慢性阻塞性肺疾病患者视网膜神经纤维层厚度的研究

StudYy of Retinal Nerve Fiber Layer Thickness in Patients with Chronic Obstructive Pulmonary Disease

目的:观察慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患者的视网膜神经纤维层(retinal nerve fiber layer,RNFL)厚度。方法:选取2016年5月-2017年3月本院的体检患者60例作为研究对象,最终将同时患有高血压疾病的COPD患者30例设置为COPD组,将仅患有高血压疾病的患者30例设置为对照组。对所有受试者行详尽的眼科检查和肺功能检查,并使用Topcon3D OCT.2000检测受试者上方、下方、鼻侧、颞侧和平均RNFL厚度,观察其与FEV_1占预计值百分比的相关性。结果:初诊时,COPD组的FEV_1占预计值的百分比为(66.10±2.27)%,明显低于对照组的(103.68±1.98)%,差异有统计学意义(t=14.274,P=0.000)。COPD组上方、鼻侧、颞侧及平均RNFL厚度较对照组均无明显变化,差异均无统计学意义(P>0.05);下方RNFL厚度较对照组明显变薄,差异有统计学意义(t=2.063,P=0.048)。经Pearson相关性分析,COPD组患者下方RNFL厚度与FEV_1占预计值百分比呈负相关(r=-0.015,P=0.936)。结论:COPD组上方、鼻侧、颞侧及平均RNFL厚度较对照组均无明显变化,且下方RNFL厚度较对照组明显降低,其降低程度与COPD病情严重程度具有相关性。

To observe the retinal nerve fiber layer(RNFL)thickness in patients with chronic obstructive pulmonary disease(COPD).Method:A total of60patients with physical examination in our hospital from May2016to March2017were selected as the study subjects.Finally,30patients with COPD who also suffered from hypertension were assigned to the COPD group;30cases who only with hypertension were assigned to the control group.All subjects were given detailed ophthalmologic examination and pulmonary function examination,and Topcon3D OCT.2000was used to measure the thickness of the superior,inferior,nasal,temporal and average RNFL of the subjects,and the correlation between them and the percentage of FEV1in the predicted value was observed.Result:The percentage of FEV1in the predicted value of the COPD group was(66.10±2.27)%,which was significantly lower than(103.68±1.98)%of the control group,the difference was statisticallysignificant(t=14.274,P=0.000).There were no significant changes in the thickness of the superior,nasal,temporal and average RNFL between the COPD group and the control group,the differences were not statistically significant(P>0.05);but the thickness of inferior RNFL was significantly thinner than that in the control group,the difference was statistically significant(t=2.063,P=0.048).After Pearson correlation analysis,the RNFL thickness of patients in the COPD group was negatively correlated with the percentage of FEV1in the predicted value(r=-0.015,P=0.936).Conclusion:There were no significant changes in the thickness of the superior,nasal,temporal and the average RNFL in the COPD group compared with the control group,and the inferior thickness was significantly lower than that in the control group.The degree of decrease was correlated with the severity of COPD.