NAION患者RAPD檢測與視功能及證候積分的相關(guān)性研究
發(fā)布時間：2018-11-27 07:08
【摘要】：相對性傳入瞳孔障礙(RAPD)反映的是客觀的視功能信息,能提供可能的病因?qū)W診斷依據(jù),對于判斷病情的發(fā)展變化亦有指導(dǎo)作用的一項體征,而國內(nèi)有關(guān)RAPD的研究相對較少。RAPD的產(chǎn)生來自于雙眼對光信號接受傳遞的不對稱性,本文旨在嘗試證明RAPD與各項視功能檢查差值及中醫(yī)證候積分之間的相關(guān)性。本論文主要包括文獻綜述和臨床研究分析兩大部分。文獻綜述部分包括"相對傳入瞳孔障礙的現(xiàn)代研究概況"、"非動脈炎性前部缺血性視神經(jīng)病變的現(xiàn)代研究進展"、"中醫(yī)青盲相關(guān)理論概述"三個部分。在"相對傳入瞳孔障礙(RAPD)的現(xiàn)代研究概況"中介紹了 RAPD的定義、原理、測量方法、相關(guān)疾病以及國內(nèi)外對其與視功能之間的相關(guān)性研究;"非動脈炎性前部缺血性視神經(jīng)病變的現(xiàn)代研究進展"中介紹了 NAION的發(fā)病機制、高危因素、相關(guān)檢查、治療及預(yù)后;"中醫(yī)青盲相關(guān)理論概述"中介紹了青盲的定義、辨證分型、辨證治療及特色治療。臨床研究分析部分:目的:研究RAPD值與各項視功能檢查差值及中醫(yī)證候積分之間的相關(guān)性;方法:入組45名由NAION引起的,中醫(yī)辨證為肝腎不足型的視神經(jīng)萎縮患者,對患者的性別、眼別、既往史等基本資料進行整理統(tǒng)計,并以RAPD的中性濾光鏡片檢查法定量RAPD值,搜集患者視力、視野、OCT、電生理等方面數(shù)據(jù),完成中醫(yī)證候積分量表,然后進行RAPD值與各項檢查數(shù)據(jù)及證候積分之間的相關(guān)性研究,在此基礎(chǔ)上,嘗試以多元回歸方程描述其間的關(guān)系。結(jié)果:本次入組的45例樣本中,男性24人(53.3%),女性21人(46.7%);RAPD表現(xiàn)陽性的右眼有23例(51.1%),左眼22例(48.9%),在性別、眼別等方面無差異;最小發(fā)病年齡為34歲,最大發(fā)病年齡為77歲,發(fā)病平均年齡為54.09±9.596歲,50-55歲發(fā)病的人數(shù)最多。其中確診有頸部動脈斑塊的有16人(35.6%),動脈硬化或有內(nèi)膜增厚等早期病變的有17人(37.8%),確診有阻塞性睡眠呼吸暫停低通氣綜合癥(OSAS)的25人(55.6%);而且此45例樣本中,合并有高血壓、糖尿病或高脂血癥的患者過半數(shù);RAPD值的大小與雙眼的視力差值、視野MD差值、視野MS差值、RNFL厚度差值具有線性相關(guān),與電生理VEP差值之間未見明顯相關(guān),與中醫(yī)青盲的肝腎不足證候積分之間無統(tǒng)計學(xué)意義,得到了多元回歸方程如下:RAPD 值=0.09+0.066 × 視野 MS 差值+0.003 × RNFL 差值+0.034 × 視力差值。結(jié)論:NAION的發(fā)病,在性別、眼別方面不存在偏向性,發(fā)病多集中在中老年人;高血壓、糖尿病、高脂血癥、OSAS、頸部動脈異常等都有可能是NAION的危險因素。RAPD值與視野的相關(guān)性最大,視力、平均RNFL厚度次之,四個變量之間存在方程關(guān)系,而電生理與RAPD值之間未發(fā)現(xiàn)明顯相關(guān)性。中醫(yī)證候積分與RAPD值的關(guān)聯(lián)證據(jù)不充分。
[Abstract]:Relativistic afferent pupillary disorder (RAPD) reflects objective information of visual function, can provide possible etiological diagnosis basis, and has a guiding function in judging the development and change of the disease. However, there are relatively few studies on RAPD in China. The production of RAPD comes from the asymmetry of optical signal transmission in both eyes. This paper attempts to prove the correlation between RAPD and the difference of visual function examination and TCM syndromes integral. This paper mainly includes two parts: literature review and clinical research analysis. The literature review includes three parts: "A Survey of Modern Research on relative Afferent pupil Disorder", "Modern Research Progress of Non-Arterial inflammatory anterior Ischemic Optic Neuropathy", and "Overview of related theories of traditional Chinese Medicine and Blindness". The definition, principle, measurement method, related diseases and the correlation between RAPD and visual function of relative afferent pupillary disorder (RAPD) were introduced in "A Survey of Modern Research on relative Afferent pupillary Disorder". The pathogenesis, high risk factors, relevant examination, treatment and prognosis of NAION were introduced in the present study of anterior ischemic optic neuropathy of non-arterial inflammation. The definition, syndrome differentiation, syndrome differentiation and characteristic treatment of youth blindness are introduced in outline of related theories of youth blindness in traditional Chinese medicine. Part of clinical analysis: objective: to study the correlation between RAPD value and the difference of visual function and TCM syndromes. Methods: 45 patients with optic nerve atrophy caused by NAION with syndrome differentiation of liver and kidney deficiency were collected and analyzed. The basic data such as sex, eye differentiation, past history and so on were analyzed, and the RAPD value was measured by neutral filter of RAPD. Collect the patient's visual