超声测量视神经鞘直径影响因素的研究

Role of ultrasonography in detecting influencing factors of optic nerve sheath diameter

目的探讨超声测量视神经鞘直径(optic nerve sheath diameter,ONSD)的影响因素。方法连续收集2016年9月~2017年2月北京大学第一医院神经内科门诊志愿者181例临床资料,分别测量双眼的ONSD,同时完成经颅多普勒超声检查。独立样本t检验分析左、右眼ONSD测量值是否有差异;多元线性回归分析ONSD与年龄、性别、体质量指数、基础疾病、颅内血管狭窄等因素的相关性。结果 181例志愿者平均ONSD(4.39±0.76)mm,2次测量的左眼ONSD与右眼比较,差异无统计学意义(P>0.05)。有无高血压、糖尿病、冠心病、血脂异常、脑血管病及颅内血管狭窄患者的ONSD比较,差异无统计学意义(P>0.05)。男性ONSD明显高于女性,差异有统计学意义[(4.56±0.81)mmvs(4.29±0.71)mm,P=0.018]。以ONSD为因变量,性别、年龄、体质量指数、基础疾病(高血压、糖尿病、冠心病、血脂异常、脑血管病)、颅内血管狭窄等为自变量,采用逐步多元线性回归分析结果显示,性别是ONSD的影响因素(B=-0.273,95%CI:-0.499^-0.047,P=0.018)。结论性别对ONSD有显著影响,ONSD相关的研究应考虑性别差异。

Objective To study the role of ultrasonography in detecting the influencing factors of optic nerve sheath diameter（ONSD）.Methods The clinical data of 181 volunteers who visited our hospital were recorded.The ONSD of their eyes was measured.The volunteers underwent transcranial Doppler ultrasonography.The ONSD of left and right eyes was analyzed by independent sample t test analysis.The relationship between ONSD and age,gender,BMI,basic diseases,intracranial angiostenosis was analyzed by multivariate linear regression analysis.Results The mean ONSD was 4.39±0.76 mm.No significant difference was found in ONSD of left and right eyes（P〉0.05）and in ONSD between patients with hypertension,DM,CHD,abnormal blood-lipid,cerebrovascular disease,intracranial angiostenosis and those without the above diseases（P〉0.05）.The ONSD was significantly longer in males than in females（4.56±0.81 mmvs4.29±0.71 mm,P=0.018）.Multivariate linear regression analysis showed that gender was an influencing risk factor for ONSD（P=0.018）.Conclusion Gender can significantly influence the ONSD.Relevant studies on ONSD should thus take the gender difference into consideration.