【摘要】： 目的：研究回彈式眼壓計(Rebound tonometer, RT) Icare (Icare rebound tonometer, Icare)及IOPen (IOPen tonometer, IOPen)在正常人群眼壓測量中的準(zhǔn)確性及可靠性,以及與中央角膜厚度(central corneal thickness,CCT)的相關(guān)性。 方法：收集2009年3月至2009年5月在我院門診就診的124例正常人的244只眼,隨機(jī)采用Icare回彈式眼壓計(Icare)、IOPen回彈式眼壓計(IOPen)測量眼壓后,再用Goldmann壓平式眼壓計(Goldmann applanation tonometry,GAT)測量眼壓值,隨后用超聲角膜測厚儀(Pachymeter,SP-3000,TOMEY,Japan)測量中央角膜厚度(CCT),比較Icare、IOPen及GAT三種眼壓計的測量結(jié)果,進(jìn)行描述性分析,同時將三組眼壓值分別與CCT進(jìn)行相關(guān)性分析。 結(jié)果：124例受檢者的年齡為16～76歲,平均年齡為40.22±14.47歲。Icare測得的眼壓平均值為15.46±3.52mmHg, IOPen測得的眼壓平均值為13.05±3.59mmHg, GAT測得的眼壓平均值為15.64±2.57mmHg, IOPen測量值明顯低于Icare與GAT測量值。經(jīng)Wilcoxon配對秩檢驗(yàn),Icare與GAT的眼壓測量值之間的平均差異為-0.19±2.68mmHg,差異無統(tǒng)計學(xué)意義(Z=-1.193,P=0.2330.05)；IOPen與GAT的眼壓測量值之間的平均差異為-2.60±4.17mmHg,差異有極顯著統(tǒng)計學(xué)意義(Z=-8.437,P=0.0000.01)。在一致性分析中,Icare與GAT差值的均值為-0.2mmHg,標(biāo)準(zhǔn)差為2.68mmHg,95%的一致性界限為(-5.4～5.1) mmHg;在一致性界限范圍內(nèi),Icare與GAT的眼壓測量值相比,差值的絕對值最大為5.4mmHg;差異分布頻率顯示Icare與GAT的差值84%在±3mmHg范圍內(nèi),68%的差異值在±2mmHg范圍內(nèi),47%的差異值在±1mmHg范圍內(nèi)。IOPen與GAT差值的均值為-2.6mmHg,標(biāo)準(zhǔn)差為4.17mmHg,95%的一致性界限為(-10.8～5.6)mmHg,在一致性界限范圍內(nèi),IOPen與GAT的眼壓測量值相比,差值的絕對值最大為10.8mmHg。差異分布頻率顯示IOPen與GAT的差值49%在±3mmHg范圍內(nèi),34%的差異值在±2mmHg范圍內(nèi),16%的差異值在1mmHg范圍內(nèi)。Icare與GAT之間存在直線相關(guān)關(guān)系,且呈正相關(guān)性(rs=0.656,p0.01); IOPen與GAT之間無直線相關(guān)關(guān)系(rs=0.122,p0.05)。CCT的平均值為539.90±31.85μm。Icare, GAT與CCT之間均呈正相關(guān),相關(guān)系數(shù)分別為0.382(p0.01)和0.342 (p0.01)。IOPen與CCT之間無直線相關(guān)關(guān)系(rs=-0.073,P0.05)。Icare與GAT差值與CCT之間有直線相關(guān)關(guān)系且兩者呈正相關(guān)(rs=0.180,P0.01),即角膜越厚,Icare與GAT差值越大。CCT每增加10μm, Icare與GAT差值則增加0.17mmHg。 結(jié)論：Icare與GAT的眼壓測量值之間具有很好的相關(guān)性和一致性,Icare眼壓計既容易操作又無需表面麻醉,但其測量值仍然受中央角膜厚度的影響,所以臨床實(shí)踐中要考慮CCT對Icare測量結(jié)果的影響,這樣才能更加準(zhǔn)確地反映真實(shí)的眼壓值。而IOPen測量眼壓的準(zhǔn)確性稍差。
[Abstract]:Objective: to study the accuracy and reliability of (Rebound tonometer, RT) Icare (Icare rebound tonometer, Icare) and IOPen (IOPen tonometer, IOPen) in the measurement of intraocular pressure (IOP) in normal subjects and its correlation with central corneal thickness (central corneal thickness,CCT). Methods: from March 2009 to May 2009, 244 eyes of 124 normal subjects who were treated in our hospital from March 2009 to May 2009 were collected. The intraocular pressure was measured by (Icare) rebound IOPen intraocular pressure meter (IOPen) and then measured by Goldmann flat intraocular pressure meter (Goldmann applanation tonometry,GAT). Then the central corneal thickness (CCT),) was measured by ultrasound keratometer (Pachymeter,SP-3000,TOMEY,Japan). The results of Icare,IOPen and GAT were compared, and the correlation between IOP and CCT was analyzed. Results the mean IOP measured by care was 15.46 