目的 比较高眼压症患者和正常人群的24 h眼压及眼灌注压的节律,为高眼压症的临床诊治提供参考.方法 前瞻性病例对照研究.依据高眼压症(OHT)诊断标准,纳入(107例)高眼压症者,同时选取年龄性别相匹配的正常对照人群(71例),两组均进行24 h眼压值(IOP)、血压值监测.平均动脉压(MAP)=舒张压+1/3(收缩压-舒张压).平均眼灌注压(MOPP)=2/3平均动脉压-眼压;收缩期眼灌注压(SOPP)=收缩期动脉压-眼压;舒张期眼灌注压(DOPP)=舒张期动脉压-眼压.结果 OHT组的MOPP最大值,最小值及平均值均明显低于正常对照组,差异有统计学意义(P<0.05).OHT组SOPP和DOPP最小值,平均值均小于正常对照组,差异有统计学意义(P<0.05).OHT组的IOP、MOPP、SOPP、DOPP波动值明显大于正常对照组,差异均有统计学意义(均P<0.05).OHT组和正常对照组的IOP、MOPP、SOPP峰值谷值时间吻合.正常对照组的24 h DOPP表现出昼高夜低趋势,而OHT组没有表现出明显的昼夜变化曲线.结论 OHT组的整体眼压比对照组高,平均眼灌注压比正常对照组低,且眼灌注压波动较正常对照组大.OHT组的24 h IOP、MOPP、SOPP节律与对照组相似,而24 h DOPP节律与正常对照组有一定差异.在确定OHT的诊断及随访中,不仅要考虑到眼压,角膜厚度,视野,视神经纤维层厚度的变化,也应关注到眼灌注压的变化,特别是夜间低灌注和DOPP节律的紊乱.为调整治疗方案提供一些参考.
Rhythm of 24 h intraocular and perfusion pressure in patients with ocular hypertension
Objective To characterize the rhythm of 24 hours intraocular pressure(IOP)and ocular perfusion pressure(OPP)in patients with ocular hypertension(OHT),in order to provide a reference for the clinical diagnosis and treatment of OHT.Methods A prospective case-control study.According to the diagnostic criteria,107 patients with OHT were included,and an age-and sex-matched healthy control group(71 patients)was selected.The IOP and blood pressure(BP)of the OHT and the healthy control groups were recorded every 2 h ours over a 24 h ours period.BP was measured using a digital automatic BP monitor,and IOP was measured using a non-contact tonometer.Results The maxi-mum,minimum and mean IOP were significantly higher in subjects with OHT than in the healthy control group(P<0.05),and the maximum,minimum and mean OPP(MOPP)were significantly lower in the OHT group than in the healthy control group(P<0.05).The minimum and mean systolic OPP(SOPP)and diastolic OPP(DOPP)values of the OHT group were lower than those of the healthy control group(P<0.05),and the IOP,MOPP,SOPP and DOPP diurnal and nocturnal fluctuation values were significantly greater in the OHT group than in the healthy control group(P<0.05).Con-clusions The OPP of patients with OHT is lower,and the 24 h ours OPP fluctuates more than that of healthy control sub-jects.Pay attention to OPP changes in the treatment and follow-up of OHT.
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