红光及蓝光刺激下正常人瞳孔直接对光反射的特点分析

Analysis on the characteristics of direct pupil light reflex in normal subjects by red and blue light stimulation

目的探讨分析红光及蓝光刺激下正常人瞳孔直接对光反射的特点,以期找到更为敏感的瞳孔刺激光。方法选取健康工作人员、家属及学生共32例(55眼),根据年龄分为年长组[41~56岁,14例(24眼)]和年少组[21~40岁,18例(31眼)]。两组分别采用红光及蓝光作为刺激光进行瞳孔对光反射检查,观察红光及蓝光分别刺激下瞳孔的收缩速度、收缩幅度、潜伏期、收缩前瞳孔直径等指标。比较在蓝光及红光刺激下年长组不同性别及眼别的瞳孔对光反应参数,在蓝光及红光刺激下年少组不同性别及眼别的瞳孔对光反应参数,两组在红、蓝光分别刺激下瞳孔对光反应参数。结果在红光刺激下,年长组不同眼别和性别的瞳孔收缩速度、收缩幅度、潜伏期、收缩前瞳孔直径比较差异均无统计学意义(P>0.05)。在蓝光刺激下,年长组不同眼别和性别的瞳孔收缩速度、收缩幅度、潜伏期、收缩前瞳孔直径比较差异均无统计学意义(P>0.05)。在红光刺激下,年少组不同眼别和性别的瞳孔收缩速度、收缩幅度、潜伏期、收缩前瞳孔直径比较差异均无统计学意义(P>0.05)。在蓝光刺激下,年少组不同眼别和性别的瞳孔收缩速度、收缩幅度、潜伏期、收缩前瞳孔直径比较差异均无统计学意义(P>0.05)。年长组红光刺激下瞳孔的收缩速度、收缩幅度、潜伏期、收缩前瞳孔直径分别为(3.00±1.00)mm/s、(0.54±0.18)mm、(245.71±19.45)ms、(3.85±0.47)mm,蓝光刺激下分别为(1.61±0.47)mm/s、(0.31±0.08)mm、(279.25±30.73)ms、(3.28±0.32)mm;年少组红光刺激下瞳孔的收缩速度、收缩幅度、潜伏期、收缩前瞳孔直径分别为(4.03±0.75)mm/s、(0.69±0.14)mm、(234.19±16.17)ms、(4.50±0.75)mm,蓝光刺激下分别为(2.13±0.56)mm/s、(0.38±0.10)mm、(253.81±22.47)ms、(3.81±0.55)mm。两组在蓝光及红光刺激下瞳孔的收缩速度、收缩幅度、潜伏期、收缩前瞳孔直径比较差异均具有统计学意义(P<0.05)。年长组红光刺激下瞳孔的收缩速度、收缩幅度、潜伏期、收缩前瞳孔直径与蓝光刺激比较差异具有统计学意义(P<0.05);年长组红光刺激下瞳孔的收缩速度较快、收缩幅度较大、收缩前瞳孔直径较大、潜伏期较短,蓝光刺激下瞳孔的收缩速度较慢、收缩幅度较小、收缩前瞳孔直径较小、潜伏期较长。年少组红光刺激下瞳孔的收缩速度、收缩幅度、潜伏期、收缩前瞳孔直径与蓝光刺激比较差异具有统计学意义(P<0.05);年少组红光刺激下瞳孔的收缩速度较快、收缩幅度较大、收缩前瞳孔直径较大、潜伏期较短,蓝光刺激下瞳孔的收缩速度较慢、收缩幅度较小、收缩前瞳孔直径较小、潜伏期较长。结论正常人的瞳孔直接对光反射的特点与年龄具有显著的关联,与眼别及性别无关;在等亮度的红光及蓝光中,瞳孔对红光的光反射可能具有较高的敏感性,对蓝光的光反射敏感性可能较低。