鹵3.52mmHg, the IOP by IOPen was 13.05 鹵3.59mmHg, and the IOP measured by GAT was 15.64 鹵2.57mmHg.The IOPen value was significantly lower than that of Icare and GAT, and the mean age of 1: 124 subjects was 16 ~ 76 years, and the mean age was 40.22 鹵14.47 years old. The IOP measured by IOPen was 15.05 鹵3.59mmHg, and the IOP measured by GAT was 15.64 鹵2.57mmHg. IOPen was significantly lower than that measured by Icare and GAT. The average difference between IOP measured by Wilcoxon pair rank test and GAT was -0.19 鹵2.68 mmHg, and there was no significant difference between IOP and IOP measured by GAT. The average difference was -2.60 鹵4.17mmHg, and the difference was statistically significant (Z-8.437P0. 0000.01). In the consistency analysis, the average value of the difference between GAT and Icare is -0.2mmHg, and the standard deviation is 2.68mm Hgg 95%. The consistency limit of (-5.45.1) mmHg; is compared with the IOP measured by GAT within the range of consistency. The maximum absolute value of the difference is 5.4 mm Hg.The frequency of the difference distribution shows that the difference between Icare and GAT is 84% in 鹵3mmHg range, and the difference value is 47% in 鹵2mmHg range. The mean value of the difference between GAT and Icare is -2.6 mmHg, and the standard deviation is 4.17mmHg95%. The limit of (-10.8 ~ 5. 6) mmHg, was compared with the intraocular pressure measurements of GAT within the range of consistency limits. The absolute value of the difference is 10.8mmHg. The difference between IOPen and GAT was 49% in 鹵3mmHg range, 34% in 鹵2mmHg range and 16% in 鹵2mmHg range. There was a linear correlation between 1mmHg and GAT. There was no linear correlation between rs=0.656,p0.01); IOPen and GAT (rs=0.122,p0.05). The average value of CCT was 539.90 鹵31.85 渭 m.Icare.There was a positive correlation between GAT and CCT. The correlation coefficients were 0.382 (p0.01) and 0.342 (p0.01). IOPen had no linear correlation with CCT (rs=-0.073,P0.05). The difference between GAT and GAT was positively correlated with CCT (rs=0.180,P0.01). Conclusion there is a good correlation and consistency between the intraocular pressure measurements of GAT and that of the GAT. The IOP is easy to operate and needs no surface anesthesia, but the measured value is still affected by the central corneal thickness. Therefore, the effect of CCT on the results of Icare measurement should be considered in clinical practice, so that the true IOP can be more accurately reflected. The accuracy of intraocular pressure measured by IOPen was slightly poor.
【學(xué)位授予單位】：中南大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2010
【分類號】：R77

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