原发性闭角型青光眼眼压与眼球后血流动力学改变的相关研究

目的:研究原发性闭角型青光眼(PACG)眼动脉(OA)、视网膜中央动脉(CRA)血流动力学改变及眼压(IOP)对眼球后血流动力学的影响。方法:PACG患者45例(90眼),并根据IOP情况分为正常IOP组(52眼)与高IOP组(38眼)。应用彩色多普勒成像技术研究PACG眼球后OA、CRA血流动力学改变。观察指标:收缩期最大血流速度(PSV)、舒张末期血流速度(EDV)、搏动指数(PI)、阻力指数(RI)。彩色多普勒检查前采用非接触IOP计测量受检者IOP。结果:PACG患者CRA-EDV(P<0.01),CRA-RI(P<0.01)均显著不同于正常对照组,且患者正常IOP组与高IOP组之间亦有显著性差异(P<0.01)。CRA-EDV呈逐级降低趋势。CRA-RI的表现与CRA-EDV相反,呈逐级增高现象。无论是CRA还是OA,三组间PSV均无显著性差异。相关分析表明:PACGIOP与CRA-RI(r=0.51;P=0.001)及CRA-EDV(r=-0.396;P=0.014)显著相关。偏相关分析显示:IOP与CRA-RI显著相关(r=0.393;P<0.001),而与CRA-EDV无显著相关(r=-0.065;P=0.559)。其回归方程为:RI=58.82 0.47×IOP。结论:IOP对OA无显著影响。PACGIOP升高可导致CRA-RI增高,继而使EDV降低,视网膜血流量下降。

Correlation of intraocular pressure with retrobulbar hemodynamic changes in patients with primary angle-closure glaucoma

Objective: To investigate the hemodynamic changes of ophthalmic artery(OA) and central retinal artery(CRA) in patients with primary angle-closure glaucoma(PACG) and the effects of intraocular pressure(IOP) on retrobulbar hemodynamics. Methods: Following the measurement of IOP by non-contact tonometry,hemodynamic changes of OA and CRA were examined by color Doppler imaging(CDI) in 45 patients(90 eyes) with PACG,who were divided according to IOP into a hypertension(38 eyes) and a normal tension group(52 eyes).Observations were made of the peak systolic velocity(PSV),end-diastolic velocity(EDV),pulsatility index(PI) and resistance index(RI).Results: Significant differences were found between the PACG patients and the normal controls in CRA-EDV(P<0.01) and CRA-RI(P<0.01),as well as between the normal and the high IOP group(P<0.01).EDV had a tendency to decrease while RI to increase gradually.PSV exhibited no difference among the 3 groups either in CRA or in OA.Correlation analysis showed significant correlation of IOP with CRA-EDV(r=-0.396,P=0.014) and RI(r=0.51.P=0.001) in the PACG patients;partial correlation analysis revealed that IOP was significantly correlated with CRA-RI(r=0.393,P<0.001) but not with CRA-EDV(r=-0.065,P=0.559).The regression equation was RI=58.82 0.47 IOP.Conclusion: IOP has no remarkable effect on OA,but higher IOP may cause an increase in CRA-RI,a decrease in CRA-EDV and eventually a reduction in retinal blood flow.