圆锥角膜患者同胞角膜地形图和角膜生物力学改变  

Changes of corneal topography and biomechanics in siblings of keratoconus patients

作　　者：张宇 杨凯丽 徐丽妍 任胜卫 ZHANG Yu;YANG Kaili;XU Liyan;REN Shengwei(Department of Ophthalmology,Henan Provincial People's Hospital,Henan Eye Hospital,Zhengzhou,Henan 450003,China)

机构地区：[1]河南省人民医院眼科河南省立眼科医院,河南郑州450003

出　　处：《中华实用诊断与治疗杂志》2024年第9期904-909,共6页Journal of Chinese Practical Diagnosis and Therapy

基　　金：国家自然科学基金青年科学基金(81200664);河南省自然科学基金面上项目(222300420536);河南省医学科技攻关计划省部共建重点项目(SBGJ202002028);河南省中青年卫生健康科技创新杰出青年人才培养项目(YXKC2020023)。

摘　　要：目的观察圆锥角膜患者及其同胞角膜地形图和角膜生物力学参数特征,探讨角膜生物力学参数在圆锥角膜高危人群筛查中的价值。方法2019年1月—2022年12月河南省立眼科医院诊治圆锥角膜患者32例为圆锥角膜组,圆锥角膜患者的健康同胞32例为同胞组,同期拟配戴角膜塑形镜或行屈光手术无圆锥角膜的近视或散光患者32例为对照组。应用Pentacam三维眼前节分析仪及Corvis ST角膜生物力学分析仪测量3组受试眼角膜地形图及角膜生物力学参数,比较3组性别、年龄、受试眼眼压。结果(1)圆锥角膜组、同胞组、对照组受试眼眼压[(11.87±2.64)、(15.13±2.39)、(16.14±1.70)mmHg]比较差异有统计学意义(F=30.213,P<0.001),性别比例、年龄比较差异均无统计学意义(χ^(2)=0.341,P=0.843;F=3.525,P=0.095)。圆锥角膜组受试眼眼压低于对照组、同胞组(P<0.05),对照组与同胞组比较差异无统计学意义(P>0.05)。(2)3组K1、K2、Km、K_(max)、IS、ARC、PRC、ACT、CCT、CKI、ISV、IVA、KI、CKI、IHA、IHD、BAD-D比较差异均有统计学意义(F=12.878、21.777、17.085、50.041、84.244、12.970、21.703、14.112、10.256、15.709、98.664、154.367、31.437、14.095、34.838、104.989、53.802,P均<0.05);圆锥角膜组上述角膜地形图参数与同胞组比较差异均有统计学意义(P<0.05),同胞组与对照组比较差异均无统计学意义(P>0.05)。(3)3组DLAML、A1T、A1V、A2T、A2V、HCT、Radius、HCDLL、Max Inverse Radius、Pachy Slope、DA Ratio Max[2 mm]、DA Ratio Max[1 mm]、ARTh、bIOP、Integrated Radius、SPA1、CBI比较差异均有统计学意义(F=23.523、22.183、10.534、7.516、12.218、6.383、46.826、3.549、30.236、31.109、36.229、45.337、58.959、12.497、46.128、78.604、122.600,P均<0.05),PD比较差异无统计学意义(F=1.800,P=0.171)。同胞组CBI(0.25±0.24)大于对照组(0.03±0.02)(P<0.05),小于圆锥角膜组(0.91±0.24)(P<0.05);同胞组Radius[(6.51±0.64)mm]、HCDLL[(6.28Objective To observe the characteristics of corneal topographic and corneal biomechanical parameters in patients with keratoconus and their siblings,and to explore the value of corneal biomechanical parameters to the screening of high-risk populations of keratoconus.Methods Thirty-two patients with keratoconus diagnosed and treated in Henan Eye Hospital from January 2019 to December 2022 and their 32 healthy siblings were enrolled as keratoconus group and sibling group,respectively,and another 32 patients scheduled for orthokeratology lens fitting and refractive surgery but no keratoconus were included as control group.The corneal topographic and biomechanical parameters were measured by using the Pentacam anterior segment analyzer and Corvis ST tonometer,respectively.The gender,age and intraocular pressure were compared among three groups.Results(1)There was significant difference in the intraocular pressure among keratoconus group,sibling group and control group[(11.87±2.64),(15.13±2.39),(16.14±1.70)mmHg](F=30.213,P<0.001).There were no significant differences in the age and gender ratio among three groups(χ^(2)=0.341,P=0.843;F=3.525,P=0.095),The intraocular pressure was lower in keratoconus group than that in control group and sibling group(P<0.05),and showed no significant difference between control group and sibling group(P>0.05).(2)Significant differences were observed in K1,K2,Km,K_(max),IS,ARC,PRC,ACT,CCT,CKI,ISV,IVA,KI,CKI,IHA,IHD and BAD-D among three groups(F=12.878,21.777,17.085,50.041,84.244,12.970,21.703,14.112,10.256,15.709,98.664,154.367,31.437,14.095,34.838,104.989,53.802:all P values<0.05)and between keratoconus group and sibling group(P<0.05),and showed no significant differences between sibling group and control group(P>0.05).(3)Significant differences were observed in DLAML,A1T,A1V,A2T,A2V,HCT,Radius,HCDLL,Max Inverse Radius,Pachy Slope,DA Ratio Max[2 mm],DA Ratio Max[1 mm],ARTh,bIOP,Integrated Radius,SPA1 and CBI among three groups(F=23.523,22.183,10.534,7.516,12.218,6.383,46.826,3.549,3

关 键 词：圆锥角膜 同胞 角膜地形图 角膜生物力学 

分 类 号：R772.2[医药卫生—眼科]