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[开角型青光眼患者局部血流动力学指标的变化]

[Changes in regional hemodynamics indices in patients with open-angle glaucoma].

作者信息

Bakshinskiĭ P P, Vagin B I, Budnik V M, Doronina N M

出版信息

Vestn Oftalmol. 1998 Mar-Apr;114(2):9-12.

PMID:9621812
Abstract

Changes in the hemodynamic parameters of the eye were examined in patients with primary open-angle glaucoma (OAG) in the well developed and far advanced stages with moderately increased (up to 32 mm Hg) and high (33 mm Hg and higher) pressure before and after surgery. Computer-aided vacuum ophthalmodynamometer was used with a sucking cup calibrated for two levels of ophthalmic tone, whose external diameter was 13 mm and funnel angle 60 degrees. A total of 59 patients (82 eyes) aged 50 to 84 years were examined, control group consisted of 18 patients (36 eyes). Mean dynamic pressure in the orbital artery and perfusion pressure were measured, and the orbital-brachial coefficient estimated. Progressive decrease of perfusion pressure was paralleled by increase of the mean dynamic pressure in the orbital artery in patients with stages Iic and IIIb OAG and by its decrease in those with stage IIIc OAG. Such changes of the hemodynamics are explained by the compensatory work of the ocular bloodflow autoregulation mechanism in the first case and its failure in the second. After regression analysis, linear equations of the relationship between changes in the mean dynamic pressure and intraocular pressure were calculated. After surgery, changes in the hemodynamic parameters were followed up for 12 months in 27 eyes with well-developed condition and for 6 months in 13 eyes with far advanced condition.

摘要

对处于病情发展良好和晚期阶段的原发性开角型青光眼(OAG)患者进行了手术前后眼压中度升高(高达32毫米汞柱)和高度升高(33毫米汞柱及更高)时眼部血流动力学参数变化的检查。使用计算机辅助真空眼压计,其吸盘针对两种眼压水平进行了校准,吸盘外径为13毫米,漏斗角为60度。共检查了59例年龄在50至84岁之间的患者(82只眼),对照组由18例患者(36只眼)组成。测量了眶动脉平均动态压力和灌注压力,并估算了眶臂系数。在Iic期和IIIb期OAG患者中,灌注压力的逐渐降低与眶动脉平均动态压力的升高并行,而在IIIc期OAG患者中则与眶动脉平均动态压力的降低并行。第一种情况下的血流动力学变化是由眼部血流自动调节机制的代偿作用引起的,而第二种情况是由该机制的失效引起的。经过回归分析,计算了平均动态压力变化与眼压之间关系的线性方程。手术后,对27只病情发展良好的眼睛的血流动力学参数变化进行了12个月的随访,对13只病情严重的眼睛进行了6个月的随访。

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