CAJ | 학술논문

目的通过24 h眼压的测量来深入分析比较正常眼压性青光眼(NTG)与原发性开角型青光眼(POAG)的眼压曲线特征.方法前瞻性病例对照研究.收集2006年4月至2009年4月在上海市闸北区北站医院和复旦大学附属眼耳鼻喉科医院门诊就诊的NTG患者131例及POAG患者102例,测量24 h眼压,用非接触性眼压计从8 am起每隔2 h测一次眼压,0 am至6 am之间测得的为唤醒后即刻坐位眼压.主要观察指标为眼压波动曲线、平均眼压、峰值时间及眼压、谷值时间及眼压和眼压波动值.采用独立样本t检验和卡方检验比较各指标在两组之间的差异.结果 NTG组双眼平均眼压为(14.2±2.1)mmHg,低于POAG组[(19.9±3.5)mmHg];NTG组双眼峰值眼压为(17.0±2.4)mmHg,低于POAG组[(24.7±4.3)mmHg];NTG组双眼谷值眼压为(11.8±2.2)mmHg,低于POAG组[(16.5±3.1)mmHg];NTG组双眼眼压波动值为(5.2±1.8)mmHg低于POAG组(8.2±3.1)mmHg];两组的平均眼压、峰值、谷值及眼压波动值的差异均有统计学意义(t=-14.52、-16.44、-13.16、-8.90,P均＜0.01).NTG组63.3%患者、POAG组73.5%患者的峰值眼压位于门诊工作时间以外;尤其是NTG组有51.5%患者、POAG组有64.7%患者的峰值位于0 am至6 am时间段,两组差异有统计学意义(X2=8.150,P=0.017).结论 NTG及POAG患者24 h眼压曲线的变化规律具有相似性,是诊断和个体化治疗方案制订的依据,并可用作治疗随访中评价疗效和调整方案的重要参考指标.
목적 통과24 h안압적측량래심입분석비교정상안압성청광안(NTG)여원발성개각형청광안(POAG)적안압곡선특정.방법 전첨성병례대조연구.수집2006년4월지2009년4월재상해시갑북구북참의원화복단대학부속안이비후과의원문진취진적NTG환자131례급POAG환자102례,측량24 h안압,용비접촉성안압계종8 am기매격2 h측일차안압,0 am지6 am지간측득적위환성후즉각좌위안압.주요관찰지표위안압파동곡선、평균안압、봉치시간급안압、곡치시간급안압화안압파동치.채용독립양본t검험화잡방검험비교각지표재량조지간적차이.결과 NTG조쌍안평균안압위(14.2±2.1)mmHg,저우POAG조[(19.9±3.5)mmHg];NTG조쌍안봉치안압위(17.0±2.4)mmHg,저우POAG조[(24.7±4.3)mmHg];NTG조쌍안곡치안압위(11.8±2.2)mmHg,저우POAG조[(16.5±3.1)mmHg];NTG조쌍안안압파동치위(5.2±1.8)mmHg저우POAG조(8.2±3.1)mmHg];량조적평균안압、봉치、곡치급안압파동치적차이균유통계학의의(t=-14.52、-16.44、-13.16、-8.90,P균＜0.01).NTG조63.3%환자、POAG조73.5%환자적봉치안압위우문진공작시간이외;우기시NTG조유51.5%환자、POAG조유64.7%환자적봉치위우0 am지6 am시간단,량조차이유통계학의의(X2=8.150,P=0.017).결론 NTG급POAG환자24 h안압곡선적변화규률구유상사성,시진단화개체화치료방안제정적의거,병가용작치료수방중평개료효화조정방안적중요삼고지표.
Objective To analyze the characteristics of diurnal intraocular pressure (IOP) curves in normal tension glaucoma (NTG) patients and primary open angle glaucoma (POAG) patients by measuring IOP over 24 hours. Methods This was a prospective case control study. Subjects diagnosed as POAG and NTG were enrolled from April 2006 to April 2009 in the Shanghai Beizhan Hospital and Eye & ENT Hospital of Fudan University. A total of 131 NTG patients and 102 POAG patients were included in this study. All the subjects accepted 24-hour IOP measurements by a non-contact tonometer every two hours starting at 8:00 am in a sitting position. The IOP between 0:00 to 6:00 am were also measured in a sitting position immediately after the subject was awakened. The main observation indices included an IOP fluctuating curve, average IOP, peak time and IOP, valley time and IOP and the IOP fluctuating value. Differences in these indices between the two groups were analyzed by a independent samples t test and chi-square test. Results The average IOP in the NTG group were (14.2±2.1)mmHg for the two eyes, and in the POAG group were (19.9±3.5)mmHg. The peak IOP in the NTG group were (17.0±2.4)mmHg for the two eyes, and in the POAG group were (24.7±4.3)mmHg. The valley IOP in the NTG group were (11.8±2.2)mmHg for the two eyes, and in the POAG group were (16.5±3.1)mmHg. IOP fluctuations in the NTG group were (5.2±1.8)mmHg for the two eyes, and in the POAG group were (8.2±3.1)mmHg. All differences between the two groups were statistically significant (t=-14.52,-16.44,-13.16,-8.90, P＜0.01 for all). Notably, 63.3% of the peak IOP in the NTG and 73.5% of the peak IOP in the POAG occurred outside working hours, especially during the period from 0:00 to 6:00 am with 51.5% peak IOP in the NTG group and 64.7% in the POAG group. Differences between the two groups were statistically significant (x2=8.150, P=0.017). Conclusion The fluctuation curves of IOP in NTG and POAG patients are similar over 24 hours. These properties are not only guidelines for establishing individual treatment, but also for evaluating the therapeutic effects and treatment adjustments during follow-up.