本文選題：多發(fā)性硬化癥 + 光學相干斷層掃描��； 參考：《新疆醫(yī)科大學》2012年碩士論文

【摘要】：目的：通過正常人和多發(fā)性硬化患者視網膜神經纖維層厚度的差異以及多發(fā)性硬化患者視網膜神經纖維層厚度與視野缺損的相關性研究,探討多發(fā)性硬化患者早期診斷及隨訪的方法。方法：了解多發(fā)性硬化患者及正常健康人在年齡,性別構成,病程以及眼壓之間相關性。分析多發(fā)性硬化患者性別構成及RNFL不同損害范圍組在患者年齡,發(fā)病年齡及病程方面的相關性。采用OCT檢測并比較多發(fā)性硬化患者及正常人視網膜上方、下方、顳側及鼻側的神經纖維層厚度、多發(fā)硬化患者視野正常組及正常人組上方、下方、顳側及鼻側的神經纖維層厚度。采用全自動視野計檢測MS患者,探討視網膜神經纖維層厚度改變與視野損害的相關性。結果：MS組和正常人組在年齡,性別構成以及眼壓之間差別無統(tǒng)計學意義,說明兩組之間均衡可比。MS組男性患者和女性患者在發(fā)病年齡上,差別無統(tǒng)計學意義；男性患者和女性患者在病程上差別有統(tǒng)計學意義,男性患者較女性患者病程短。MS組患者視網膜神經纖維層損害在年齡,發(fā)病年齡之間,差別無統(tǒng)計學意義。伴有任意象限損害的MS患者較無象限損害的MS患者病程長。MS組患者與正常人組眼部上方的神經纖維層的厚度分別為117.24±10.34μm,140.15±8.24μm,P≤0.05；下方分別為117.24±10.34μm,137.31±10.03μm,P=0.000；顳側分別為74.98±1.21μm,89.9±14.14μm,P=0.000；鼻側分別為89.9±14.12μm,88.45±1.01μm,P=0.000,差別均有統(tǒng)計學意義。MS組患者中RNFL厚度正常眼與正常人組眼部上方的神經纖維層的厚度分別為135.00±3.89μm,140.15±8.24μm,P≤0.05;下方分別為131.33±6.34μm,137.31±10.03μm,P=0.000；顳側分別為91.66±9.30μm,89.9±14.14μm,P=0.734；鼻側分別為87.00±8.03μm,88.45±1.01μm,P=0.171,上方及下方差別均有統(tǒng)計學意義,鼻側及顳側差別均無統(tǒng)計學意義。MS組患者中RNFL厚度正常眼與異常眼在眼部上方的神經纖維層的厚度分別為135.00±3.89μm,123.24±10.76μm,P≤0.05；下方分別為131.33±6.34μm,117.05±10.74μm,P=0.001；顳側分別為91.66±9.30μm,72.33±15.96μm,P=0.002；鼻側分別為87.00±8.03μm,61.19±11.47μm,P=0.000,差別均有統(tǒng)計學意義。MS組視野正常組及正常人組上方的神經纖維層的厚度分別為128.28±12.31μm,140.15±8.24μm,P≤0.05；下方分別為120.31±13.03μm,137.31±10.03μm,P=0.000；顳側分別為78.9±10.12μm,89.9±14.12μm,P=0.000；鼻側分別為75.45±14.01μm,88.45±1.01μm,P≤0.05,差別均有統(tǒng)計學意義。MS組中不同視網膜神經纖維層異常范圍組的平均視野損害之間,差別有統(tǒng)計學意義(P≤0.05)。MS組伴隨視網膜神經纖維異常范圍的增大,平均視野損害也在增大。MS組隨著視神經纖維層損害范圍的增大其眼部平均RnFL厚度在變薄。結論：OCT可以準確的測量視網膜神經纖維層厚度；多發(fā)性硬化患者的視網膜神經纖維層厚度的改變早于視野的改變；視神經纖維層厚度改變與視野平均缺損存在一定的對應關系；OCT測量RNFL厚度具有較好可重復性,有助于多發(fā)性硬化的早期診斷和隨訪觀察；MS患者RNFL厚度異常程度與病程存在相關性。
[Abstract]:Objective: To investigate the correlation of retinal nerve fiber layer thickness between normal and multiple sclerosis patients and the correlation between retinal nerve fiber layer thickness and visual field defect in patients with multiple sclerosis, and to explore the methods of early diagnosis and follow-up in patients with multiple sclerosis. Methods: to understand the age of multiple sclerosis and normal healthy people in age. Correlation between gender composition, course of disease and intraocular pressure. Analysis of the sex composition of multiple sclerosis patients and the correlation of different RNFL lesion groups in the age, age and course of disease in patients with multiple sclerosis and comparison of the thickness of the nerve fiber layer above the retina, the lower side, the temporal and nasal sides of the patients with multiple sclerosis and normal people, the temporal and nasal sides. The thickness of the nerve fiber layer in the lower, inferior, temporal and nasal side of the normal group and the normal group. The correlation between the retinal nerve fiber layer thickness change and the visual field damage was examined by the full automatic perimeter. Results: there was no statistical difference between the MS group and the normal group in age, sex composition and intraocular pressure in MS. It shows that the balance between the two groups is comparable to that of the.MS group and the female patients at the age of