目的 探讨自发性眼震在眩晕疾病中临床价值.方法 对自发性眼震观察要点、异常眼动类型、异常的非前庭性自发性眼震,探讨自发性眼震在眩晕疾病中临床价值.结果 自发性眼震在外周性和中枢性前庭疾病表现不同,外周性自发眼震可因病变演化转归不同而不同,根据病史可对疾病作出判断.结论 对自发眼震的方向和强度进行正确评估对于提高眩晕定位诊断效果有重要作用[1].

目的:分析兰州地区220例儿童及青少年变应性鼻炎(AR)患者进行变应原检测的结果.方法:选取2010年4月至2016年12月期间兰州大学第一医院收治的220例儿童及青少年AR患者作为研究对象.将其中年龄为1～12岁的129例AR患儿设为儿童组,将其中年龄为13～18岁的91例AR患者设为青少年组.在这些患者入院后,均对其进行变应原皮肤点刺试验.分析这些患儿变应原的分布特点.结果:这些AR患者进行变应原皮肤点刺试验结果的总阳性率为77.27％(170/220).在进行变应原皮肤点刺试验结果呈阳性的170例患者中,进行吸入类变应原皮肤点刺试验结果呈阳性的患者占93.53％(159/170),进行食物类变应原皮肤点刺试验结果呈阳性的患者占55.29％(94/170).在159例患者检出的吸入类变应原中,排在前三位的吸入类变应原分别为蒿属花粉、葎草花粉、玉米花粉.在每年的7～9月,这159例患者进行吸入类变应原皮肤点刺试验结果的阳性率均较高.在94例患者检出的食物类变应原中,排在前三位的食物类变应原分别为花生、大豆、海蟹.在每年的7～9月,这94例患者进行花生、大豆、海蟹、牛奶、桃子变应原皮肤点刺试验结果的阳性率均较高.结论:兰州地区儿童及青少年AR患者的吸入性变应原以花粉为主,其食物类变应原以花生、大豆为主.

目的 观察糖尿病视网膜病变眼轴轴长与中心视网膜厚度的相关性.方法 收集2012年1月至2013年5月入住我院眼科及内分泌科的糖尿病患者,经眼底荧光血管造影(fundus fluorescence angiography,FFA)确诊为糖尿病非增殖期的患者,采用眼科Axeg超测量眼轴长度,根据眼轴长度分为3组:22 ～ 24 mm组(正常组)60例(60眼)、＞24 ～ 26 mm组(长眼轴组)65例(65眼)、26 mm以上组(超长眼轴组)55例(55眼),对所有患者采用光学相干断层扫描(optical coherence tomography,OCT)进行中心视网膜厚度测量,对3组患者测量所得数据分析其差异性.结果 正常组中心视网膜厚度为(293.51±23.73) μm,长眼轴组中心视网膜厚度为(292.76±31.76) μm,超长眼轴组中心视网膜厚度为(277.89±37.82) μm.正常组与长眼轴组比较,中心视网膜厚度差异无统计学意义(t=0.191,P=0.849);正常组与超长眼轴组比较,超长眼轴组比正常组中心视网膜厚度显著变薄(t=-3.627,P=0.000);长眼轴组与超长眼轴组比较,超长眼轴组比长眼轴组中心视网膜厚度显著变薄(t=-3.644,P=0.000).结论 眼轴轴长与糖尿病视网膜病变中心视网膜厚度有明显的相关性,超长眼轴患者的中心视网膜厚度显著变薄.

为研究糖尿病视网膜病变(DR)患者中心视网膜厚度与眼部彩色多普勒血流动力学的相关性,我们对糖尿病无眼底病变及非增生期DR患者的中心视网膜厚度及眼部彩色多普勒血流动力学指标进行测量,现将结果报告如下. 一、资料与方法 (一)研究对象及分组 2012年1-12月入住甘肃省第二人民医院眼科及内分泌科的糖尿病患者527例,经荧光素眼底血管造影(FFA)确诊为糖尿病无眼底病变及非增生期DR患者248例248眼.入选患者采用蔡司Cirrus 400相干光断层扫描仪(OCT)测量黄斑中心区1-6 mm直径范围的中心视网膜神经上皮层厚度并将此范围界定为中心视网膜.依据黄斑及周围视网膜正常厚度参考值确定正常中心视网膜厚度为216.4～304.5 μm[1].

