超声测量的视神经鞘直径与颅内压关系的研究  

Correlation of Optic Nerve Sheath Diameter measured by ultrasound and Intracranial Pressure

作　　者：张丹 黄艾华[2] 黄玲[2] 王磊[2] 

机构地区：[1]锦州医科大学火箭军总医院研究生培养基地,北京100088 [2]中国人民解放军火箭军总医院神经内科,北京100088

出　　处：《中风与神经疾病杂志》2016年第11期995-998,共4页Journal of Apoplexy and Nervous Diseases

摘　　要：目的 探讨国内人群超声测量的球后3 mm的视神经鞘直径（ONSD）与颅内压（ICP）的关系,分析可能影响超声测量ONSD的相关因素。方法 收集2015年7月～2016年2月在火箭军总医院神经内科住院的需要行腰椎穿刺术的患者,术前进行ONSD的超声测量,测量时每侧横纵向分别测量两次,两侧共获得8个ONSD测量值,取其平均值作为该受试者ONSD的最终报告值;收集性别、年龄、身高、体重等一般资料。根据腰椎穿刺术时测得的ICP分为ICP正常组及ICP增高组,分别在两组内分析ONSD与以上因素的相关性;从入组的研究对象中选择行头部MRI检查的患者,在T2加权相上最大径（显示晶状体及视神经）的一层图像进行眼球前后径、眼球横径的测量,并分析ONSD与眼球前后径、眼球横径的关系。结果 共入组40例研究对象,ICP正常组27例,ICP增高组13例,分析后得出两组内ICP均是ONSD的相关因素（ICP正常组P〈0.001;ICP增高组P=0.045）,且通过回归分析显示ONSD可作为独立预测ICP增高的因素。同时得出该样本中ONSD与性别、年龄、BMI之间无明显相关。从40例研究对象中选择了24例行头部MRI检查的患者（其中,ICP正常者17例,ICP增高者7例）,分析ONSD与眼球径的关系,得出ONSD与眼球横径存在相关（P〈0.05）,ONSD与眼球前后径无明显相关（P〉0.05）。结论 ONSD与ICP明显相关,ONSD可作为ICP是否增高的预测因素;ONSD与眼球横径有相关性。Objective To evaluate the correlation between the optic nerve sheath diameter （ ONSD） behind the eye globe 3 mm measured by ultrasonography and the intracranial pressure （ ICP） and to find the potential factors influencing ONSD.Methods The patients in neurological department of the PLA Rocket Force General Hospital who would have the lumbar puncture were chosen according to the inclusion criteria from July 2015 to February 2016 .The ONSD was measured before undergoing lumbar puncture ,and the ONSD of each side was measured two times with each scan ,we get got eight val-ues finally for every patient .The mean of the eight measurements was used for analysis .We collected following data after lumbar puncture：sex,age,BMI,ICP,MABP,then analyzed the potential factors influencing ONSD .We chosen the patients finished skull MRI scanning from the people who had been included in study ,then measured the anterior-to-posterior diame-ter and the transverse diameter of each eye ball in T 2 image.The correlation analysis between the eye ball diameter and the ONSD was performed.Results 40 subjects were included in the study ,13patiets with raised ICP and 27patients with nor-mal ICP.In both groups,ICP was independently associated with ONSD （normal ICP：P〈0.001;raised ICP：P=0.045）. ONSD was a significant independent predictor of intracranial hypertention .There were no correlation between ONSD and gender,age,and BMI.24 subjects （17 of normal ICP and 7 of raised ICP included）were recruited for analyzing the rela-tionship of the diameter of eye globe and ONSD .We got that the transverse diameter of eye was significant associated with ONSD（P〈0.05）,and there were no correlation between ONSD and the anterior-to-posterior diameter（P〉0.05）.Con-clusion ICP was independently associated with ONSD ,and ONSD was a significant independent predictor of intracranial hypertention .The ONSD was significant associated with the transverse diameter of eye ball .

关 键 词：超声 视神经鞘直径 颅内压 颅内压增高 眼球横径 

分 类 号：R741.044[医药卫生—神经病学与精神病学]