不同类型音乐对健康人眼压的影响及其机制研究

Effects of different types of music on intraocular pressure and the underlying mechanism

目的研究听不同类型音乐对健康人眼压的影响并探讨其潜在的机制。方法横断面研究。本研究受试者为2017年10月至2018年5月中山大学在校健康学生志愿者。研究由两部分组成。在第一部分中,受试者分别听3种类型音乐(舒缓音乐、正性音乐、负性音乐)各15 min,听音乐前后测量眼压,以确定可以降低眼压的音乐,并用问卷评估受试者对每种类型音乐的情绪反应。在第二部分中,分别在7:30、9:30、11:30、13:30、15:30和17:30测量眼压,以确定每名受试者的眼压峰值时间点;在第2天,受试者在各自的眼压峰值时间听降眼压音乐15 min,分别测量听音乐前后的眼压、血压、心率,并用扫频源相干光层析成像术拍摄眼前节图像,用Image J软件测量Schlemm管横截面积和直径。采用配对t检验进行统计学分析。结果第一部分共纳入15名受试者,包括7名男性和8名女性,年龄(23±1)岁。听舒缓音乐前、后眼压分别为(12.65±2.49)、(11.62±2.51)mmHg(1 mmHg=0.133 kPa),听舒缓音乐后眼压降低,差异有统计学意义(t=-2.39,P=0.032);听正性音乐前、后眼压分别为(12.65±2.46)、(12.45±2.77)mmHg,差异无统计学意义(P=0.566);听负性音乐前、后眼压分别为(10.86±2.78)、(12.13±1.60)mmHg,听负性音乐后眼压升高,差异有统计学意义(t=2.45,P=0.029)。15人中有14人听舒缓音乐后感到放松。第二部分共纳入55名受试者,包括20名男性和35名女性,年龄(26±10)岁。在每个人的眼压峰值时间点听舒缓音乐后眼压、心率、收缩压、舒张压均降低,听音乐前、后眼压分别为(13.99±4.47)、(12.66±4.32)mmHg,心率分别为(79.57±10.43)、(75.57±9.62)次/min,收缩压分别为(118.11±13.92)、(110.82±12.67)mmHg,舒张压分别为(70.07±9.96)、(66.14±8.48)mmHg,差异均有统计学意义(t=-5.72,-3.68,-5.10,-3.65;均P<0.01)。听舒缓音乐后Schlemm管显著增大,听音乐前、后Schlemm管的横截面积分别为(230.07±92.20)、(255.96±93.36)像素,直径分别为(8.62±1.89)、(9.41±2.37)像素,差异均有统计学意义(t=2.88,3.39;均P<0.01)。结论舒缓音乐可以降低健康人的眼压,可能通过扩张Schlemm管发挥一定作用。

Objective To explore the effect of listening to different types of music on intraocular pressure(IOP)and the underlying mechanism.Methods Cross-sectional study.Participants were students from Sun Yat-sen University from October 2017 to May 2018.The study consisted of two parts.In part 1,three types of music,including relaxing,positive and negative music,were used to find out which kind of music could reduce IOP.IOP was measured before and after listening to music.A self-report questionnaire was used to evaluate emotional responses to each type of music.In part 2,the diurnal curve of IOP at 6 time points of 7:30,9:30,11:30,13:30,15:30 and 17:30 was measured to determine when the individual's IOP peaked.On the second day,the subject listened to the music that could reduce IOP for 15 minutes at his/her IOP peak time.IOP,blood pressure(BP)and heart rate(HR)were measured,and morphology of the chamber angle was captured by swept-source optical coherence tomography before and after listening to music.Image J software was used to measure the diameter and cross-sectional area of Schlemm's canal(SC).Paired t-test was used to compare BP,HR and SC measurements prior to and post-music intervention.Results In part 1,fifteen subjects,including 7 males and 8 females,were enrolled,with an average age of(23±1)years.Relaxation music could significantly lower IOP[(11.62±2.51)vs.(12.65±2.49)mmHg(1 mmHg=0.133 kPa),t=-2.39,P=0.032].Positive music had no effect on IOP[(12.45±2.77)vs.(12.65±2.46)mmHg,P=0.566]and negative music increased IOP[(12.13±1.60)vs.(10.86±2.78)mmHg,t=2.45,P=0.029].Relaxation music could also arouse relaxation emotions in 14 out of 15 subjects.In part 2,55 subjects,including 20 males and 35 females,were enrolled,with an average age of(26±10)years.The diurnal curve of IOP at 6 time points of every participant was measured.At each individual's peak time point,listening to relaxation music could decrease IOP[(12.66±4.32)vs.(13.99±4.47)mmHg,t=-5.72,P<0.01].HR before and after listening to relaxation music was(79.57±10.43)and(75.57±9.62)beats/min,respectively(t=-3.68,P=0.001).Systolic BP was(118.11±13.92)and(110.82±12.67)mmHg,respectively(t=-5.10,P<0.01).Diastolic BP significantly declined from(70.07±9.96)to(66.14±8.48)mmHg(t=-3.65,P=0.001).Average SC area significantly increased after listening to relaxation music[(255.96±93.36)vs.(230.07±92.20)pixels,t=2.88,P=0.006].Average SC diameter was(8.62±1.89)and(9.41±2.37)pixels,respectively before and after listening to relaxation music(t=3.39,P=0.001).Conclusion Relaxation music reduces IOP in healthy subjects probably by dilating the SC.(Chin J Ophthalmol,2020,56:25-31)