目的 评估泪小管皮下结扎术治疗泪液缺乏性干眼的临床可行性.方法 前瞻性研究.采用泪小管皮下结扎术治疗经药物治疗效果不传佳的泪液缺乏性干眼患者16例(29只眼),分别于治疗前及治疗后1个月、3个月进行眼表疾病指数(OSDI)评分、泪膜破裂时间(BUT)及基础泪液分泌试验(SIT)以观察临床疗效,观察泪小管皮下结扎术术区外观形态、缝线稳定性、缝线组织兼容性以及泪小管阻塞效果以观察该手术的临床可行性.结果 术后16例(29只眼)术区无明显的畸形,下睑形态无改变,2例患者于术后2~3周线节外露,1例患者于术后1周线结部位红肿,术后1周内所有患者泪小管阻塞效果确切,留线13例患者(26只眼)1~3个月泪小管术区外观形态、缝线稳定性、缝线组织兼容性以及泪小管阻塞效果均好,手术成功率89.66%(χ2=94.32 P= 0.005);治疗前、治疗后1个月、治疗后3个月患者OSDI平均值分别为35.32±2.41、19.86±8.07及17.97±7.93,BUT平均值分别为(3.71±0.66)s、(6.02±2.34)s及(7.56±2.33)s,SIT平均值分别为(4.03±0.75)mm、(6.60±2.16)mm及(6.43±2.11)mm,3项评价指标治疗前后差异均有统计学意义(P＜0.01).治疗后3个月,11例23只眼干眼症状明显缓解,治疗有效率88.46%(χ2=85.23,86.15 P＜0.05 ).结论 泪小管皮下结扎术治疗泪液缺乏性干眼简单经济、实用有效、安全易行.

Objective To study the relationship between central retinal thickness and retinal vascular filling state of patients with non-proliferative diabetic retinopathy (NPDR).Methods A total of 248 diabetic patients without retinopathy or with NPDR in the hospital were enrolled in the study.Only the right eye of these patients were examined by optical coherence tomography (OCT),fundus fluorescein angiography (FFA),color Doppler flow imaging (CDFI).Patients with central retinal edema,hemorrhage and exudation were excluded from this study.Central retinal thickness was measured by OCT at the points of 1 mm,1 to 3 mm,and 3 to 6 mm from the fovea.The patients were divided into retinal thickness normal,thinning and thickening groups according to their central retinal thickness.The normal range of central retinal thickness was defined as 216.4-304.9 μm in this study.The arm retinal circulation time and retinal arterial phase and venous phase (A-V) fluorescence filling time were recorded by FFA examination.The peak systolic velocity (PSV),pulsatility index (PI) and resistance index (RI) of ophthalmic artery (OA),central retinal artery (CRA) and posterior ciliary artery (PCA) were measured by CDFI examination.The retinal fundus vascular filling state and ocular hemodynamic indexes were compared between different groups.Results The arm retinal circulation time of retinal thickness normal,thinning,thickening groups was (10.42±0.51),(10.36±0.64),(12.94±0.46) seconds respectively; the retinal A-V fluorescence filling time was (9.15±1.36),(6.36±1.15),(13.56±2.04) seconds.The difference of the arm retinal circulation time was statistically significant between the thickening and normal groups (t=1.93,P=0.04),and between the thickening and thinning groups (t=4.49,P=0.00).The retinal A-V fluorescence filling time was statistically significant between the thinning and normal groups (t=2.13,P=0.03),and between the thickening and normal groups (t=2.49,P=0.02),and between the thickening and thinning groups (t=5.38,P=0.00).The difference of PSV (t=3.290,-5.520,-4.900),PI (t=-4.310,-5.230,-4.390) and RI (t=4.970,6.160,5.990) of OA,CRA and PCA was statistically significant between the thickening and thinning groups (P＜0.05).Conclusion Central retinal thickness can affect the retinal vascular filling state of diabetic patients without retinopathy or with NPDR.