饮水试验对眼压、房水流出道和自主神经系统活动的影响。
Influence of the Water-Drinking Test on Intraocular Pressure, Schlemm's Canal, and Autonomic Nervous System Activity.
机构信息
Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
出版信息
Invest Ophthalmol Vis Sci. 2018 Jul 2;59(8):3232-3238. doi: 10.1167/iovs.18-23909.
PURPOSE
To assess changes in Schlemm's canal (SC), intraocular pressure (IOP), and autonomic nervous system activity in healthy individuals after performing the water-drinking test (WDT).
METHODS
The SC area (SCAR), trabecular meshwork (TM) thickness, IOP, high frequency (HF) of heart rate variability (HRV), heart rate (HR), and systolic (SBP) and diastolic blood pressure (DBP) were measured in 22 young healthy participants before and after the WDT, which involved drinking a 1-liter water load in 5 minutes.The SC and TM profiles were captured using a Spectralis optical coherence tomography device (anterior segment module). HF was recorded using Kubios HRV Premium software to evaluate parasympathetic nervous system activity.
RESULTS
Compared with baseline values, IOP increased significantly (14.9 ± 2.7 mm Hg vs. 18.4 ± 3.3 mm Hg; P < 0.001), whereas HF (1587 ± 930 ms2 vs. 2193 ± 863 ms2; P < 0.001), mean SCAR (6521 ± 1360 μm2 vs. 5180 ± 1455 μm2; P < 0.001), and HR (69 ± 9.7 beats/min vs. 63 ± 8.9 beats/min; P < 0.001) values decreased significantly by 15 minutes after water-loading. Least significant difference pairwise comparison revealed significant fluctuations of all parameters (SCAR, IOP, HF, and HR) at 15 minutes and their recovery at 30-minutes post-WDT. TM thickness, SBP, and DBP post-WDT did not differ significantly. The increase in IOP (r = -0.4047; P = 0.010) and HF (r = -0.386; P = 0.014) correlated significantly with the decrease in SCAR.
CONCLUSIONS
The WDT may cause parasympathetic nervous system stimulation, leading to the collapse of SC, which leads to increased IOP.
目的
评估健康个体在进行饮水试验（WDT）后 Schlemm 管（SC）、眼内压（IOP）和自主神经系统活动的变化。
方法
在 WDT 前后，使用 Spectralis 光学相干断层扫描设备（前段模块）测量 22 名年轻健康参与者的 SC 面积（SCAR）、小梁网（TM）厚度、IOP、高频（HF）心率变异性（HRV）、心率（HR）、收缩压（SBP）和舒张压（DBP）。WDT 涉及在 5 分钟内饮用 1 升水负荷。使用 Kubios HRV Premium 软件记录 HF 以评估副交感神经系统活动。
结果
与基线值相比，IOP 显著升高（14.9 ± 2.7 mm Hg 与 18.4 ± 3.3 mm Hg；P < 0.001），而 HF（1587 ± 930 ms2 与 2193 ± 863 ms2；P < 0.001）、平均 SCAR（6521 ± 1360 μm2 与 5180 ± 1455 μm2；P < 0.001）和 HR（69 ± 9.7 次/分钟与 63 ± 8.9 次/分钟；P < 0.001）值在水负荷后 15 分钟显著下降。最小显著差异成对比较显示所有参数（SCAR、IOP、HF 和 HR）在 15 分钟时均有显著波动，并在 WDT 后 30 分钟时恢复。WDT 后 TM 厚度、SBP 和 DBP 无显著差异。IOP（r = -0.4047；P = 0.010）和 HF（r = -0.386；P = 0.014）的增加与 SCAR 的减少显著相关。
结论
WDT 可能引起副交感神经系统刺激，导致 SC 塌陷，从而导致 IOP 升高。
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