onset. The difference in the course of disease between male and female patients is statistically significant, and there is no statistical difference between the age and age of the age and the age of onset of the retinal nerve fiber layer in the male patients and the short course of the.MS group. MS patients with arbitrary quadrant damage were 117.24 + 10.34 mu m, 140.15 + 8.24 mu m, P < 0.05, respectively, the thickness of the nerve fiber layer above the eye of the MS patients with no quadrant damage, respectively, 140.15 + 8.24 mu m and P < 0.05, respectively, and 74.98 + 1.21 mu m, 89.9 + 14.14 in the temporal side, respectively. M, P=0.000; the nasal side was 89.9 + 14.12 m, 88.45 + 1.01 m, P=0.000, and the difference was statistically significant. The thickness of the normal eyes of the.MS group was 135 + 3.89 u m, 140.15 + 8.24 mu, P < 0.05, respectively. The lower part was 131.33 + 6.34 mu m, 137.31 + 10.03 mu m, temporal lateral fraction. The difference was 91.66 + 9.30 m, 89.9 + 14.14, m, P=0.734, and the nasal side was 87 + 8.03 m, 88.45 + and P=0.171, P=0.171, and the difference between the upper and the lower was statistically significant. There was no statistically significant difference between the nasal side and the temporal side in.MS group. The thickness of RNFL thickness normal eyes and abnormal eyes in the eye area was 135 + 3.89 mu, 12, respectively. 3.24 + 10.76 mu m, P < 0.05, 131.33 + 6.34 mu m, 117.05 + 10.74 mu m, P=0.001, respectively, 91.66 + 9.30 mu, 72.33 +, P=0.002, respectively, 87 + 8.03, m, P=0.000, respectively. There were significant differences in the thickness of the nerve fiber layer above the normal group and the normal group. 128.28 + 12.31 mu m, 140.15 + 8.24 mu m and P < 0.05, respectively, 120.31 + 13.03 mu m, 137.31 + 10.03 mu m, respectively, respectively, 78.9 + 120.31 mu m, 89.9 + 14.12 mu m and P=0.000, respectively. There was a significant difference between the average visual field damage (P < 0.05) and the increase in the abnormal range of retinal nerve fibers in the.MS group. The average visual field damage was also increased in the.MS group with the increase of the optic nerve fiber layer damage. Conclusion: OCT can be used to accurately measure the thickness of the retinal nerve fiber layer. The changes in the thickness of the retinal nerve fiber layer in the patients with hair sclerosis were earlier than the changes in the visual field; the thickness of the optic nerve fiber layer was related to the average defect of the visual field; the thickness of the RNFL was better repeatable by OCT, and was helpful to the early diagnosis and follow-up of the multiple sclerosis; the degree of RNFL thickness abnormality in the patients with MS and the degree of the abnormality of the thickness of the patients. There was a correlation between the course of the disease.

【學位授予單位】：新疆醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2012
【分類號】：R771.3

【參考文獻】

相關期刊論文 前10條

1 成云翠;段宣初;;HRT-Ⅱ和OCT3檢測視網膜神經纖維層厚度在原發(fā)性開角型青光眼早期診斷中的應用[J];國際眼科雜志;2007年04期

2 趙煒;盧艷;;視野缺損計分與OCT測量RNFL厚度的關系[J];國際眼科雜志;2009年07期

3 徐肖;多發(fā)性硬化患者視野改變的意義(附46例臨床分析)[J];臨床神經病學雜志;1998年04期

4 王S茍，

本文編號：1896937