CSC患者血浆儿茶酚胺与视网膜厚度变化的临床观察

Effect of catecholamine in the central serous chorioretinopathy

目的 探讨儿茶酚胺在中心性浆液性脉络膜视网膜病变 (CSC)中的作用机制 ,以及与黄斑中心凹厚度与视力转归的关系。方法 对随访的 3 0例CSC患者不同时期血浆肾上腺素 (E)与去甲肾上腺素 (NE)定量检测 ,并应用RTA测量其黄斑视网膜厚度改变 ,所得数据同正常人进行比较并用SAS进行统计学分析。结果 CSC患者活动期血浆E与NE质量浓度为 ( 5 69± 12 3 )ng/L和 ( 72 1± 10 4)ng/L ,较正常人明显升高 (P <0 0 1) ,恢复期E与NE质量浓度趋于正常。RTA检测CSC患者活动期与恢复期视网膜厚度均较正常人增厚 ;且CSC患者血浆E质量浓度与视网膜厚度有显著相关性 (t=2 173 ,P <0 0 5 ) ;黄斑中心凹厚度改变与患者远视力有负相关关系 (r =-0 80 46,P <0 0 1)。结论 CSC患者黄斑视网膜厚度测量可以定量检测患者病情变化和评估视力恢复预后。血浆中E质量浓度影响CSC黄斑水肿的产生与吸收 ,可能是CSC早期损害的病因机制。

Objective To explore the role of catecholamine(CA) in the pathogenesis and development of central serous chorioretinopathy(CSC) and the relations with visual acuity. Methods Concentration of epinephrine (E) and norepinephrine (NE) in plasma were detected in 30 consecutive eyes with CSC.Central macular thickness was analyzed with RTA,and all the data were compared with normal eyes. Results Concentration of epinephrine (E) and norepinephrine (NE) in plasma increased to(569±123)ng/L and(721±104)ng/L in active CSC patients with significant statistics difference in comparison to normal subjects (P<0.01),and returned to normal in convalescent stage.RTA analysis showed retina thickening in active and recovery-stage of CSC.The concentration of epinephrine in plasma was significantly correlative with central macular thickness(t=2.173,P<0.05),and increased central macular thickness was significantly correlative with the decrease of visual acuity(r=- 0.804 6,P< 0.001)in CSC eyes. Conclusion RTA analysis is a useful tool for quantitatively evaluation of macular thickness in CSC patients.The concentration of epinephrine in plasma may play an important role in the early pathogenesis of CSC.