兔眼中央角膜厚度与Perkins压平眼压关系的研究

目的探讨中央角膜厚度(CCT)与Perkins压平眼压的关系,建立CCT、真实眼压与Perkins压平眼压三者关系的数学模型和CCT对Perkins压平眼压的校正公式。方法健康新西兰大耳白兔32只,双眼中1只眼行准分子激光屈光性角膜切削术(PRK),另1只眼测得的数据对行PRK眼得出的数据进行验证。采用随机数字表法随机取1只眼,采用PRK,人为改变兔眼的CCT,建立不同CCT的活体眼模型,分别采用Perkins压平眼压计、A型超声角膜测厚仪、角膜曲率计测量术前、术后Perkins压平眼压、CCT、角膜曲率以及应用电子直接眼压计测量真实眼压,分别对术前和术后测量值做相关分析和多元线性回归分析,并对另1组未行PRK眼测得的真实眼压、Perkins压平眼压、CCT对实验组得出的公式进行验证。结果兔眼双眼Perkins压平眼压、CCT、角膜曲率无统计学差别,无论是术前还是术后Perkins压平眼压与CCT均显著相关(r=0.761P<0.01;r=0.829,P<0.01),与角膜曲率无关(r=0.098,P>0.05;r=0.260P>0.05)。对术前、术后Perkins压平眼压与CCT建立回归公式,曲线的斜率分别为0.066、0.053,Perkins压平眼压的改变与CCT的改变有关。对真实眼压Y与Perkins压平眼压、CCT三者的关系建立回归公式为Y=12.107+1.254X1-0.033X2(X1=Perkins压平眼压,X2=CCT)。结论CCT的改变影响Perkins压平眼压的测量值,临床上应根据CCT来校正Perkins压平眼压的测量值。     

颅压平口服液结合早期康复训练治疗创伤性颅脑损伤的临床研究

目的探讨颅压平口服液结合早期康复训练对急性颅脑损伤的临床疗效及其机制。方法45例创伤性颅脑损伤（TBI）患者随机分为药康组、康复组、对照组,对照组按神经外科西医常规治疗;康复组按西医常规治疗加用早期康复训练;药康组在康复组的基础上加用颅压平口服液,每6h一次,每次40mL。对3组治疗前后及组间神经功能缺损评分（GCS评分）、Barthel指数评分进行比较。结果药康组显愈率为86．6％,总有效为93．33％,明显优于对照组和康复组。3组治疗后Barthel指数评分比较药康组明显优于对照组（P〈0．01）,康复组优于对照组（P〈0．05）,药康组与康复组间比较无统计学意义（P〉0．05）。结论颅压平口服液结合早期康复训练在缓解和消除急性颅脑损伤临床症状、改善患者日生活常能力（ADL）,降低伤残率,提高生活质量方面起到了较好的临床疗效。     

常用几种眼压计在临床应用中的特点

<正>眼压测量是眼科临床工作中常规检查。眼压测量值对眼科疾病的诊治、病情观察、疗效观察、用药情况观察及对青光眼的诊断及治疗随访有着重要意义。     

卡托普利致味觉失常1例

病例介绍男性,4 2岁,因高血压病来诊。测血压1 75 / 1 0 0 m m Hg,给予卡托普利1 2 .5 mg,1日3次口服。2 d后患者出现味觉减退现象,未停药,1周后患者味觉丧失。血压稳定后,患者停用卡托普利,味觉又逐渐恢复正常。2周后患者又因头晕、高血压来诊,再次给予卡托普利口服治疗,服药当日晚患者又出现味觉丧失现象,第二日来院咨询,考虑为药物所致不良反应,嘱停用卡托普利,改用北京降压0号(复方降压平片) 1日1片口服,未再出现味觉减退现象。讨论该患者两次服用卡托普利均出现味觉减退现象,由此可见,味觉丧失确系卡托普利所致,其机制尚不清楚,可能与…     

正常人中央角膜厚度对不同眼压计测量值的影响

目的 探讨正常人中央角膜厚度(central corneal thickness,CCT)对Icare 回弹式眼压计(Icare rebound tonometer,Icare)、Goldmann压平眼压计(Goldmann Applanation Tonometer,GAT)和PASCAL动态轮廓眼压计(Dynami...     

Long-term intraocular pressure fluctuation of primary angle closure disease following laser peripheral iridotomy/iridoplasty

Background  Many studies indicated that short-term and long-term intraocular pressure (IOP) fluctuations in primary open angle glaucoma patients might lead to glaucomatous progression. However, seldom study has evaluated the long-term fluctuation of IOP in primary chronic angle closure diseases. The objective of this study was to investigate the long-term IOP fluctuation of primary angle closure diseases and its associations following laser peripheral iridotomy (LPI) with or without laser peripheral iridoplasty.

