24小时眼压监测中夜间眼压测量方法的探讨

Investigation of measuring method of intraocular pressure at night during 24-hour circadian intraocular pressure monitoring

目的比较24h眼压监测中夜间即刻坐位眼压值和坐起休息10min后测得的眼压值,探讨夜间眼压的不同测量方法对青光眼24h眼压昼夜波动的影响。方法对已确诊且未用药、未做过手术的48例正常眼压性青光眼及17例原发性开角型青光眼患者进行24h眼压监测,每2h1次,其中测量夜间0:00、2:00、4:00眼压时,逐个唤起患者后立即测,后嘱患者坐起休息10min再测,采用SPSS软件以配对t检验分析比较测量结果。结果夜间即刻坐位眼压值和坐起休息10min后测得的眼压值差异有统计学意义(P<0.001),正常眼压性青光眼与原发性开角型青光眼间眼压差值差异有统计学意义(P<0.05)。结论即刻坐位眼压值能更准确反映夜间眼压,对24h眼压测量及青光眼诊断及治疗更有价值,值得临床应用。

Objective To investigate the influence of different measuring methods on intraocular pressure （IOP） values taken at night during 24-hour circadian IOP monitoring, by comparing the IOP values measured at night instantly in the sitting position and the lOP values after 10 minutes rest in the sitting position. Methods Twenty-four hour circadian IOP monitoring was conducted to 48 patients with normal tension glaucoma （NTG） and 17 patients with primary open angle glaucoma （POAG） who had been diagnosed but not yet treated. IOPs were measured with non-contact tonometer （NCT） every two hours in sitting position. IOP were measured instantly after patients waked up from supine position to sitting position on 0：00, 2：00, 4：00 at night, and repeated after keeping in the sitting position for 10 minutes. Statistical analysis was conducted by SPSS software, and paired T test was implied to compare the differences between two groups. Results The IOP values measured instantly after body position changed from supine to sitting were statistically significant different from the IOP measured 10 minutes after the body position change （P 〈 0.001 ）. The IOP difference between NTG and POAG patients was also statistically significant （P 〈 0.05）. Conclusions Instant sitting lOP meas- urement might be more accurate on reflecting the supine lOP at night. It has more diagnostic and therapeutic value in glaucoma managements.