Wang Wei, Wang Maode, Li Zhijin, Wang Tuo, Da Rong
a Department of Neurosurgery , The First Affiliated Hospital of Xi'an Jiaotong University , Xi'an , People's Republic of China.
b Department of Clinical Laboratory , The First Affiliated Hospital of Xi'an Jiaotong University , Xi'an , People's Republic of China.
Int J Neurosci. 2019 Jan;129(1):42-48. doi: 10.1080/00207454.2018.1486832. Epub 2018 Nov 5.
An accurate intracranial pressure (ICP) measurement is vital for patients with hydrocephalus. ICP is generally measured by lumbar puncture opening pressure, which is invasive and has potential adverse side effects. Intraocular pressure (IOP) was investigated to measure ICP indirectly; however, its accuracy was controversial. We conducted this retrospective study to investigate whether IOP can be used as a surrogate for ICP in hydrocephalus patients.
We performed a retrospective study enrolled 50 cases, including 32 patients with normal pressure hydrocephalus (NPH) and 18 patients with high pressure hydrocephalus (HPH). The independent factors of ICP, the correlation between ICP and other factors, and diagnostic value of IOP and papilledema to predict ICP were analysed, respectively.
Patients with HPH were more likely suffered from visual deterioration (33.33% vs. 9.38%, p = .045) and papilledema (55.56% vs. 3.13%, p = .001). Multivariate analysis revealed that papilledema was a significant factor (OR =40.765, 95%CI 3.331-498.846, p = .004). Pearson's correlation analysis indicated that ICP did not correlate with any other factors.
IOP was not an independent factor of ICP in patients with hydrocephalus, and could not be used to determine IOP. Papilledema might be a significant factor of ICP in hydrocephalus sufferers. Compared with NPH patients, patients with HPH were more prone to develop papilledema.
准确测量颅内压（ICP）对脑积水患者至关重要。ICP通常通过腰椎穿刺开放压进行测量，这是一种侵入性操作，且有潜在的不良副作用。人们研究了通过测量眼压（IOP）来间接测量ICP；然而，其准确性存在争议。我们进行了这项回顾性研究，以调查在脑积水患者中IOP是否可作为ICP的替代指标。
我们进行了一项回顾性研究，纳入50例患者，其中包括32例正常压力脑积水（NPH）患者和18例高压脑积水（HPH）患者。分别分析了ICP的独立因素、ICP与其他因素之间的相关性，以及IOP和视乳头水肿对预测ICP的诊断价值。
HPH患者更易出现视力下降（33.33%对9.38%，p = 0.045）和视乳头水肿（55.56%对3.13%，p = 0.001）。多因素分析显示视乳头水肿是一个显著因素（OR = 40.765，95%CI 3.331 - 498.846，p = 0.004）。Pearson相关性分析表明ICP与任何其他因素均无相关性。
在脑积水患者中，IOP不是ICP的独立影响因素，不能用于确定ICP。视乳头水肿可能是脑积水患者ICP的一个重要影响因素。与NPH患者相比，HPH患者更容易发生视乳头水肿。
