光学相干断层扫描对阿尔茨海默病视网膜形态结构的研究

发布时间：2018-05-06 05:20

本文选题：阿尔茨海默病 + 视网膜神经纤维　；参考：《南昌大学》2017年硕士论文

【摘要】：目的:探讨阿尔茨海默病(AD)患者视网膜形态结构的变化及其与AD的相关性。方法:采用病例对照研究,选取(2015/01-2016/01)在南昌大学第一附属医院神经内科老年病学科医师诊断出临床轻度和/或中度痴呆患者,确诊AD患者20人(男性/女性:11/9;年龄58~90岁,平均(72.75±8.25)岁)40眼(左眼20只,右眼20只)作为实验组;同期于南昌大学第一附属医院神经内科和/或眼科就诊的患者20人(男性/女性:11/9;年龄61~84岁,平均(71.05±7.08)岁)40眼(左眼20只,右眼20只)作为正常年龄匹配对照组。所有的入组人员均接受神经内科严格的相关血液学检验、神经影像学检查及精神心理检查以协助诊断。眼科检查均测量矫正视力、眼压、扩瞳检查眼底以及光学相干断层扫描(OCT)检查,以视乳头盘周平均视网膜神经纤维层(RNFL)厚度及上方、下方、鼻侧和颞侧区域视网膜神经纤维层(RNFL)厚度作为研究内容,分析比较同组左右眼之间及实验组与正常对照组之间的差异性。对结果应用SPSS17.0软件进行统计学处理并行统计学分析,以P0.05代表有统计学意义。结果:1、与正常年龄匹配的对照组(101.70±9.57μm)相比,AD患者视乳头盘周区域的RNFL平均厚度(81.60±12.92μm)明显变薄(P0.05),而视乳头盘周上(87.35±12.36μm)、下(90.23±12.40μm)视网膜区域变薄更为明显,鼻、颞侧区域厚度也低于对照组但差异无统计学意义。2、两组组内比较,左右眼之间RNFL厚度均不具有差异性。结论:1、AD患者视乳头周围视网膜神经纤维层厚度较正常同龄人变薄;2、AD患者视网膜神经纤维变薄首先出现在视乳头周围的上、下象限;3、OCT可作为评估早期AD视网膜神经纤维变化的有效而无创检查方法。
[Abstract]:Objective: to investigate the changes of retinal morphology and its correlation with AD in patients with Alzheimer's disease (AD). Methods: in a case-control study, 20 AD patients (male / female: 11 / 9; age 580-90; male / female: 11 / 9; age 580-90) were diagnosed as mild and / or moderate dementia by the geriatricians of Department of Neurology, first affiliated Hospital of Nanchang University. An average of 72.75 卤8.25 years old 40 eyes (20 left eyes and 20 right eyes) were used as experimental group, and 20 eyes (male / female: 11 / 9, male / female) in Department of Neurology and / or Ophthalmology, first affiliated Hospital of Nanchang University, 40 eyes (left eye, 20 eyes), aged 6184 years (mean 71.05 卤7.08). The right eye (n = 20) was used as a normal age matched control group. All of them were examined by neurology, neuroimaging and psycho-psychological examination to assist in diagnosis. The corrected visual acuity, intraocular pressure, fundus dilatation and optical coherence tomography (Oct) were measured in ophthalmology, and the mean thickness of retinal nerve fiber layer (RNFL) around the optic papilla was measured. The thickness of retinal nerve fiber layer (RNFL) in the nasal and temporal regions was analyzed and compared between the left and right eyes of the same group and between the experimental group and the normal control group. The results were analyzed by using SPSS17.0 software in parallel statistical analysis, with P0.05 as the representative of statistical significance. Results compared with normal age matched control group (101.70 卤9.57 渭 m), the average thickness of RNFL in the peripapillary area of AD patients was 81.60 卤12.92 渭 m) and the mean thickness of RNFL in the peripapillary area was significantly thinner than that in the normal age-matched control group (P 0.05), while the retinal area in the superior optic papillary disc was 87.35 卤12.36 渭 m, and the retinal area in the inferior part of the papillary disc was 90.23 卤12.40 渭 m). The thickness of temporal region was also lower than that of the control group, but there was no significant difference between the two groups. The thickness of RNFL between the left and right eyes was not different between the two groups. Conclusion the thickness of retinal nerve fiber layer around optic papilla in AD patients is thinner than that in normal people. Lower quadrant Oct can be used as an effective and noninvasive method to evaluate the changes of retinal nerve fibers in early AD.
【学位授予单位】：南昌大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R749.16;R774.1

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