开角型青光眼小梁切除前后搏动性眼血流量比较研究

目的：以OBF仪对开角型青光眼（primary open angle glaucoma,POAG)患者手术前后的搏动性眼血流量（pulsatile ocular blood flow,POBF）值及眼压进行测量，探讨POAG患者行小梁切除术后眼内血流变化。方法：本院诊断及手术治疗的POAG患者39例39眼，均在本院行小梁切除术，术中加用0．2g.．L^-1丝裂霉素C(mitomycin C,MMC)抗瘢痕，测量项目包括搏动眼血流量，脉搏周期内眼压变化值（pulse amplitude of IOP,PA IOP）,脉搏周期内眼容积变化值（pulse amplitude of volume,PV）,心率（pulse/heart rate,HR），最大眼压（Max-IOP），最小眼压（Min-IOP），平均眼压（Max-IOP Min-IOP）/2,Average IOP(Ave-IOP),手术前测量时间为药物治疗前，手术后测量时间为手术后1－2周，手术前后比较采用配对t检验，Ave-IOP的变化值与OBF的变化值作相关分析，结果：POAG患者手术后POBF，PV增高，Ave-IOP降低，差异有统计学,意义，Ave-IOP的变化值与OBF的变化之间有相关关系r=0.674,t=5.552,P=0.000，结论：POAG患者行小梁切除术后眼压降低有助于眼血流改善，但并不意味着所有POAG患者眼血流都得到改善，推测POAG发病部分原因是血管自身调节功能及供血异常。

Measurement of pulsatile ocular blood flow in primary open angle glaucoma patients undergoing trabeculectomy

Objective To measure the pulsatile ocular blood flow (POBF) and intraocular pressure (IOP) in primary open angle glaucoma (POAG) patients before and after trabeculectomy used OBF tonometry; Determine the influence of trabeculectomy on OBF in POAG patients.Methods Thirty nine patients with POAG who were diagnosed and underwent trabeculectomy at Xiamen Eye Center were examined. The antimetabolits Mitomycin C (MMC) was used in the operation. Pulse amplitude of IOP (PA IOP), pulse amplitude of volume(PV),pulse/heart rate (HR), maximum IOP (Max IOP), minimum IOP (Min IOP) and average IOP (Ave IOP) were obtained before the medical therapy and one or two weeks after the operation.Results The value of POBF, PV were increased and Ave IOP decreased after the operation in POAG patients, and there was statistical difference. The correlation between the change of Ave IOP and OBF was analysed r =0 674, t =5 552 and P =0.000.Conclusion The trabeculectomy can improve the ocular blood flow in POAG patients, but it doesn't mean that all the POAG patients' ocular blood flow can be improved. It suggests that part of the pathogenesis of POAG can be contributed to the abnormal of vas autoregulation and blood supply.