【摘要】 目的：采用PASCAL动态轮廓眼压计（dynamic contour tonometer,DCT）及KEELER非接触眼压计(non contact tonometer,NCT)对一组健康青年昼夜眼压进行监测，描述其波动规律，并比较两种方法异同。方法：以PASCAL动态轮廓眼压计对一组19～22岁健康青年27例（54眼）进行24h眼压监测；以KEELER非接触眼压计对一组19～22岁健康青年84例（168眼）进行24h眼压监测。测量自早晨08∶00开始至次日凌晨06∶00，每隔2h为一个观察时间点，每个时间点测量3次，以平均值作为该时间点眼压。结果：DCT法与NCT法所测得的眼压平均值分别为15.76±2.37mmHg和13.77±4.33mmHg，DCT组眼压均值的最高值出现在08∶00,最低值出现在20∶00；NCT组眼压均值的最高值出现在06∶00,最低值出现在22∶00。DCT组双眼眼压波动值分别为:左眼4.56±1.19mmHg，右眼4.12±1.21mmHg；NCT组双眼眼压波动值分别为:左眼4.71±2.23mmHg，右眼5.00±1.50mmHg，两种方法左右眼间眼压值差异无统计学意义(F=0.668,P=0.415),男女眼压值差异无统计学意义(F=1.459,P=0.229),12个时间点之间眼压值差异有统计学意义(F=64.407,P=0.000) ，且变化趋势呈为二次抛物线，两种方法随时间变化趋势有统计学意义(F=16.615,P=0.000)。结论：正常青年眼压呈昼夜节律变化，于白昼结束时最低，夜晚结束时最高。不同的测量方法在各时间点所得测量值及昼夜变化趋势上存在差异，且采用动态轮廓眼压计在多个时间点上均比采用非接触眼压计所测值高。临床上在应用眼压作为原发性青光眼诊断和疗效判断时，应注意测量时间及方法选择上的差别。
【关键词】 动态轮廓眼压计；非接触眼压计；青光眼
Research on dynamic contour tonometer and noncontact tonometer intraocular pressure in normal young people sitting day and night fluctuations trend
RuiDan Cao,YuePeng Zhang,Jia Geng,JuanJuan Sheng,ZuoMing Zhang
Air Pro Teaching and Research, Department of Aerospace Medicine, the Fourth Military Medical University, Xian 710032, Shaanxi Province, China
Abstract
AIM: To monitor intraocular pressure (IOP) fluctuation change in healthy young with PASCAL dynamic contour tonometer (DCT) and KEELER noncontact tonometer (NCT) and to compare the measuring results with the two methods.
METHODS: Prospective study including 54 eyes of 27 healthy young with DCT and another 168 eyes of 84 healthy young with NCT for 24 hours. All the healthy young are aged from 19 to 22, and every two hours should be a time interval. IOP was measured from 08∶00 am to next day 06∶00am. The measurement at each time was repeated three times with the two methods and the mean value was taken into account.
RESULTS: The mean values were in DCT and NCT were 15.76±2.37mmHg and 13.77±4.33mmHg. The maximum mean IOP in DCT group appears at 08∶00am and the minimum at 08∶00pm, while the maximum mean IOP in NCT group appears at 06∶00am and the minimum at 10∶00pm. The fluctuations of binocular IOP were 4.56±1.19mmHg and 4.12±1.21mmHg in left and right eyes in DCT group, while were 4.71±2.23mmHg and 5.00±1.50mmHg in NCT group. There was no significant difference in the mean IOP between different genders (F=1.459,P=0.229) and both eyes (F=0.668,P=0.451) by the two methods. Variance in 24 hours had statistical significance (F=64.407,P=0.000), and the trend is a hyperbola. Tendency of variance with the change of time between the two methods has statistical significance (F=16.615,P=0.000).
CONCLUSION: IOP in healthy young shows a circadian change, where lowest point comes at the end of daylight, while the highest at the end of night. Tendency of circadian variation and measured values at each situs recorded from different measurements have significant difference. IOP readings are higher at majority situs with DCT than NCT. For routine clinical use, it should take note of the differences of measuring time and methods, when IOP is taken as the reference to evaluate the diagnosis and treatment for primary glaucoma.
KEYWORDS: dynamic contour tonometer; noncontact tonometer; glaucoma
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