CAJ | 학술논문

目的：探讨夜间眼压测量在疑似正常眼压性青光眼（ NPG）诊治中的应用价值，以减少高眼压性青光眼（HPG）的漏诊。方法选取我院2011年1月-2012年1月收治的疑似NPG患者共50例（96眼），根据夜间眼压测量结果将患者分为NPG组21例（38眼）和HPG组29例（58眼），比较两组患者的一般情况、日间和夜间眼压、视网膜神经纤维层厚度及视野。结果两组患者的性别构成（χ2＝1.05，P ＝0.910）、平均年龄（t ＝3.20，P ＝0.760）、平均视力（t＝0.17，P＝0.480）比较，差异均无统计学意义。HPG组日间眼压谷值、峰值均大于NPG组，波动幅度小于NPG组（P﹤0.05）。HPG组夜间眼压谷值和峰值、波动幅度均大于NPG组（P﹤0.05）。HPG组16例、NPG组3例患者出现夜间眼压﹥21 mm Hg（1 mm Hg＝0.133 kPa），HPG组夜间眼压﹥21 mm Hg发生率（55.2％）高于NPG组（14.3％）（χ2＝4.31，P＝0.035）。两组患者上方象限、下方象限、颞侧象限、鼻侧象限视网膜神经纤维层厚度及视网膜神经纤维层平均厚度，视野平均偏差及模式标准偏差比较，差异均无统计学意义（ P﹥0.05）。结论夜间眼压测量能更好地反映受试者眼压变化，从而减少HPG的漏诊，值得在疑似NPG诊治中推广应用。
목적：탐토야간안압측량재의사정상안압성청광안（ NPG）진치중적응용개치，이감소고안압성청광안（HPG）적루진。방법선취아원2011년1월-2012년1월수치적의사NPG환자공50례（96안），근거야간안압측량결과장환자분위NPG조21례（38안）화HPG조29례（58안），비교량조환자적일반정황、일간화야간안압、시망막신경섬유층후도급시야。결과량조환자적성별구성（χ2＝1.05，P ＝0.910）、평균년령（t ＝3.20，P ＝0.760）、평균시력（t＝0.17，P＝0.480）비교，차이균무통계학의의。HPG조일간안압곡치、봉치균대우NPG조，파동폭도소우NPG조（P﹤0.05）。HPG조야간안압곡치화봉치、파동폭도균대우NPG조（P﹤0.05）。HPG조16례、NPG조3례환자출현야간안압﹥21 mm Hg（1 mm Hg＝0.133 kPa），HPG조야간안압﹥21 mm Hg발생솔（55.2％）고우NPG조（14.3％）（χ2＝4.31，P＝0.035）。량조환자상방상한、하방상한、섭측상한、비측상한시망막신경섬유층후도급시망막신경섬유층평균후도，시야평균편차급모식표준편차비교，차이균무통계학의의（ P﹥0.05）。결론야간안압측량능경호지반영수시자안압변화，종이감소HPG적루진，치득재의사NPG진치중추엄응용。
pressure glaucoma(NPG),to reduce missed diagnoses of high pressure glaucoma(HPG). Methods A total of 50 suspected NPG patients(96 eyes)admitted to this hospital from January 2011 to January 2012 were divided,according to nocturnal IOP results,into groups NPG(21 cases,38 eyes),HPG(29 cases,58 eyes). The general state of health,daytime/ nighttime IOP,thickness of retinal nerve fibre layer and field of vision were compared between 2 groups. Results There was no significant difference in gender composition(χ 2 =1. 05,P =0. 910),mean age(t =3. 20,P =0. 760),average visual acuity(t =0. 17,P =0. 480). The valley and peak values at daytime and nighttime,fluctuation range of nocturnal IOP at nighttime were greater in HPG group than in NPG group(P ﹤0. 05). The fluctuation of nocturnal IOP at daytime was lower in HPG group than in NPG group(P ﹤0. 05). Sixteen patients of HPG group,3 of NPG group had nocturnal IOP ﹥ 21 mm Hg, the incidence was higher in HPG group(55. 2%)than in NPG group(14. 3%)(χ 2 =4. 31,P =0. 035). There was no significant difference in retinal nerve fibre layer thickness,mean thickness in upper,bottom,temporal or nasal quadrants,mean deviation of visual field,standard deviation of pattern between 2 groups( P ﹥ 0. 05). Conclusion Nocturnal IOP measurement, which can reflect IOP changes better to reduce missed diagnoses of HPG,is worthy of application in diagnosis of suspected NPG.