原发性先天性青光眼临床特征的相关性

目的 分析原发性先天性青光眼的临床特征及其相关关系.方法 收集2006～2007年于北京同仁医院诊治三岁内原发性先天性青光眼患者临床资料,应用SPSS软件进行相关分析和回归分析.结果 共收集144例(259只眼),79.9%为双眼患病,男性明显多于女性(男女比=2.51:1),一岁内发病者占71.53%.有先天性青光眼家族史者占2.78%.最常见的症状为角膜混浊(41.0%)和畏光流泪(38.9%),多元回归分析发现发病时间与此相关(β=-0.191,P=0.027;β=-0.235,P=0.008).多元线性回归分析发现眼压与角膜直径(β=-0.244,P=0.038)、视乳头C/D比(β=0.293,P=0.005)之间显著相关.Logistic回归分析显示角膜直径(OR=0.403,P=0.000)与Haab纹显著相关.Pearson相关分析发现角膜直径与发病时间和病程无关.结论 角膜混浊与畏光流泪同是原发性先天性青光眼最常见的症状.检查角膜是否清亮,患儿是否怕光可作为先天性青光眼初步筛查的检查项目.眼压、角膜直径、Haab纹及视乳头C/D比均可以作为判断病情严重程度的指标.角膜直径仅与眼压相关,与发病时间和病程无关,是很好的判断疾病是否进展的指标.

The correlation of clinical feature in primary congenital glaucoma

Objective To analysis the correlation of clinical feature in primary congenital glaucoma (PCG). Methods Clinical data of PCG were collected in Beijing Tongren Hospital from 2006 to 2007. Correlation and regression analysis was performed to identify the correlation of parameters. Results The data of PCG were presented for 144 patients (259 eyes). 79.9% of cases were binoculus. Boys were more common, with a total ratio of boys to girls of 2.51:1.2.78% of cases were familial. 71.53% of PCG presented to the referring or treating ophthalmologist within the first 12 months. The cloudiness of cornea was the most common symptom, accounting for 41.0%. The epiphora and photophobia were the second most common symptom (38.9%). Linear regression analysis indicated that the age of clinical onset was related with the cloudiness of cornea (β=-0,191,P=0.027)and epiphora photophobia (β=-0.235,P=0.008). A parallel exists among changes in intraocular pressure, corneal diameter (β=0.244, P=0.038) and cup-disc ratio (β=0.293, P=0.005). Logistic regression analysis indicated that corneal diameter was related with Haab' s striae. The corneal diameter were independent with age of clinical onset and time of diagnosis. Conclusions The common symptom was cloudiness of corneal, epiphora and photophobia in PCG patients. Child health surveillance should include corneal clearness and photophobia symptom examination that is helpful to detect congenital glaucoma. The intraocular pressure, corneal diameter, cup-disc ratio and Haab' s striae are useful to judge severity. The corneal diameter is important and good index for follow up to identify progression.