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目的研究鞍区肿瘤患者发生类青光眼样视神经病变的患病率和影响因素。设计回顾性比较性病例系列。研究对象北京天坛医院2008-2009年确诊的连续的501例鞍区肿瘤患者。方法回顾患者的眼底像及自动视野检查结果。对照组454例为随机选取北京眼病研究中年龄匹配的受试者。青光眼样视神经病变依据视盘形态结合视野综合判断。鞍区肿瘤类型和大小依据头颅磁共振成像(MRI)检查测算。主要指标患病率及影响因素。结果 501例鞍区肿瘤患者中,青光眼样视神经病变患病率为6.8%(形态学标准)或6.3%(形态+功能标准),明显高于对照组(1.3%,P均<0.001)。多元回归分析显示,青光眼样视神经病变的发生与肿瘤位置(鞍上>鞍旁>鞍内)(P=0.010及P=0.001)及肿瘤宽度相关(P=0.003)。结论鞍区肿瘤患者中青光眼样视神经病变患病率明显高于正常人;青光眼样视神经病变的发生与鞍区肿瘤的位置及肿瘤宽度相关。
Objective To study the prevalence and influencing factors of glaucomatous optic neuropathy in patients with sellar tumors. Design retrospective comparative case series. Study Object Beijing Tiantan Hospital, 2008-2009 confirmed a continuous series of 501 patients with sellar tumors. Methods The patients’ fundus images and autopsy findings were reviewed. The control group of 454 patients were randomly selected age-matched Beijing Eye Disease study subjects. Glaucomatous optic neuropathy is based on the combination of optic disc morphology combined with field of vision. The type and size of the tumor in the sellar area is based on a cranial magnetic resonance imaging (MRI) examination. The prevalence of major indicators and influencing factors. Results The prevalence of glaucomatous optic neuropathy was 6.8% (morphology standard) or 6.3% (morphology + functional standard) in 501 cases of sellar tumors, which was significantly higher than that of the control group (1.3%, P <0.001). Multivariate regression analysis showed that the incidence of glaucomatous optic neuropathy correlated with tumor location (saddle> saddle> saddle) (P = 0.010 and P = 0.001) and tumor width (P = 0.003). Conclusions The prevalence of glaucomatous optic neuropathy in patients with sellar region is significantly higher than that in normal people. The incidence of glaucomatous optic neuropathy is related to the location of tumor in sellar region and tumor width.