Objective To discuss and analyze the characteristics of direct pupil light reflex in normal subjects by red and blue light stimulation,in order to find a more sensitive pupil stimulation light.Methods A total of 32 cases(55 eyes)of healthy staff,family members and students were selected and divided into older group[41-56 years old,14 cases(24 eyes)]and younger group[21-40 years old,18 cases(31 eyes)].Red light and blue light were used as stimulation light respectively in both groups,and the pupils of the older group and the younger group were examined to observe the changes of velocity of contraction,amplitude of contraction,latency of contraction,initial diameter before contraction and other indexes under the stimulation of red light and blue light respectively.Comparison was made on pupil light reflex parameters of different genders and eye types in the older group under the stimulation of blue light and red light,the pupil light reflex parameters of different genders and eye types in the younger group under the stimulation of blue light and red light,as well as the pupil light reflex parameters under the stimulation of blue light and red light between the two groups.Results Under the stimulation of red light,there was no statistically significant difference in velocity of contraction,amplitude of contraction,latency of contraction,initial diameter before contraction of different eye types and genders in the older group(P>0.05).Under the stimulation of blue light,there was no statistically significant difference in velocity of contraction,amplitude of contraction,latency of contraction,initial diameter before contraction of different eye types and genders in the older group(P>0.05).Under the stimulation of red light,there was no statistically significant difference in velocity of contraction,amplitude of contraction,latency of contraction,initial diameter before contraction of different eye types and genders in the younger group(P>0.05).Under the stimulation of blue light,there was no statistically significant difference in velocity of contraction,amplitude of contraction,latency of contraction,initial diameter before contraction of different eye types and genders in the younger group(P>0.05).In the older group,the velocity of contraction,amplitude of contraction,latency of contraction,initial diameter before contraction were(3.00±1.00)mm/s,(0.54±0.18)mm,(245.71±19.45)ms,(3.85±0.47)mm under the stimulation of red light,and(1.61±0.47)mm/s,(0.31±0.08)mm,(279.25±30.73)ms,(3.28±0.32)mm under the stimulation of blue light;in the younger group,the velocity of contraction,amplitude of contraction,latency of contraction,initial diameter before contraction were(4.03±0.75)mm/s,(0.69±0.14)mm,(234.19±16.17)ms,(4.50±0.75)mm under the stimulation of red light,and(2.13±0.56)mm/s,(0.38±0.10)mm,(253.81±22.47)ms,and(3.81±0.55)mm under the stimulation of blue light.Under the stimulation of blue light and red light,there was no statistically significant in velocity of contraction,amplitude of contraction,latency of contraction,initial diameter before contraction between the two groups(P<0.05).In the older group,the velocity of contraction,amplitude of contraction,latency of contraction,initial diameter before contraction under the stimulation of red light were statistically significant compared with those under the stimulation of blue light(P<0.05).In the older group,under the stimulation of red light,the pupil constricted faster,the amplitude of contraction was larger,the initial diameter before contraction was larger,and the latency of contraction was shorter;under the stimulation of blue light,the pupil constricted slower,the amplitude of contraction was smaller,the initial diameter before contraction was smaller,and the latency of contraction was longer.In the younger group,the velocity of contraction,amplitude of contraction,latency of contraction,initial diameter before contraction under the stimulation of red light were statistically significant compared with those under the stimulation of blue light(P<0.05).In the older group,under the stimulation of red light,the pupil constricted faster,the amplitude of contraction was larger,the initial diameter before contraction was larger,and the latency of contraction was shorter;under the stimulation of blue light,the pupil constricted slower,the amplitude of contraction was smaller,the initial diameter before contraction was smaller,and the latency of contraction was longer.Conclusion The characteristics of direct pupil light reflex in normal subjects are significantly correlated with age,but have nothing to do with eye types and gender;in red light and blue light of equal brightness,the pupil may have a higher sensitivity to light reflex from red light and a lower sensitivity to light reflex from blue light.