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

【摘要】：目的：通過(guò)正常人和多發(fā)性硬化患者視網(wǎng)膜神經(jīng)纖維層厚度的差異以及多發(fā)性硬化患者視網(wǎng)膜神經(jīng)纖維層厚度與視野缺損的相關(guān)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(gòu)成,病程以及眼壓之間相關(guān)性。分析多發(fā)性硬化患者性別構(gòu)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(guān)性。采用OCT檢測(cè)并比較多發(fā)性硬化患者及正常人視網(wǎng)膜上方、下方、顳側(cè)及鼻側(cè)的神經(jīng)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(cè)及鼻側(cè)的神經(jīng)纖維層厚度。采用全自動(dòng)視野計(jì)檢測(cè)MS患者,探討視網(wǎng)膜神經(jīng)纖維層厚度改變與視野損害的相關(guān)性。結(jié)果：MS組和正常人組在年齡,性別構(gòu)成以及眼壓之間差別無(wú)統(tǒng)計(jì)學(xué)意義,說(shuō)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(wú)統(tǒng)計(jì)學(xué)意義；男性患者和女性患者在病程上差別有統(tǒng)計(jì)學(xué)意義,男性患者較女性患者病程短。MS組患者視網(wǎng)膜神經(jīng)纖維層損害在年齡,發(fā)病年齡之間,差別無(wú)統(tǒng)計(jì)學(xué)意義。伴有任意象限損害的MS患者較無(wú)象限損害的MS患者病程長(zhǎng)。MS組患者與正常人組眼部上方的神經(jīng)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(cè)分別為74.98±1.21μm,89.9±14.14μm,P=0.000；鼻側(cè)分別為89.9±14.12μm,88.45±1.01μm,P=0.000,差別均有統(tǒng)計(jì)學(xué)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(jīng)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(cè)分別為91.66±9.30μm,89.9±14.14μm,P=0.734；鼻側(cè)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(jì)學(xué)意義,鼻側(cè)及顳側(cè)差別均無(wú)統(tǒng)計(jì)學(xué)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(jīng)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(cè)分別為91.66±9.30μm,72.33±15.96μm,P=0.002；鼻側(cè)分別為87.00±8.03μm,61.19±11.47μm,P=0.000,差別均有統(tǒng)計(jì)學(xué)意義。MS組視野正常組及正常人組上方的神經(jīng)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(cè)分別為78.9±10.12μm,89.9±14.12μm,P=0.000；鼻側(cè)分別為75.45±14.01μm,88.45±1.01μm,P≤0.05,差別均有統(tǒng)計(jì)學(xué)意義。MS組中不同視網(wǎng)膜神經(jīng)纖維層異常范圍組的平均視野損害之間,差別有統(tǒng)計(jì)學(xué)意義(P≤0.05)。MS組伴隨視網(wǎng)膜神經(jīng)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(jīng)纖維層損害范圍的增大其眼部平均RnFL厚度在變薄。結(jié)論：OCT可以準(zhǔn)確的測(cè)量視網(wǎng)膜神經(jīng)纖維層厚度；多發(fā)性硬化患者的視網(wǎng)膜神經(jīng)纖維層厚度的改變?cè)缬谝曇暗母淖�；視神�?jīng)纖維層厚度改變與視野平均缺損存在一定的對(duì)應(yīng)關(guān)系；OCT測(cè)量RNFL厚度具有較好可重復(fù)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(guān)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(xué)位授予單位】：新疆醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類號(hào)】：R771.3

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本文編號(hào)：1896937