acuity, visual field, OCT, electrophysiology and other data, complete the TCM syndrome integral scale, and then carry on the research of the correlation between the RAPD value and the examination data and syndromes integral, on the basis of this, This paper attempts to describe the relationship with multivariate regression equation. Results: there were 24 males (53.3%) and 21 females (46.7%). There were 23 cases (51.1%) in right eye and 22 cases (48.9%) in left eye. The minimum age of onset was 34 years old, the maximum age of onset was 77 years old, the average age of onset was 54.09 鹵9.596 years, and the number of patients aged 50-55 years was the highest. Among them, 16 cases (35.6%) were diagnosed with carotid artery plaque, 17 cases (37.8%) with early lesions such as atherosclerosis or intimal thickening. 25 patients (55.6%) were diagnosed with obstructive sleep apnea hypopnea syndrome (OSAS). And more than half of the 45 patients with hypertension, diabetes or hyperlipidemia; There was a linear correlation between RAPD value and visual acuity, visual field MD difference, visual field MS difference, RNFL thickness difference, there was no significant correlation between RAPD value and electrophysiological VEP difference, and there was no statistical significance between RAPD value and liver and kidney deficiency syndrome score of traditional Chinese medicine. The multivariate regression equation was obtained as follows: RAPD value = 0.09 0.066 脳 visual field MS difference 0.003 脳 RNFL difference 0.034 脳 visual acuity difference. Conclusion: the incidence of NAION is not biased in sex and eye sex. Hypertension, diabetes, hyperlipidemia and abnormal OSAS, cervical artery may all be risk factors of NAION. The correlation between RAPD value and visual field is the greatest, visual acuity, average RNFL thickness is the second, and there is an equation relationship among four variables. There was no significant correlation between electrophysiology and RAPD. The evidence of correlation between TCM syndromes integral and RAPD value is insufficient.
【學(xué)位授予單位】：北京中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R276.7
本文編號：2359801
[Abstract]:Relativistic afferent pupillary disorder (RAPD) reflects objective information of visual function, can provide possible etiological diagnosis basis, and has a guiding function in judging the development and change of the disease. However, there are relatively few studies on RAPD in China. The production of RAPD comes from the asymmetry of optical signal transmission in both eyes. This paper attempts to prove the correlation between RAPD and the difference of visual function examination and TCM syndromes integral. This paper mainly includes two parts: literature review and clinical research analysis. The literature review includes three parts: "A Survey of Modern Research on relative Afferent pupil Disorder", "Modern Research Progress of Non-Arterial inflammatory anterior Ischemic Optic Neuropathy", and "Overview of related theories of traditional Chinese Medicine and Blindness". The definition, principle, measurement method, related diseases and the correlation between RAPD and visual function of relative afferent pupillary disorder (RAPD) were introduced in "A Survey of Modern Research on relative Afferent pupillary Disorder". The pathogenesis, high risk factors, relevant examination, treatment and prognosis of NAION were introduced in the present study of anterior ischemic optic neuropathy of non-arterial inflammation. The definition, syndrome differentiation, syndrome differentiation and characteristic treatment of youth blindness