缺铁性贫血和健康儿童视网膜神经纤维层厚度的对比分析  

Comparison of retinal nerve fiber layer thickness between iron deficiency anemia and healthy children

作　　者：吴超琼[1] 朱晶[1] 

机构地区：[1]武汉市第一医院,湖北省武汉市430022

出　　处：《眼科新进展》2017年第1期56-58,共3页Recent Advances in Ophthalmology

基　　金：武汉市卫计委基金资助(编号:WX14B05)~~

摘　　要：目的对比分析缺铁性贫血(iron deficiency anemia,IDA)儿童和健康儿童的视网膜神经纤维层(retinal nerve fiber layer,RNFL)厚度。方法选取IDA儿童58例116眼和健康儿童46例92眼,分别纳入IDA组和对照组。对所有儿童进行眼压、等效球镜度和血红蛋白浓度测定,并于同日进行光学相干断层扫描仪检测,以获得上方、下方、鼻侧、颞侧和平均RNFL厚度。IDA组儿童接受铁剂治疗后检测RNFL厚度和血红蛋白浓度的变化。使用SPSS 19.0对数据进行统计学分析。结果与健康儿童相比,IDA儿童的RNFL厚度较薄。对于合并IDA的青光眼或视神经病变儿童,应综合进行贫血的内科治疗。IDA组儿童血红蛋白浓度显著低于对照组(t=-21.99,P=0.00),分别为(69.59±5.78)g·L^(-1)和(145.46±6.20)g·L^(-1)。IDA组儿童上方、下方和平均RNFL厚度均低于对照组(均为P<0.05),而鼻侧和颞侧RNFL厚度与对照组差异均无统计学意义(均为P>0.05)。对IDA儿童的平均RNFL厚度和同期血红蛋白浓度行Spearman相关分析,结果显示平均RNFL厚度与血红蛋白浓度呈正相关(r=0.725,P=0.03)。IDA组儿童接受规范的铁剂治疗后,血红蛋白浓度由(69.59±5.78)g·L^(-1)上升到(132.47±6.24)g·L^(-1)。此时所有儿童均接受OCT复查RNFL厚度。结果显示上方、下方、鼻侧、颞侧和平均RNFL厚度分别为(180.11±50.58)μm、(168.79±47.14)μm、(188.57±39.86)μm、(185.34±42.67)μm和(180.48±41.98)μm,铁剂治疗后上方RNFL厚度较治疗前有所增厚(t=-21.25,P=0.04)。结论与健康儿童相比,IDA儿童的RNFL厚度较薄。对于合并IDA的青光眼或视神经病变儿童,应综合进行贫血的内科治疗。Objective To observe and compare the retinal nerve fiber layer （ RNFL） thickness in iron deficiency anemia （IDA） and healthy children Methods One hundred and sixteen eyes from 58 children with IDA,as well as 92 eyes from 45 healthy children were consecutively enrolled in IDA group and control group respectively. Intraocular pressure, spherical equivalent refraction, and hemoglobin concentration were routinely examined. On the same day, RNFL thickness （ superior, inferior, nasal, temporal, and average） was measured using optical coherence tomography, and the information was recorded for statistical analysis using SPSS 19.0. Results RNFL thickness of IDA children was thinner than that of healthy children. The hemoglobin concentration of IDA and healthy children were （69.59 ± 5.78 ） g · L- 1 and （ 145.46 ± 6.20） g · L- 1 , there was a significant difference （ t = -21.99 ,P =0.00）. The upper,lower and average RNFL thickness of IDA children were all thinner than those of healthy children （ all P 〈 0.05 ）, but there was no statistically significant difference in nasal and temporal RNFL thickness （ all P 〉 0.05 ）. The average RNFL thickness was positive correlated with hemoglobin concentration （ r = 0.725, P = 0.03 ）. The hemoglobin concentration of IDA children after iron treatment was increased from （69.59 ±5.78）g · L-1 to （ 132.47 ±6.24）g · L-1 ,the upper,lower,nasal and temporal RNFL thickness were （ 180. 11 ± 50.58 ） μm, （ 168.79 ±47.14） μm, （ 188.57 ±39.86） μm and （ 180.48 ±41.98） μm,respectively,there was a significant difference compared with that before treatment （ t = - 21.25, P = 0. 04）. Conclusion Compared with the healthy children, RNFL thickness measured by OCT is thinner in children with IDA. For those children with IDA and concomitant glaucoma or optic neuropathy, the treatment of anemia should be paid attention.

关 键 词：缺铁性贫血 视网膜神经纤维层 血红蛋白 

分 类 号：R774.1[医药卫生—眼科]