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目的比较原发性开角型青光眼患者和非青光眼性眼患者的脑脊液压。方法采用病例对照研究的方法,随机抽选1996-2007年在明尼苏达州梅奥诊所进行腰椎穿刺的31786人中的28例原发性开角型青光眼患者和49例非青光眼性眼患者。采用单变量和多变量回顾分析2组患者的病例资料并比较影响脑脊液压力的相关因素:包括年龄、性别、病史、治疗方法、腰椎穿刺的效果、眼压、视神经盘杯盘比值、视野和脑脊液压。结果非青光眼性眼患者组平均脑脊液压为(13.0±4.2)mmHg,原发性开角型青光眼患者组平均脑脊液压为(9.2±2.9)mmHg。原发性开角型青光眼患者的脑脊液压力较低,与年龄大小和腰椎穿刺效果无关。线性回归分析结果显示:杯盘比值与眼压、脑脊液压显著相关(P均<0.0001),多变量分析提示大的杯盘比值与低脑脊液压显著相关(P<0.0001)。结论原发性开角型青光眼患者的脑脊液压显著低于非青光眼性眼患者。这提示脑脊液压的高低在原发性开角型青光眼的诊断中具有重要价值。
Objective To compare cerebrospinal fluid pressure in patients with primary open angle glaucoma and non-glaucomatous eyes. METHODS: A case-control study was performed in 28 patients with primary open-angle glaucoma and 49 non-glaucomatous eyes from 31,786 people who underwent lumbar puncture at the Mayo Clinic in Minnesota in 1996-2007. Univariate and multivariable retrospective analysis of two groups of patients and to compare the impact of cerebrospinal fluid pressure factors related factors: including age, gender, medical history, treatment, lumbar puncture effect, intraocular pressure, optic disc tray ratio, visual field and cerebrospinal fluid Pressure Results The average cerebrospinal fluid pressure in patients with non-glaucoma was (13.0 ± 4.2) mmHg and that in patients with primary open-angle glaucoma was (9.2 ± 2.9) mmHg. Cerebral pressure in patients with primary open-angle glaucoma is low, regardless of age and lumbar puncture. Linear regression analysis showed that the ratio of cup-to-cup was significantly correlated with IOP and CSF pressure (P <0.0001). Multivariate analysis indicated that the large cup-to-cup ratio was significantly associated with low cerebrospinal fluid pressure (P <0.0001). Conclusions Cerebral spinal pressure is significantly lower in patients with primary open-angle glaucoma than in non-glaucomatous eyes. This suggests that the level of cerebrospinal fluid pressure in the diagnosis of primary open-angle glaucoma has an important value.