急性闭角型青光眼患者房水、血浆及尿儿茶酚胺的测定

Determination and significance of catecholamines in aqueous humor, plasma and 24 hour urine of patients with acute angle closure glaucoma

目的探讨急性闭角型青光眼（ａｃｕｔｅａｎｇｌｅ－ｃｌｏｓｕｒｅｇｌａｕｃｏｍａ，ＡＡＣＧ）发作期眼和全身交感神经系统的功能状态及相关的神经体液因素——儿茶酚胺（ｃａｔｅｃｈｏｌａｍｉｎｅｓ，ＣＡ）与眼压的关系，探讨ＡＡＣＧ的触发机制。方法应用荧光法测定ＡＡＣＧ发作期患者房水、血浆及２４小时尿液中ＣＡ的含量，并与老年性白内障患者及正常人进行对比。结果ＡＡＣＧ发作期患者房水、血浆中ＣＡ含量及２４小时尿ＣＡ总量明显高于对照组（Ｐ＜０．００１），房水与血浆中ＣＡ含量与眼压水平呈正相关关系。结论ＡＡＣＧ发作期眼交感神经高度兴奋。释放大量ＣＡ入房水；同时全身交感神经系统也处于应激兴奋状态，ＣＡ进入血循环，可起调节眼压的作用。因此，ＣＡ可能是急性闭角型青光眼发作期眼压持续增高的重要辅加因素。

Objective To study the functional state of ocular and systemic sympathetic nervous system and the effects of its related neurohumoral factor, catecholamines (CA), on intraocular pressure (IOP) in patients with acute angle closure glaucoma (AACG). Methods The levels of CA in the aqueous humor, plasma and the total amount of CA in 24 hour urine of cases with AACG during attack stage were determined with fluorometry, and the results were compared to that of patients with senile cataract and normal adults. Results The CA levels within aqueous humor and plasma and in 24 hour urine of the patients with AACG during attack stage were elevated obviously as compared with that of the control subjects ( P <0.001), and positively correlated with the level of IOP. Conclusion During attack stage of AACG, the ocular sympathetic nervous system is highly excited and a large amount of CA is released into the aqueous humor, in the meantime the systemic sympathetic nervous system is also excited and CA is released into the blood circulation, which may play a certain role in the regulation of IOP. Possibly, CA is an important supplemental factor within the attack stage of AACG.