原发性开角型青光眼患者不同体位眼灌注压昼夜波动趋势分析

发布时间：2018-12-11 12:31

【摘要】：目的探讨原发性开角型青光眼(primary open-angle glaucoma,POAG)患者不同体位眼灌注压(ocular perfusion pressure,OPP)的波动趋势。设计队列研究。研究对象北京大学深圳医院POAG患者19例19眼和健康对照组18例18眼。方法受试者分别行24小时眼压及血压监测,于10:00,14:00,18:00及22:00时各时间点行坐位眼压及血压测量,POAG组于坐位测量完毕后平卧位5分钟再行监测;夜间于2:00、5:00及7:00时各时间点行卧位眼压及血压监测,POAG组于卧位测量完毕后坐起5分钟后再行监测。计算平均眼灌注压(mean ocular perfusion pressure,MOPP)、收缩期眼灌注压(systolic ocular perfusion pressure,SOPP)、舒张期眼灌注压(diastolic perfusion pressure,DOPP)。主要指标MOPP、SOPP、DOPP。结果两组习惯性体位(日间坐位、夜间卧位)MOPP、SOPP及DOPP均呈昼高夜低趋势;两组内习惯性体位MOPP均表现为夜间低于日间(POAG组t=4.092,P=0.000;对照组t=4.513,P=0.000),而两组间MOPP则无明显统计学差异(t=-0.973,P=0.350);POAG患者习惯性体位MOPP昼夜波动较对照组大(t=2.204,P=0.039),SOPP夜间波动较对照组大(t=3.097,P=0.018),DOPP的夜间及昼夜波动亦较对照组大(P均0.05)。POAG组24小时坐位或卧位MOPP日间均值与夜间均值无明显统计学差异(P均0.05)。24小时坐位MOPP均值明显高于24小时卧位MOPP均值(t=4.306,P=0.001)。POAG组习惯性体位MOPP均值与24小时坐位MOPP均值无明显统计学差异(t=-2.101,P=0.080),但高于24小时卧位MOPP均值(t=2.707,P=0.035)。结论不同体位下POAG患者OPP昼夜波动趋势不完全相同,习惯性体位下MOPP呈昼高夜低趋势,24小时坐位或卧位下MOPP昼夜变化不明显。
[Abstract]:Objective to investigate the fluctuation trend of (ocular perfusion pressure,OPP in patients with primary open angle glaucoma (primary open-angle glaucoma,POAG). Design cohort study. Participants 19 POAG patients (19 eyes) and 18 healthy subjects (18 eyes) in Shenzhen Hospital of Peking University were studied. Methods Intraocular pressure (IOP) and blood pressure (BP) were monitored at 10: 00 (14: 00) and 18: 00 (22:00), respectively. Intraocular pressure (IOP) and blood pressure (BP) were measured at each time point at 10: 00: 14: 00 and 22:00, respectively. In POAG group, the intraocular pressure and blood pressure were monitored in supine position for 5 minutes after sitting position measurement. Intraocular pressure (IOP) and blood pressure (BP) were monitored at 2: 00 and 5: 00 at different time points at 2: 00 and 7:00. The POAG group was monitored after sitting up for 5 minutes after the measurement of lying position. Mean intraocular perfusion pressure (mean ocular perfusion pressure,MOPP), systolic intraocular perfusion pressure (systolic ocular perfusion pressure,SOPP) and diastolic perfusion pressure (diastolic perfusion pressure,DOPP) were calculated. Main index MOPP,SOPP,DOPP. Results the MOPP,SOPP and DOPP of the two groups were higher than that of the night, and the MOPP of the two groups was lower than that of the day (POAG group, t 4.092, P < 0.000). In the control group, there was no significant difference in MOPP between the two groups (t = 4.513, P = 0.350), but there was no significant difference between the two groups (t = 0.973, P = 0.350). The night fluctuation of MOPP in habitual posture of POAG patients was greater than that in control group (t = 2.204P ~ (0.039), SOPP) than that in control group (t ~ (3.097) P ~ (0. 018). The diurnal and diurnal fluctuation of DOPP was also greater than that of the control group (P0. 05). There was no significant difference between the day and night mean of MOPP in 24 hours sitting position or lying position in). POAG group (P 0. 05). The mean value of MOPP in 24 hour sitting position was significantly higher than that in the control group. The mean value of MOPP in lying position at 24 hours (t = 4.306), There was no significant difference in the mean value of MOPP between habitual posture and 24 hour sitting position in P0. 001). POAG group (t0. 080), but it was higher than that of MOPP in lying position at 24 hours (t0. 707 P0. 035). Conclusion the diurnal fluctuation trend of OPP in patients with POAG in different postures is not identical, MOPP in habitual posture is higher and lower at night and day, and MOPP in sitting position at 24 hours or in supine position is not obvious.
【作者单位】：北京大学深圳医院眼科;
【基金】：深圳市卫生和计划生育委员会项目(20141039) 深圳市科技计划项目(cxzz201404182638764)
【分类号】：R775.2

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