼,男性11只眼）,TAO静止期组CH为（9.68±1.45） mmHg（1 mmHg=0.133 kPa）,活动期组CH为（9.82±1.53）mmHg,均低于正常组CH的（10.67±1.68） mmHg,差异有统计学意义（t1=-2.51,P1=0.01;t2=-2.01,P2=0.048;静止期组IOPcc为（17.91±3.67）mmHg,活动期组IOPcc为（17.88±5.44）mmHg,高于正常组IOPcc的（13.90±3.39）mmHg,差异有统计学意义（t1=3.76,P1=0.001;t2=3.46,P2=0.001）;静止期组CRF为（10.19±1.73） mmHg,活动期组CRF为（10.36±1.01） mmHg,正常组CRF为（10.08±1.40） mmHg,3组相比差异无统计学意义（t1=0.31,P1=0.761;t2=0.69,P2=0.491）;静止期组CCT为（531.41±37.60） μm,活动期组CCT为（533.52±18.88） μm,正常组为（546.25±28.84）μm,3组间差异无统计学意义（t1=-1.91,P1=0.059;t2=-1.52,P2=0.132）;TAO患者中角膜滞后量与眼球突出度、模拟Goldmann眼压值、角膜补偿眼压呈负相关（Pearson=-0.279,-0.385,-0.663,P＜0.05）,与CCT和CRF呈正相关（Pearson=0.246,0.583,P＜0.05）.结论 TAOObjective This study aims to compare the corneal biomechanical properties of patients with Graves＇orbitopathy （GO） with normal people and analysis the correlated factors.Methods Retrospective case series study.34 eyes of 20 patients （6 eyes are unilateral） diagnosed with inactive Graves＇ orbitopathy and 25 eyes of 14 patients （3 eyes are unilateral） diagnosed with active Graves＇ orbitopathy were recruited as study group.30 eyes of 28 healthy volunteers with age and sex-matched were enrolled as control group in the affiliated eye hospital of Wenzhou medical university from December 2013 to June 2014.Central corneal thickness （CCT） measured with A ultrasound, corneal hysteresis （CH） measured with Ocular Response Analyser （ORA）, corneal resistance factor （CRF）, Goldman-corrected IOP value （IOPg） and Cornea-Compensated Intraocular Pressure（IOPcc） were collected.An ANONA and Kruskal-Wallis Test was used to compare the indexes mentioned above.Results The mean age of inactive group was （47.3±12.8）y （23 eyes were female, 11 eyes were male）, the mean age of active group was （51.9± 9.6）y （16 eyes were female, 9 eyes were male）, the mean age of normal group was （47.2±10.4）y （19 eyes were female, 9 eyes were male）.CH of inactive group was （9.68± 1.45） mmHg, （1 mmHg=0.133 kPa）, CH of active group was （9.82±1.53） mmHg, lower than the CH of （10.67±1.68） mmHg in control group, which was statistically significant different （t1=-2.51, P1=0.014, t2=-2.01,P2=0.048）.IOPcc of inactive group was （17.91±3.67） mmHg, IOPcc of active group was （17.88±5.44） mmHg, which were higher than the IOPcc of （13.90±3.39） mmHg in the control group, which was statistically significant different （t1=3.76, P1=0.001;t2=3.461, P2=0.001）.There were no significant difference between study and control group in CRF, that was in inactive group （10.19± 1.73）mmHg, active group （10.36± 1.01）mmHg, normal group （10.08± 1.40）mmHg respectively

关 键 词：GRAVES眼病 角膜 生物力学 诊断技术 眼科 

分 类 号：R581[医药卫生—内分泌] R771.3[医药卫生—内科学]