CAJ | 학술논문

目的初步探讨永存原始玻璃体增生症(persistent hyperplastic primary vitreous,PHPV)患儿眼眶发育状况及其与眼轴发育、病变类型间关系.方法对2009年3月至2011年8月在上海交通大学医学院附属新华医院就诊的18例PHPV患儿进行眼部超声检查、眼轴长度测量及CT三维重建眶容积分析.结果患儿平均年龄10个月(最小56 d,最大24个月),均单眼发病.患眼轴长(17.8±3.2) mm,眶容积(12.5±2.9) cm3;健眼轴长(20.4±2.7) mm,眶容积(13.5±3.1) cm3.患眼轴长及眶容积均显著＜对侧眼,差异有统计学意义(t值=-5.517、-5.701,P值=3.772× 104、2.598×10-5).根据超声特征,按病变累及玻璃体前部、后部或全程,分成A组(4例)、B组(5例)、C组(9例),计三组.A组患眼与对侧眼间眼轴长度及眶容积差异均无统计学意义(t值=-1.151、-2.485,P值=0.333、0.089);B组患眼轴长及眶容积均＜对侧眼(t值=-2.835、-2.809,P值=0.047、0.048).C组患眼轴长及眶容积均显著＜对侧眼(t值=-8.472、-5.365,P值=2.885×10-5、0.001).C组双眼轴长差值显著＞A、B两组(P值=0.001、0.008),C组双眼眶容积差均值最大,但与其他组比较差异无统计学意义(P＞0.05).眶容积与眼轴长度呈较强差异有统计学意义(r=0.486,P=0.003).双眼眶容积差值与眼轴长度差值差异有统计学意义(r=0.560,P=0.016).结论 PHPV患眼眼轴发育及眶容积发育均受阻,两者存在正相关关系.单纯前部玻璃体增殖影响不明显,前后混合型影响显著.CT三维重建是有效的眶容积测量方法.
목적 초보탐토영존원시파리체증생증(persistent hyperplastic primary vitreous,PHPV)환인안광발육상황급기여안축발육、병변류형간관계.방법 대2009년3월지2011년8월재상해교통대학의학원부속신화의원취진적18례PHPV환인진행안부초성검사、안축장도측량급CT삼유중건광용적분석.결과 환인평균년령10개월(최소56 d,최대24개월),균단안발병.환안축장(17.8±3.2) mm,광용적(12.5±2.9) cm3;건안축장(20.4±2.7) mm,광용적(13.5±3.1) cm3.환안축장급광용적균현저＜대측안,차이유통계학의의(t치=-5.517、-5.701,P치=3.772× 104、2.598×10-5).근거초성특정,안병변루급파리체전부、후부혹전정,분성A조(4례)、B조(5례)、C조(9례),계삼조.A조환안여대측안간안축장도급광용적차이균무통계학의의(t치=-1.151、-2.485,P치=0.333、0.089);B조환안축장급광용적균＜대측안(t치=-2.835、-2.809,P치=0.047、0.048).C조환안축장급광용적균현저＜대측안(t치=-8.472、-5.365,P치=2.885×10-5、0.001).C조쌍안축장차치현저＞A、B량조(P치=0.001、0.008),C조쌍안광용적차균치최대,단여기타조비교차이무통계학의의(P＞0.05).광용적여안축장도정교강차이유통계학의의(r=0.486,P=0.003).쌍안광용적차치여안축장도차치차이유통계학의의(r=0.560,P=0.016).결론 PHPV환안안축발육급광용적발육균수조,량자존재정상관관계.단순전부파리체증식영향불명현,전후혼합형영향현저.CT삼유중건시유효적광용적측량방법.
Objective To study the orbital volume development and its relationship with the axial length and pathological type in children PHPV eyes.Methods Eighteen cases of children who were diagnosed PHPV in Xinhua Hospital affiliated to Medical School of Shanghai Jiaotong University from March 2009 to August 2011 performed ultrasonography of the eye and reconstructed computed tomography of the orbital.The axial length was measured and the orbital volume was calculated by computer procedure.Results The average age of these cases was 10 months (56 days to 24 months),all were unilateral.The axial length and the orbital volume were (17.8±3.2)mm and (12.5±2.9)cm3 in PHPV eyes; while those of the lateral eyes were (20.4±2.7)mm and (13.5±3.1)cm3.Both the axial length and the orbital volume of PHPV eyes were significantly shorter and smaller compared with those of the lateral eyes (t-5.517,-5.701,P 3.772× 105,2.598× 105).According to the anterior,posterior,and combination type of pathological characteristics shown on B-scan images,three groups were made as Group A (4 cases),Group B (5 cases),and Group C (9 cases).There was no significant difference of axial length or orbital volume found between PHPV eyes and the lateral eyes in group A (t-1.151,-2.485,P 0.333,0.089).Both the axial length and the orbital volume were statistically shorter or smaller in PHPV eyes compared with those of the lateral eyes in group B (t-2.835 and-2.809,P 0.047,0.048).Both the axial length and the orbital volume were significantly shorter or smaller in PHPV eyes compared with those of the lateral eyes in group C (t-8.472 and-5.365,P-2.885×105,0.001).The axial length difference between both eyes of group C was significantly larger than that of group A and group B (P 0.001,0.008),but the orbital volume difference between both eyes showed no statistical difference among groups,although the average value was the biggest in group C (P ＞0.05).The orbital volume was positively correlate with the axial length (r 0.486,P 0.003),and the positive correlation could also be found between the orbital volume difference and the axial length difference between two eyes (r 0.560,P 0.016).Conclusions The development of axial length and orbital volume in PHPV eyes are impeded,positive correlation can be found between the axial length and the orbital volume development.The influence of axial length and orbital volume development is not significant in the anterior proliferation type,while it is severe in the combined type.Reconstructed computed tomography is an effective method of orbital volume measurement.