温度刺激引起原发性开角型青光眼患者的全身和眼部异常血管反应:1例植物神经功能紊乱病例  

Abnormal systemic and ocular Vascular response to temperature provocatio n in primary open-angle glaucoma patients: A case for autonomic failure?

作　　者：Gherghel D. Hosking S.L. Cunliffe I.A. 齐翔云 

机构地区：[1]Neuroscience Research In stitute, School of Life and Health Sciences, Aston University, Aston Triangle, B irmingham B4 7ET, United Kingdom

出　　处：《世界核心医学期刊文摘（眼科学分册）》2005年第2期35-35,共1页Digest of the World Core Medical Journals:Ophthalmology

摘　　要：PURPOSE. To assess systemic and ocular vascular reactivity in response to warm and cold provocation in untreated patients with primary open-angle glaucoma an d normal control subjects. METHODS. Twenty-four patients with primary openangle glaucoma and 22 normal control subjects were subjected to a modified cold press or test involving immersion of the right hand in 40°C warm water followed by 4 °C cold water exposure, and finger and ocular blood flow were assessed by means of peripheral laser Doppler flowmetry and retinal flowmetry, respectively. Fing er and body temperature as well as intraocular pressure, systemic blood pressure , systemic pulse pressure, heart rate, and ocular perfusion pressure were also m onitored. RESULTS. The patients with glaucoma demonstrated an increase in diasto lic blood pressure (P=0.023), heart rate (P=0.010), and mean ocular perfusion pr essure (P=0.039) during immersion of the tested hand in 40°C water. During cold provocation, the patients demonstrated a significant decrease in finger (P=0.00 03) and ocular blood flow (the parameter velocity measured at the temporal neuro retinal rim area; P=0.021). Normal subjects did not demonstrate any blood flow o r finger temperature changes during immersion of the tested hand in 40°C water (P >0.05); however, they exhibited increases in systolic blood pressure (P=0.034 ) and pulse pressure (P= 0.0009) and a decrease in finger blood flow (P=0.0001) during cold provocation. In normal subjects, the ocular blood flow was unchanged during high and low temperature challenge. CONCLUSIONS. Cold provocation elicit s a different blood pressure, and ocular blood flow response in patients with pr imary open-angle glaucoma compared with control subjects. These findings sugges t a systemic autonomic failure and ocular vascular dysregulation in POAG patient s.PURPOSE. To assess systemic and ocular vascular reactivity in response to warm and cold provocation in untreated patients with primary open-angle glaucoma an d normal control subjects. METHODS. Twenty-four patients with primary openangle glaucoma and 22 normal control subjects were subjected to a modified cold press or test involving immersion of the right hand in 40°C warm water followed by 4 °C cold water exposure, and finger and ocular blood flow were assessed by means of peripheral laser Doppler flowmetry and retinal flowmetry, respectively. Fing er and body temperature as well as intraocular pressure, systemic blood pressure , systemic pulse pressure, heart rate, and ocular perfusion pressure were also m onitored. RESULTS. The patients with glaucoma demonstrated an increase in diasto lic blood pressure (P=0.023), heart rate (P=0.010), and mean ocular perfusion pr essure (P=0.039) during immersion of the tested hand in 40°C water. During cold provocation, the patients demonstrated a significant decrease in finger (P=0.00 03) and ocular blood flow (the parameter velocity measured at the temporal neuro retinal rim area; P=0.021). Normal subjects did not demonstrate any blood flow o r finger temperature changes during immersion of the tested hand in 40°C water (P >0.05); however, they exhibited increases in systolic blood pressure (P=0.034 ) and pulse pressure (P= 0.0009) and a decrease in finger blood flow (P=0.0001) during cold provocation. In normal subjects, the ocular blood flow was unchanged during high and low temperature challenge. CONCLUSIONS. Cold provocation elicit s a different blood pressure, and ocular blood flow response in patients with pr imary open-angle glaucoma compared with control subjects. These findings sugges t a systemic autonomic failure and ocular vascular dysregulation in POAG patient s.

关 键 词：眼部异常 血管反应 温度刺激 颞侧视网膜 手指血 灌注压 冷刺激 量仪 边缘区 

分 类 号：R775[医药卫生—眼科]