摘要
目的探讨成人睫状肌麻痹前后屈光度变化及其影响因素的流行病学特点。方法收集2012年5月至2013年6月在中国河北省邯郸永年县进行眼科屈光检查710例(1410只眼)的资料。其中,男性364例(721只眼),女性346例(689只眼);年龄30~83岁,平均年龄(50.9±10.3)岁。采用自动电脑验光仪检测所有受检者睫状肌麻痹前后的屈光度。采用眼科A型超声检查所有受检者睫状肌麻痹前的眼部生物学参数。所有受检者睫状肌麻痹前后等效球镜(SE)的描述采用均数±标准差表示,两者的比较采用配对t检验。不同年龄受检者睫状肌麻痹前后SE的一致性,采用Bland-Altman plots进行评估。不同性别间睫状肌麻痹后SE与睫状肌麻痹前角膜曲率K值(K)、前房深度(ACD)、眼轴长度(AL)、睫状肌麻痹后中央角膜厚度(LT)、晶状体混浊程度(NO)、晶状体核的颜色(NC)、晶状体皮质(C)及晶状体后囊下混浊的程度(PSC)的比较,采用线性混合模型分析。采用Pearson相关分析检验各屈光指标间的相关性。结果710例(1410只眼)受检者睫状肌麻痹前的平均SE为(-0.37±1.22)D,睫状肌麻痹后的平均SE为(0.13±1.11)D。经t检验,两者的差异有统计学意义(t=-25.75,P<0.05)。Bland-Altman plots分析显示睫状肌麻痹后的SE发生远视漂移,且随年龄的增加该漂移逐渐减小。所有受检者睫状肌麻痹前的K值、CCT、ACD及AL,以及睫状肌麻痹后的LT、NO、NC、C及PSC分别为(44.02±1.51)D、(2.88±0.36)mm、(23.07±0.95)mm、(4.52±0.41)mm、(2.72±0.43)、(2.72±0.43)、(0.26±0.63)及(0.13±0.26)。睫状肌麻痹后的LT、NO、NC、C与SE呈正相关。经Pearson相关分析,其相关性具有统计学意义(r=0.13,0.11,0.11,0.07;P<0.05)。受检者睫状肌麻痹前的K值、ACD、AL及睫状肌麻痹后的PSC与SE呈负相关(r=-0.12,-0.17,-0.20,-0.13;P<0.05)。近视眼与睫状肌麻痹前的AL、睫状肌麻痹后的NO、NC、C及PSC呈负相关。经Pearson相关分析,其相关性具有统计学意义(r=-0.22,-0.15,-0.15,-0.14,-0.42;P<0.05)。结论受检者睫状肌麻痹后SE发生明显的远视漂移,且随年龄增加此现象逐渐减小。睫状肌麻痹前的K、ACD、AL,以及睫状肌麻痹后的LT、NO、NC、C和PSC均与SE相关,其中影响近视眼的因素有AL、NO、NC、C及PSC。
ObjectiveThe aim of this study was to explore the changes of diopter measurement before and after cycloplegia in adults and analysis of its related factors.Methods710 rural people(1410 eyes)in Yongnian County of Handan,Northern China were selected to participate in the measurement of diopter and ocular biological parameters.Among of them,there were 364 male(721 eyes)and 346 female(689 eyes).Automatic computer refractometer was used for diopter between after and before cycloplegia.Ocular biological parameters were taken by Ophthalmic A-scan before cycloplegia.Paired t-test was used for SE before and after cycloplegia.The consistency of SE before and after cycloplegia was evaluated by Bland-Altman plots among different age groups.The comparison between corneal curvature(K),len thickness(LT),anerior chamber depth(ACD),axis length(AL),nuclear opacity(NO),nuclear color(NC),cortical(C),posterior subcapsular cataract(PSC)and SE after cycloplegia in different genders was analyzed by linear mixed model.Pearson correlation analysis was used for ocular biological parameters.ResultsThe mean SE of 710 cases(1410 eyes)before and after cycloplegia was respectively(-0.37±1.22)D and(0.13±1.11)D with statistical significance(t=-25.75,P<0.05).Bland-Altman analysis showed that the hyperopia drift of SE after cycloplegia decreased with the increasing of age.The characteristics of LT,NO,NC,C were positively correlated with SE after cycloplegia.After Person correlation analysis,there was significant difference among them(r=0.13,0.11,0.11,0.07;P<0.05).There was a negative correlation between K,ACD,AL,PSC and SE.After Person correlation analysis,there was significant difference among them(r=-0.12,-0.17,-0.20,-0.13;P<0.05).Myopia was negatively correlated with Al,NO,NC,C and PSC.After Person correlation analysis,there was significant difference among them(r=-0.22,-0.15,-0.15,-0.14,-0.42;P<0.05).ConclusionsThe hyperopia shift of SE occurred after cycloplegia,which disappeared with the increasing of age.K,ACD,LT,AL,NO,NC,C and PSC were all related to SE after cycloplegia,among which AL,NO,NC,C and PSC were the influencing factors for myopia.
作者
白大勇
李莉
魏士飞
李思珍
张烨
郝洁
王宁利
Bai Dayong;Li Li;Wei Shifei;Li Sizhen;Zhang Ye;Hao Jie;Wang Ningli(National Children′s Medical Center,Pediatric National Key Discipline,Beijing Children′s Hospital,Capital Medical University,Beijing 100045,China;Beijing Tongren Eye Center,Beijing Tongren Hospital,Capital Medical University,Beijing Institute of Ophthalmology,Beijing Key Laboratory of Ophthalmology and Visual Sciences,Beijing 100730,China;Department of Ophthalmology,Nanjing Tongren Hospital,Southeast University,Nanjing 211189,China;College of Ophthalmology,Capital Medical College,Beihang University,Beijing 100191,China)
出处
《中华眼科医学杂志（电子版）》
2020年第3期166-171,共6页
Chinese Journal of Ophthalmologic Medicine(Electronic Edition)
基金
北京市属医学科研院所公益发展改革试点项目(京医研2016-5)。
关键词
屈光度
中央角膜厚度
眼轴
前房深度
晶状体分级
成人
Diopter
Central corneal thickness
Ocular axis
Anterior chamber depth
Lens opacity classification system
Adult
