中华劳动卫生职业病杂志
中華勞動衛生職業病雜誌
중화노동위생직업병잡지
CHINESE JOURNAL OF INDUSTRIAL HYGIENE AND OCCUPATIONAL DISEASES
2015年
4期
285-287
,共3页
黄冬梅%朱林平%杨金平%吴东平
黃鼕梅%硃林平%楊金平%吳東平
황동매%주림평%양금평%오동평
超声检查%三硝基甲苯%白内障%晶状体%血液动力学
超聲檢查%三硝基甲苯%白內障%晶狀體%血液動力學
초성검사%삼초기갑분%백내장%정상체%혈액동역학
Ultrasonography%Trinitrotoluene%Cataract%Lens%Hemodynamics
目的 探讨超声检查对三硝基甲苯(TNT)白内障的诊断价值.方法 应用超声和裂隙灯对比观察45例90只TNT白内障及60例120只健康成人眼晶状体的形态及内部回声,同时测量眼球后动脉血流动力学参数以裂隙灯显微镜检查结果为诊断标准,计算超声对TNT白内障诊断的敏感性、特异性和诊断符合率. 结果 超声检出 TNT白内障的敏感性为93.33％,特异性为100.00％,诊断符合率为97.14％,阳性预测值为100％,阴性预测值为95.23％,阳性似然比为93.33,阴性似然比为0.67.超声显示:随着TNT白内障期别的增加,晶状体出现梭形、球形、盘状等形态改变,后囊膜弧形回声带逐渐增厚、回声增强眼动脉(OA)、视网膜中央动脉(CRA)的收缩期峰值流速(PSV)、舒张末期流速(EDV)明显低于正常组(P＜0.01),阻力指数(RI)增高(p＜0.05),差异有统计学意义.结论 超声对TNT白内障晶状体病变的敏感性与眼科裂隙灯相近.超声能客观真实反映出晶状体混浊的形态、范围、密度程度,且容易观测,有助于裂隙灯明确TNT白内障的诊断与分期,还可提供眼球后动脉血流动力学信息,为临床医生判断病情、估测治疗效果及探索治疗途径提供新的思路.
目的 探討超聲檢查對三硝基甲苯(TNT)白內障的診斷價值.方法 應用超聲和裂隙燈對比觀察45例90隻TNT白內障及60例120隻健康成人眼晶狀體的形態及內部迴聲,同時測量眼毬後動脈血流動力學參數以裂隙燈顯微鏡檢查結果為診斷標準,計算超聲對TNT白內障診斷的敏感性、特異性和診斷符閤率. 結果 超聲檢齣 TNT白內障的敏感性為93.33％,特異性為100.00％,診斷符閤率為97.14％,暘性預測值為100％,陰性預測值為95.23％,暘性似然比為93.33,陰性似然比為0.67.超聲顯示:隨著TNT白內障期彆的增加,晶狀體齣現梭形、毬形、盤狀等形態改變,後囊膜弧形迴聲帶逐漸增厚、迴聲增彊眼動脈(OA)、視網膜中央動脈(CRA)的收縮期峰值流速(PSV)、舒張末期流速(EDV)明顯低于正常組(P＜0.01),阻力指數(RI)增高(p＜0.05),差異有統計學意義.結論 超聲對TNT白內障晶狀體病變的敏感性與眼科裂隙燈相近.超聲能客觀真實反映齣晶狀體混濁的形態、範圍、密度程度,且容易觀測,有助于裂隙燈明確TNT白內障的診斷與分期,還可提供眼毬後動脈血流動力學信息,為臨床醫生判斷病情、估測治療效果及探索治療途徑提供新的思路.
목적 탐토초성검사대삼초기갑분(TNT)백내장적진단개치.방법 응용초성화렬극등대비관찰45례90지TNT백내장급60례120지건강성인안정상체적형태급내부회성,동시측량안구후동맥혈류동역학삼수이렬극등현미경검사결과위진단표준,계산초성대TNT백내장진단적민감성、특이성화진단부합솔. 결과 초성검출 TNT백내장적민감성위93.33％,특이성위100.00％,진단부합솔위97.14％,양성예측치위100％,음성예측치위95.23％,양성사연비위93.33,음성사연비위0.67.초성현시:수착TNT백내장기별적증가,정상체출현사형、구형、반상등형태개변,후낭막호형회성대축점증후、회성증강안동맥(OA)、시망막중앙동맥(CRA)적수축기봉치류속(PSV)、서장말기류속(EDV)명현저우정상조(P＜0.01),조력지수(RI)증고(p＜0.05),차이유통계학의의.결론 초성대TNT백내장정상체병변적민감성여안과렬극등상근.초성능객관진실반영출정상체혼탁적형태、범위、밀도정도,차용역관측,유조우렬극등명학TNT백내장적진단여분기,환가제공안구후동맥혈류동역학신식,위림상의생판단병정、고측치료효과급탐색치료도경제공신적사로.
Objective To evaluate the diagnostic value of ultrasonography for trinitrotoluene (TNT) cataract.Methods The morphology and internal echoes of 90 lenses of 45 TNT cataract patients and 120 lenses of 60 healthy adults were observed and compared using ultrasonography and slit lamp,and the hemodynamic parameters of the post-ophthalmic artery were also measured.The findings of the slit-lamp microscope were regarded as diagnostic criteria,and the sensitivity,specificity,and accordance rate of ultrasonography in the diagnosis of TNT cataract were calculated.Results The sensitivity,specificity,and accordance rate of uhrasonography in the diagnosis of TNT cataract were 93.33％,100.00％,and 97.14％,respectively;the positive and negative predictive values were 100％ and 95.23％,respectively;the positive and negative likelihood ratios were 93.33 and 0.67,respectively.With the progression of TNT cataract,ultrasonography showed that the lenses demonstrated morphological changes (spindle-shaped,spherical,and discoid morphologies),and the arc echoes of the posterior capsule were thickened and enhanced.The TNT cataract patients showed significantly lowerpeak systolic velocity and end-diastolic velocity of the ophthalmic artery (OA) and central retinal artery (P＜0.01) and a significantly higher resistance index (P＜0.05) than the healthy adults.Conclusion The sensitivity of ultrasonography in the diagnosis of TNT cataract is similar to that of slit lamp.Ultrasonography can demonstrate objectively the shape,range,and degree of lens opacity in an efficient manner,which is conducive to the diagnosis and staging of TNT cataract by slit lamp,and can also provide hemodynamic information of the OA.thus providing new ideas for clinical physicians in evaluating the disease and clinical efficacy as well as exploring therapies.
