AccuPen手持压平眼压计在24小时眼压监测中的应用及影响因素的分析

Application of AccuPen hand-held tonometer in 24-hour intraocular pressure monitoring and analysis of influencing factors

目的使用新型AccuPen(压平眼压计)进行坐位及卧位下的24h眼压监测,探讨体位对眼压的影响程度,并分析测得眼压与中央角膜厚之间的相关性。方法2016年l1月至2017年10月在我院进行24h眼压监测的可疑青光眼48例、开角型青光眼确诊患者24例。使用AccuPen压平眼压计测量平卧位、坐位眼压。采用配对t检验比较各组中不同体位下测得的眼压差别,独立样本t检验比较日间坐位及夜间卧位的眼压均值。Pearson相关性分析探讨与中央角膜厚度(CCT)的相关性。结果AccuPen测得所有患者的坐位眼压为(18.41±4.79)mmHg,卧位眼压为(20.24±4.85)mmHg,日间坐位眼压为(18.31±4.43)mmHg,夜间卧位眼压为(20.21±4.89),其中可疑青光眼组平均坐位眼压为(18.61±4.96)mmHg,卧位眼压为(20.36±5.15)mmHg,日间坐位眼压为(18.58±4.53)mmHg,夜间卧位眼压为(20.08±5.20);开角型青光眼组坐位眼压为(17.79±4.20)mmHg,卧位眼压为(19.86±3.78)mmHg,日间坐位眼压为(17.47±4.03),夜间卧位眼压为(20.60±3.79),3组数据坐位眼压均小于卧位眼压,日间坐位小于夜间平卧位眼压,P<0.05。可疑青光眼组平均中央角膜厚度为(536.6±28.4)μm,青光眼组平均CCT为(527.2±28.4)μm。可疑青光眼组坐位眼压、卧位眼压与角膜厚度的相关系数r分别为0.27(P>0.05),0.26(P>0.05);开角型青光眼组坐位眼压、卧位眼压与角膜厚度的相关系数r分别为-0.31(P>0.05),-0.37(P>0.05)。结论体位对眼压的测量存在影响,平卧位的眼压高于坐位眼压。夜间卧位眼压高于日间坐位眼压。AccuPen测得的眼压值在可疑青光眼及开角型青光眼患者中受角膜厚度影响小。

Objective Using the less commonly used AccuPen (applanation tonometer) for 24-hour intraocular pressure (IOP) monitoring at the sitting and supine positions to evaluate the effect of body position on IOP and the associations between IOP and central corneal thickness (CCT).Methods Fourty-eight cases of suspect glaucoma and 24 cases of primary open angle glaucoma (POAG) receviced 24-hour IOP measurement from Nov 2016 to Oct 2017 in Chuiyangliu hospital. Measurements of IOP were taken by AccuPen at the sitting and supine positions.Paired t-test was used to compare the difference in IOP measured at different positions. Comparison of IOPs between daytime (sitting) and night(supine)was performed by Student’s t test.The correlation of CCT and IOP was investigated by Pearson correlation analysis.Results For all the patients, the mean IOP measured by AccuPen was 18.41±3.30 mmHg (siting position), 20.24±3.43 mmHg (supine position), 18.31±4.43 mmHg (daytime sitting) and 20.21±4.89 mmHg (night supine). In the suspect glaucoma group, the mean IOP was 18.61±4.96 mmHg (siting position),20.36±5.15 mmHg (supine position),18.58±4.53 mmHg (daytime sitting) and 20.08±5.20 mmHg (night supine). In the POAG group, the corresponding values were 17.79±4.20mmHg (siting),19.86±3.78 mmHg (supine position),17.47±4.03 mmHg (daytime sitting) and 20.60±3.79 mmHg (night supine), respectively.The IOPs at the sitting position were all smaller than those at the supine position, and the IOPs at the daytime sitting position were all smaller than the night supine position ( P <0.05). the mean CCT in the suspect glaucoma group and POAG group was 536.6±28.4 μm and 527.2±28.4 μm,respectively.There was a significant difference between Sitting IOP and the supine in two groups.(supine>sitting). Spearman’s correlation analysis of CCT and IOP yielded correlation coefficient (r) of 0.27 (sitting, P >0.05) and 0.26 (supine, P >0.05),and -0.31(sitting, P >0.05) and -0.37 (supine, P >0.05) in suspicious glaucoma group and POAG group, respectively.Conclusions Body position has an effect on the measurement of IOP. The IOP at supine position is significantly higher than that at sitting position.The daytime IOP at sitting position is lower than that at night supine position.The IOP measured by AccuPen had no significant correlations with CCT among patients with suspect glaucoma or POAG.