Kashiwagi K, Tsumura T, Ishii H, Ijiri H, Tamura K, Tsukahara S
Department of Ophthalmology, Yamanashi Medical University, Tamaho, Japan.
J Glaucoma. 2000 Jun;9(3):239-46. doi: 10.1097/00061198-200006000-00007.
To compare circadian rhythm of autonomic nervous function in patients with normal-tension glaucoma with subjects with normal eyes.
Thirty-two patients with normal-tension glaucoma and 32 age-matched normal subjects who had no history of systemic disorders and no currently treated systemic disorders, especially diseases of the autonomic nervous system, were studied. An ambulatory electrocardiogram was installed that recorded heartbeats for 48 hours. Low-frequency and high-frequency values were calculated as markers of the autonomic nervous system status based on heart-rate variability using a power-spectrum analysis.
The low-frequency values of patients with normal-tension glaucoma during the spans of an active day and a resting night were significantly greater than those of normal subjects, and this difference was emphasized during the night resting span. However, the high-frequency values of patients with normal-tension glaucoma were similar to those of normal subjects. The normal subjects showed a significant age-related decrease in all investigated parameters except the low-frequency values during the resting span. However, the patients with normal-tension glaucoma showed a significant age-related decrease only in low-frequency values during the active day. Patients with normal-tension glaucoma with progressive visual field defects showed much greater values than other cases, although the values were not significantly different.
These results indicate that a disturbance of the circadian rhythm of the autonomic nervous system may exist in patients with normal-tension glaucoma.
比较正常眼压性青光眼患者与正常眼受试者自主神经功能的昼夜节律。
研究了32例正常眼压性青光眼患者和32例年龄匹配的正常受试者，这些受试者无全身疾病史且目前无正在治疗的全身疾病，尤其是自主神经系统疾病。安装了动态心电图，记录48小时的心跳情况。基于心率变异性，采用功率谱分析计算低频和高频值，作为自主神经系统状态的指标。
正常眼压性青光眼患者在活动日和静息夜期间的低频值显著高于正常受试者，且这种差异在夜间静息期更为明显。然而，正常眼压性青光眼患者的高频值与正常受试者相似。正常受试者除静息期的低频值外，所有研究参数均随年龄增长显著下降。然而，正常眼压性青光眼患者仅在活动日的低频值随年龄增长显著下降。有进行性视野缺损的正常眼压性青光眼患者的值比其他病例高得多，尽管这些值没有显著差异。
这些结果表明，正常眼压性青光眼患者可能存在自主神经系统昼夜节律紊乱。