are introduced in outline of related theories of youth blindness in traditional Chinese medicine. Part of clinical analysis: objective: to study the correlation between RAPD value and the difference of visual function and TCM syndromes. Methods: 45 patients with optic nerve atrophy caused by NAION with syndrome differentiation of liver and kidney deficiency were collected and analyzed. The basic data such as sex, eye differentiation, past history and so on were analyzed, and the RAPD value was measured by neutral filter of RAPD. Collect the patient's visual acuity, visual field, OCT, electrophysiology and other data, complete the TCM syndrome integral scale, and then carry on the research of the correlation between the RAPD value and the examination data and syndromes integral, on the basis of this, This paper attempts to describe the relationship with multivariate regression equation. Results: there were 24 males (53.3%) and 21 females (46.7%). There were 23 cases (51.1%) in right eye and 22 cases (48.9%) in left eye. The minimum age of onset was 34 years old, the maximum age of onset was 77 years old, the average age of onset was 54.09 鹵9.596 years, and the number of patients aged 50-55 years was the highest. Among them, 16 cases (35.6%) were diagnosed with carotid artery plaque, 17 cases (37.8%) with early lesions such as atherosclerosis or intimal thickening. 25 patients (55.6%) were diagnosed with obstructive sleep apnea hypopnea syndrome (OSAS). And more than half of the 45 patients with hypertension, diabetes or hyperlipidemia; There was a linear correlation between RAPD value and visual acuity, visual field MD difference, visual field MS difference, RNFL thickness difference, there was no significant correlation between RAPD value and electrophysiological VEP difference, and there was no statistical significance between RAPD value and liver and kidney deficiency syndrome score of traditional Chinese medicine. The multivariate regression equation was obtained as follows: RAPD value = 0.09 0.066 脳 visual field MS difference 0.003 脳 RNFL difference 0.034 脳 visual acuity difference. Conclusion: the incidence of NAION is not biased in sex and eye sex. Hypertension, diabetes, hyperlipidemia and abnormal OSAS, cervical artery may all be risk factors of NAION. The correlation between RAPD value and visual field is the greatest, visual acuity, average RNFL thickness is the second, and there is an equation relationship among four variables. There was no significant correlation between electrophysiology and RAPD. The evidence of correlation between TCM syndromes integral and RAPD value is insufficient.
【學(xué)位授予單位】：北京中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R276.7
【參考文獻】
相關(guān)期刊論文 前10條
1 陳安穎;廖燕紅;;噻嗎心安滴眼液輔助治療對缺血性視神經(jīng)病變患者眼部血流動力學(xué)及療效的影響[J];現(xiàn)代實用醫(yī)學(xué);2016年09期
2 張堅;張樂;;低分子肝素鈉對前部缺血性視神經(jīng)病變患者視功能的改善效果[J];中國實用神經(jīng)疾病雜志;2016年15期
3 盧小波;任芳芳;楊文超;付群;;非動脈炎性前部缺血性視神經(jīng)病變患者與其頸動脈改變的相關(guān)性[J];中國民康醫(yī)學(xué);2016年13期
4 謝睿;;非動脈炎性前部缺血性視神經(jīng)病變視盤形態(tài)變化情況與病情相關(guān)性研究[J];中國處方藥;2016年04期
5 關(guān)倩;王春芳;岳雪梅;;前部缺血性視神經(jīng)病變的危險因素研究進展[J];中國中醫(yī)眼科雜志;2016年01期
6 趙霞;李雙農(nóng);;阻塞性睡眠呼吸暫停低通氣綜合征與缺血性眼病的相關(guān)性研究[J];中國中醫(yī)眼科雜志;2016年01期
7 趙朋波;周劍;蘇艷;李麗;閆曉玲;谷心怡;吳魯華;韋企平;;光學(xué)相干斷層掃描技術(shù)在前部缺血性視神經(jīng)病變不同病程中的應(yīng)用[J];中國中醫(yī)眼科雜志;2016年01期
8 龔艷;;復(fù)方樟柳堿治療缺血性視神經(jīng)病變32例臨床觀察[J];中國民族民間醫(yī)藥;2016年01期
9 郭繼援;史芳榮;杜獻芳;;頸動脈粥樣硬化及同型半胱氨酸與前部缺血性視神經(jīng)病變的相關(guān)性[J];國際眼科雜志;2015年07期
10 祝蕓蕓;左煒;蔡曉華;王恒;周金文;利煥廉;;前部缺血性視神經(jīng)病變的不典型熒光素眼底血管造影表現(xiàn)[J];臨床眼科雜志;2015年02期
，本文編號：2359801
本文鏈接：http://sikaile.net/zhongyixuelunwen/2359801.html
最近更新
教材專著