Methods  A total of 158 patients with primary angle closure suspect (PACS, n=21), primary angle closure (PAC, n=81) and primary angle closure glaucoma (PACG, n=55) had been treated by LPI with or without laser peripheral iridoplasty and followed up for more than 12 months. IOP was measured with Goldman applanation tonometer. Multivariate linear regression with generalized estimating equation (GEE) regression models was used to evaluate the association of long-term IOP fluctuation (maximum IOP minus minimum IOP) with gender, age, baseline IOP, baseline peripheral anterior synechia (PAS), baseline vertical cup/disc ratio (VCDR), baseline mean deviation (MD), need for IOP-lowering medications.

Results  IOP fluctuation during follow-up in PACS, PAC and PACG groups were (4.83±2.90), (5.67±3.35), and (9.40±7.14) mmHg, respectively. IOP fluctuation was strongly correlated with baseline IOP (r=0.356, P <0.001), PAS (r=0.374, P <0.001). IOP fluctuation was higher in patients with higher baseline IOP (0.18 mmHg per unit increase, 95% CI: 0.05–0.31 mmHg).

Conclusions  Long-term IOP fluctuation in PACG group was larger than that in PACS or PAC group. Eyes with higher baseline IOP were observed to have larger long-term IOP fluctuation.

     

应用参芎通脉汤中西医结合治疗老年性不稳定性心绞痛52例

笔者自 1997年以来 ,用自拟参芎通脉汤配合复方丹参液、精制蝮蛇抗栓酶静脉滴注治疗老年性不稳定性心绞痛 5 2例 ,疗效满意。报告如下。临床资料　所有病例符合ＷＨＯ冠心病不稳定性心绞痛诊断标准 ,辨证分型参照 1980年全国冠心病辨证论治研究座谈会制订的冠心病心绞痛中医辨证试行标准 ,且符合下列条件 :6 0岁以上 ;每周心绞痛发作 2次以上 ;静息心电图有明显ＳＴ Ｔ、ＳＴ或Ｔ波异常 ;排除严重心肝肾功能异常 ;无出血倾向。 10 2例患者均为本院住院患者 ,根据住院先后随机分为两组。治疗组 5 2例 ,男 30例 ,女 2 2例 ,年龄 6 0～ 80岁 ,…     

飞秒LASIK手术后角膜生物力学变化观察

目的对比飞秒激光制瓣的准分子激光原位角膜磨镶术(FS-LASIK)手术前后应用眼反应分析仪(Ocular Response Analyzer,ORA)及非接触眼压计(non-contact tonometer,NCT)测量眼压结果的不同。方法随机选取接受FS-LASIK手术的近视眼患者100例(200眼),分别于术前及术后3个月应用ORA检测角膜补偿眼压(corneal compensated intraocular pressure,IOPcc)、模拟Goldmann眼压((Goldmann correlated IOP value,IOPg),再应用NCT测量眼压。分析比较术前、术后眼压测量结果的差异。应用A型超声测量角膜厚度,应用地形图仪测量角膜屈光度。结果术前及术后3个月角膜平均厚度分别为(541.18±32.80,454.64±37.10)μm,差异有统计学意义(t=55.120,P=0.000);术前及术后3个月角膜屈光度分别为(43.88±1.43,38.87±2.27)D,差异有统计学意义(t=42.301,P=0.000)。结论 FS-LASIK手术不仅改变了角膜的厚度及硬度,也改变了角膜的曲率,IOPcc由于矫正了厚度及硬度的影响,所以术后比NCT更接近真实眼压值,但都比术前低。     

准分子激光屈光性角膜手术对眼压测量的影响

目的 研究准分子激光屈光性角膜手术对眼压测量的影响。方法 ４１例（８０眼）手术前后和Ｓｃｈｉｏｔｚ眼压计及非接触式眼压计）ＮＣＴ）分别测量眼压,并进行统计学分析。结果 （１）Ｓｃｈｉｏｔｚ眼压计所测眼压手术前后无显著差异,ＮＣＴ则有显著性差异;手术前后ＮＣＴ所测眼压值均显著低于Ｓｃｈｉｏｔｚ眼压计。（２）手术前后忾测眼压差值显著大于Ｓｃｈｉｏｔｚ则有所测得者;近视度与Ｓｃｈｉｏｔｚ眼压所测眼压差值