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目的探讨原发性开角型青光眼(primary open-angle glaucoma,POAG)患者不同体位眼灌注压(ocular perfusion pressure,OPP)的波动趋势。设计队列研究。研究对象北京大学深圳医院POAG患者19例19眼和健康对照组18例18眼。方法受试者分别行24小时眼压及血压监测,于10:00,14:00,18:00及22:00时各时间点行坐位眼压及血压测量,POAG组于坐位测量完毕后平卧位5分钟再行监测;夜间于2:00、5:00及7:00时各时间点行卧位眼压及血压监测,POAG组于卧位测量完毕后坐起5分钟后再行监测。计算平均眼灌注压(mean ocular perfusion pressure,MOPP)、收缩期眼灌注压(systolic ocular perfusion pressure,SOPP)、舒张期眼灌注压(diastolic perfusion pressure,DOPP)。主要指标MOPP、SOPP、DOPP。结果两组习惯性体位(日间坐位、夜间卧位)MOPP、SOPP及DOPP均呈昼高夜低趋势;两组内习惯性体位MOPP均表现为夜间低于日间(POAG组t=4.092,P=0.000;对照组t=4.513,P=0.000),而两组间MOPP则无明显统计学差异(t=-0.973,P=0.350);POAG患者习惯性体位MOPP昼夜波动较对照组大(t=2.204,P=0.039),SOPP夜间波动较对照组大(t=3.097,P=0.018),DOPP的夜间及昼夜波动亦较对照组大(P均<0.05)。POAG组24小时坐位或卧位MOPP日间均值与夜间均值无明显统计学差异(P均>0.05)。24小时坐位MOPP均值明显高于24小时卧位MOPP均值(t=4.306,P=0.001)。POAG组习惯性体位MOPP均值与24小时坐位MOPP均值无明显统计学差异(t=-2.101,P=0.080),但高于24小时卧位MOPP均值(t=2.707,P=0.035)。结论不同体位下POAG患者OPP昼夜波动趋势不完全相同,习惯性体位下MOPP呈昼高夜低趋势,24小时坐位或卧位下MOPP昼夜变化不明显。
Objective To investigate the trend of ocular perfusion pressure (OPP) in patients with primary open-angle glaucoma (POAG). Design a cohort study. Peking University Shenzhen Hospital POAG 19 cases 19 patients and 18 healthy controls 18 eyes. Methods The subjects underwent 24 hours intraocular pressure and blood pressure monitoring. The intraocular pressure and blood pressure were measured at various time points at 10:00, 14:00, 18:00 and 22:00. POAG group Lying 5 minutes and then monitoring; at 2:00, 5:00 and 7:00 at various time points underwent horizontal pressure and blood pressure monitoring, POAG group sitting in the supine position after 5 minutes and then monitor. Mean ocular perfusion pressure (MOPP), systolic ocular perfusion pressure (SOPP) and diastolic perfusion pressure (DOPP) were calculated. The main indicators MOPP, SOPP, DOPP. Results The MOPP, SOPP and DOPP of the two groups were all decreased during the day and night in the habitual position (daytime sitting, night lying position). The MOP of the habitual body position in both groups was lower than that in the daytime at night (t = 4.092, (P = 0.000; control group, t = 4.513, P = 0.000), while there was no significant difference in MOPP between the two groups (t = -0.973, P = 0.350) (t = 2.204, P = 0.039). The fluctuation of SOPP in the night was greater than that in the control (t = 3.097, P = 0.018). POAG group 24-hour sitting or supine MOPP no significant difference between the mean and night mean (P all> 0.05). Mean MOPP at 24-hour sitting was significantly higher than mean MOPP at 24-hour supine position (t = 4.306, P = 0.001). There was no significant difference between the MOPP mean of habitual posture and the MOPP of 24-hour sitting in POAG group (t = -2.101, P = 0.080), but higher than that of 24-hour lying MOPP (t = 2.707, P = 0.035). Conclusion The diurnal fluctuation of OPP in patients with POAG under different positions is not completely the same. MOPP presents a trend of high daytime and low nighttime in habitual position. There is no obvious change of MOPP in 24 hours sitting or lying position.